Whose responsibility is it to obtain informed consent?

Correct Answer: B

Rationale: The responsibility of obtaining informed consent typically falls on the physician or the healthcare provider who is performing the procedure or treatment. Informed consent is a process where the healthcare provider explains the procedure, its risks, benefits, possible alternatives, and potential outcomes to the patient or their legal representative. The patient must have a comprehensive understanding of these aspects before agreeing to the treatment. While nurses, nurse managers, anesthesiologists, midwives, and other healthcare professionals may assist in the consent process by providing information or clarifications, the ultimate responsibility lies with the physician. This is because the physician is usually the one with the expertise and knowledge about the specific procedure or treatment being performed.

Correct Answer: B

Rationale: Triangulation is the technique that refers to the use of multiple referents to draw conclusions about what constitutes the truth. In the context provided in the question, Nurse Tarly is organizing a study to investigate the "Caring behavior of Staff-Nurses and Satisfaction of Women with Ostomy". By gathering data from various sources such as observation, interviews, and surveys, Nurse Tarly can triangulate the information to gain a comprehensive understanding of the situation. Triangulation helps to validate findings, enhance the credibility of the study, and provide a more well-rounded view of the issue at hand.

Correct Answer: C

Rationale: The main source of nutrition for the baby during pregnancy is the placenta. The placenta is an organ that develops inside the uterus during pregnancy and provides essential nutrients and oxygen from the mother's blood to the baby through the umbilical cord. It acts as a barrier, protecting the baby from harmful substances while allowing necessary nutrients to pass through. The amniotic fluid serves as a protective cushion for the baby, the uterus provides the space for the baby to grow, and chorionic villi are small, hair-like structures on the placenta that aid in the exchange of nutrients and waste between the mother and the baby. However, the primary source of nutrition for the baby is the placenta, making option C the correct answer in this scenario.

Correct Answer: A

Rationale: The combination of recurrent joint pain, swelling, and limited range of motion in multiple joints along with elevated ESR, positive RF, and presence of anti-CCP antibodies is classic for rheumatoid arthritis (RA). Elevated ESR indicates inflammation, positive rheumatoid factor (RF) is an autoantibody commonly found in the serum of patients with RA, and the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies further supports the diagnosis of RA. These laboratory findings along with the clinical presentation are highly suggestive of rheumatoid arthritis. Systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) can have overlapping symptoms with RA, but the specific combination of elevated ESR, positive RF, and anti-CCP antibodies points more towards RA in this scenario.

Correct Answer: D

Rationale: Public Health Nursing is a specialized field of nursing that focuses on promoting and protecting the health of populations and communities rather than individuals. One of the key principles of Public Health Nursing is the emphasis on health promotion and disease prevention strategies. This involves educating and empowering individuals, families, and communities to adopt healthy behaviors and lifestyles in order to prevent illness and improve overall well-being. Public Health Nurses work to address the root causes of health disparities and advocate for policies and programs that promote the health of entire populations. While providing care to sick individuals may be a component of Public Health Nursing, the primary focus is on preventing illness and promoting health at the community level.

Correct Answer: C

Rationale: The most commonly associated adverse effect with ACE inhibitors is a dry cough. This cough is non-productive and can be quite bothersome for patients, often leading to non-compliance with the medication. The cough is thought to be due to the accumulation of bradykinin and substance P, which are vasodilatory and bronchoconstrictive peptides that are normally degraded by ACE. When ACE is inhibited, these peptides accumulate and can lead to irritation of the respiratory tract, resulting in the dry cough. It's important for healthcare providers to be aware of this common side effect and consider alternative medications if the cough becomes problematic for the patient.

Correct Answer: A

Rationale: The appropriate sequence of steps in the assessment of a conscious trauma patient is the ABCDE approach, which stands for Airway, Breathing, Circulation, Disability, and Exposure.

Correct Answer: C

Rationale: The health care team will try the oral route first for Ms. C for delivering nutrition and fluid because it is the most natural and least invasive method. If the patient is able to tolerate oral intake and has adequate oral intake, it is typically the preferred route. Only if she is unable to meet her nutritional needs orally or has difficulty swallowing, then alternative routes such as nasogastric tube, gastrostomy tube, or intravenous routes may be considered. It's important to promote oral intake whenever possible to maintain the patient's quality of life and prevent complications associated with more invasive methods.

Correct Answer: A

Rationale: Macrophages are the primary cells responsible for producing tumor necrosis factor-alpha (TNF-α) during the acute phase response. TNF-α is a pro-inflammatory cytokine that plays a critical role in initiating and propagating the inflammatory response. Macrophages secrete TNF-α in response to infection, injury, or other inflammatory stimuli, contributing to the recruitment of immune cells and the activation of additional inflammatory pathways. In the context of the acute phase response, macrophages are key mediators of the immune response and play a crucial role in host defense mechanisms.