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A patient presents with urinary urgency, frequency, and nocturia. On physical examination, there is enlargement of the prostate gland with a smooth, firm consistency on digital rectal examination (DRE). Which of the following conditions is most likely?
- A. Benign prostatic hyperplasia (BPH)
- B. Prostate cancer
- C. Prostatitis
- D. Urinary tract infection (UTI)
Correct Answer: A
Rationale: The clinical presentation of urinary urgency, frequency, and nocturia along with prostate enlargement with a smooth, firm consistency on digital rectal examination (DRE) is classic for benign prostatic hyperplasia (BPH). BPH is a common condition in aging men characterized by non-malignant growth of the prostate gland, which can cause varying degrees of lower urinary tract symptoms due to obstruction of the urethra. In contrast, prostate cancer typically presents with findings like an asymmetric, hard, or nodular prostate on DRE, while prostatitis presents with symptoms like fever, perineal pain, and systemic symptoms. Urinary tract infection (UTI) may present with dysuria, frequency, urgency, and suprapubic pain, but it does not usually cause prostate enlargement.
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A patient asks the nurse about alternative treatment options for their condition. What is the nurse's best response?
- A. Dismiss the patient's question and assert that the current treatment plan is the only option.
- B. Provide the patient with information about alternative treatment options, including benefits and risks.
- C. Ignore the patient's question and redirect the conversation to a different topic.
- D. Tell the patient that alternative treatments are ineffective and should be avoided.
Correct Answer: B
Rationale: The nurse's best response when a patient asks about alternative treatment options is to provide the patient with information about those options, including their benefits and risks. It is important for the nurse to support the patient in their exploration of different treatment approaches and empower them to make informed decisions about their care. Dismissing the question, ignoring it, or discouraging alternative treatments are not appropriate responses and may hinder the patient's ability to make choices that align with their values and preferences. Therefore, providing information and facilitating an open discussion about alternative treatments is the most appropriate approach for the patient's best interest.
During a patient consultation, the nurse notices the patient seems anxious and is avoiding eye contact. What is the most appropriate action for the nurse to take?
- A. Continue with the consultation without addressing the patient's behavior.
- B. Ask the patient if they are feeling anxious and if they would like to talk about it.
- C. Ignore the patient's behavior and focus solely on the medical information.
- D. Tell the patient to relax and stop being anxious.
Correct Answer: B
Rationale: The most appropriate action for the nurse to take when noticing that the patient seems anxious and is avoiding eye contact is to ask the patient if they are feeling anxious and if they would like to talk about it. This approach shows empathy, concern, and openness to addressing the patient's emotional state. By directly acknowledging the patient's behavior and giving them the opportunity to express their feelings, the nurse can create a supportive and caring environment that promotes effective communication and trust between the patient and healthcare provider. It is important to consider the patient's emotional well-being alongside their physical health during consultations.
A patient with advanced dementia is bedbound and at risk of developing pressure ulcers. What intervention should the palliative nurse prioritize to prevent pressure ulcer formation?
- A. Turn the patient every 2 hours to relieve pressure on bony prominences.
- B. Apply barrier creams or moisture barriers to protect vulnerable skin areas.
- C. Use pressure-relieving support surfaces, such as specialized mattresses or cushions.
- D. Administer prophylactic antibiotics to prevent infection in at-risk skin areas.
Correct Answer: C
Rationale: The most effective intervention to prevent pressure ulcers in bedbound patients at risk, such as those with advanced dementia, is to use pressure-relieving support surfaces like specialized mattresses or cushions. These surfaces help distribute the pressure evenly, reducing the risk of pressure ulcer formation on bony prominences. Turning the patient every 2 hours (choice A) can also help relieve pressure, but it may not be sufficient to prevent pressure ulcers in high-risk individuals. Applying barrier creams or moisture barriers (choice B) can help protect the skin but may not address the underlying issue of pressure on vulnerable areas. Administering prophylactic antibiotics (choice D) is not recommended for preventing pressure ulcers as it does not address the root cause of the problem and can lead to antibiotic resistance. Therefore, the priority intervention should be to use pressure-relieving support surfaces to minimize the risk of pressure ulcers in
Which of the following conditions may lead to death in a bulimic patient like sherry?
- A. Hypokalemia and cardiac arrhythmias and arrest
- B. Metabolic acidosis and renal failure
- C. Hyponatremia and circulatory collapse
- D. Hypernatremia and congestive heart failure
Correct Answer: A
Rationale: Bulimia nervosa is an eating disorder characterized by binge eating followed by compensatory behaviors such as self-induced vomiting, fasting, or excessive exercise. The repeated purging in bulimia can lead to electrolyte imbalances, such as hypokalemia (low potassium levels). Hypokalemia is a serious condition that can affect the function of the heart's electrical system, potentially leading to the development of cardiac arrhythmias (irregular heartbeats) and even cardiac arrest, which can result in death. Therefore, in a bulimic patient like Sherry, the risk of death is most likely due to the combination of hypokalemia and its complications, such as cardiac arrhythmias and arrest.
You informed the mother about the normal psychosocial development of pre schoolers. She correctly understands your health teaching if she verbalizes that ________.
- A. He may have temper tantrums resulting from his frustration im watching to do everything for himself.
- B. He continues to react to separation from his parents.
- C. He son is more active with his parents and tends to be a bit selfish with his toys.
- D. He may tend exaggerate, boast, and tattle on others.
Correct Answer: A
Rationale: Option A indicates an understanding of the normal psychosocial development of preschoolers. It reflects the fact that during this stage, children may demonstrate frustration and have temper tantrums as they strive for independence and attempt to do things by themselves. This behavior is a common part of their development as they learn self-control, autonomy, and decision-making skills. The other options do not directly relate to normal preschooler development but rather touch upon separate issues such as separation anxiety, possessiveness, and social behaviors that are not necessarily abnormal for preschoolers.