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質問 # 47
A 37 weeks pregnant woman presents with labor-like pain. She has mild uterine contractions (2-3 contractions in 10 minutes). On abdominal palpation, the nurse notes the fetus lie is transverse. The nurse reported to the doctor who confirm the malpresentation via an ultrasound.
The immediate nursing action is to:
正解：C
解説：
* Transverse Lie and Delivery:
* A transverse lie means the fetus is positioned horizontally in the uterus, making vaginal delivery impossible and risky.
* In such cases, a cesarean section is usually required to safely deliver the baby.
* Immediate Nursing Action:
* Oral Fluids and Pain Relief:While important, these are not the immediate priorities in this scenario.
* Monitoring Labor:This is less relevant due to the malpresentation.
* Preparing for Cesarean Section:Given the transverse lie, this is the immediate and appropriate action to ensure the safety of both mother and baby.
References:
* American College of Obstetricians and Gynecologists (ACOG)
* Mayo Clinic Guidelines on Labor and Delivery
質問 # 48
A head nurse of an intensive care unit wants to ensure that the staff are performing Basic Life Support (BLS) based on latest American Heart Association's guidelines.
What will be the head nurse's BEST action?
正解：D
解説：
Ensuring that staff perform Basic Life Support (BLS) according to the latest American Heart Association (AHA) guidelines involves several strategies, but performing regular mock drills is the best approach.
* Reviewing the BLS Policy Periodically: While this is important, it alone does not ensure that staff are up-to-date or proficient in BLS techniques.
* Performing Regular Mocks on BLS in the Unit: Regular mock drills provide hands-on practice and allow staff to apply the latest guidelines in a simulated environment. This helps in retaining skills and identifying any gaps in knowledge or performance.
* Sending Staff to Renew BLS Certification Every Three Years: Certification renewal is necessary, but practical skills can degrade over time if not regularly practiced.
* Monitoring the Staff Performing BLS During the Actual Scene: This is reactive rather than proactive and does not provide an opportunity for practice and improvement without the pressure of a real-life situation.
References:
* American Heart Association (AHA): Guidelines for CPR and ECC
* National Institutes of Health (NIH): Effective Training Strategies in Healthcare
質問 # 49
A seven-year-old boy with autism is admitted with a leg fracture. The child has been following up in the rehabilitation center for speech and occupational therapies for the past two years.
How should the nurse address the child's speech and social needs during hospitalization?
正解：B
解説：
When a child with autism is hospitalized, it is essential to maintain consistency and continuity in their care.
Reviewing the child's therapy plan from the rehabilitation center ensures that the hospital staff can continue to address the child's speech and social needs in a manner that aligns with his established routines and therapy goals. Modifying daily routines or developing a new care plan without prior review may cause unnecessary stress or disruption. Referring the child to in-hospital therapy departments can be beneficial, but it should be done in conjunction with the existing plan to ensure continuity and effectiveness.
質問 # 50
A nurse understands that patient with blood transfusion reaction is at risk to develop which of the following types of jaundice?
正解：D
解説：
A blood transfusion reaction can lead to hemolytic jaundice. This type of jaundice occurs when there is an excessive breakdown of red blood cells, leading to an increase in bilirubin production. Hemolytic reactions during a blood transfusion cause the destruction of the transfused red bloodcells, releasing large amounts of hemoglobin into the bloodstream, which is then converted to bilirubin, resulting in jaundice.
質問 # 51
A nursing director wishes to improve the job performance of a group of medical orderlies who are ineffective in their job.
Using Herzberg's theory of motivation, what would be the most appropriate motivator?
正解：A
解説：
Herzberg's two-factor theory of motivation distinguishes between hygiene factors and motivators. Hygiene factors (like pay, working conditions, and benefits) can prevent dissatisfaction but do not create long-term motivation. Motivators, on the other hand, are related to the nature of the work itself and include factors such as achievement, recognition, responsibility, and opportunities for growth. Offering opportunities for achievement and recognition is a motivator according to Herzberg's theory and would likely improve job performance by enhancing job satisfaction and intrinsic motivation.
質問 # 52
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