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A patient with suspected tuberculosis (TB) presents with cough, weight loss, night sweats, and hemoptysis. Chest X-ray reveals upper lobe infiltrates and cavitation. Which of the following diagnostic tests is most appropriate for confirming the diagnosis of pulmonary TB?
- A. Sputum acid-fast bacilli (AFB) smear and culture
- B. Tuberculin skin test (TST)
- C. Interferon-gamma release assay (IGRA)
- D. Chest CT-guided biopsy
Correct Answer: A
Rationale: In a patient with suspected pulmonary TB, the most appropriate diagnostic test for confirming the diagnosis is the sputum acid-fast bacilli (AFB) smear and culture. This test involves examining sputum samples under the microscope for the presence of acid-fast bacilli, which are characteristic of Mycobacterium tuberculosis, the bacteria that causes TB. Additionally, culturing the sputum allows for the bacteria to grow in a controlled environment, further confirming the diagnosis. In the given scenario, the patient's symptoms (cough, weight loss, night sweats, hemoptysis), along with chest X-ray findings of upper lobe infiltrates and cavitation, are highly suggestive of pulmonary TB. Therefore, performing a sputum AFB smear and culture is crucial for definitive diagnosis and initiation of appropriate treatment. The other options (Tuberculin skin test, Interferon
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A patient with advanced dementia is no longer able to communicate verbally and displays signs of distress. What should the palliative nurse consider when assessing and managing the patient's distress?
- A. Focus solely on physical comfort measures to alleviate distress.
- B. Assume the patient's distress is solely related to physical discomfort.
- C. Explore non-verbal cues and behaviors to identify the underlying causes of distress.
- D. Administer sedative medications to manage the patient's agitation.
Correct Answer: C
Rationale: When assessing and managing distress in a patient with advanced dementia who is no longer able to communicate verbally, the palliative nurse should consider exploring non-verbal cues and behaviors to identify the underlying causes of distress. Since the patient cannot communicate through words, it is essential to pay close attention to their non-verbal cues such as facial expressions, body language, and changes in behavior. Distress in dementia patients can be caused by a variety of factors including physical discomfort, unmet needs, environmental stressors, emotional distress, or even medication side effects. By carefully observing and interpreting non-verbal cues, the nurse can gain insight into what might be causing the patient's distress and tailor interventions accordingly. Simply focusing on physical comfort measures may not address the root cause of the distress, and administering sedative medications without understanding the underlying cause is not considered best practice in palliative care for dementia patients.
During a home visit, a member of the family you're visiting who has been using marijuana for three years tells theyou that he wants to be 'detoxified'. It is important for the nurse to ____.
- A. Instruct the patient to change his lifestyle
- B. Identify the patient's stage of change
- C. Tell the patient that relapses are not tolerated
- D. Realize that the patient is ready for change
Correct Answer: B
Rationale: Identifying the patient's stage of change is crucial when someone expresses a desire to be "detoxified" from a substance like marijuana. The Transtheoretical Model (Stages of Change) outlines different stages individuals go through when making behavior changes. By identifying which stage the patient is in (precontemplation, contemplation, preparation, action, maintenance, or relapse), the nurse can tailor interventions and support accordingly. This approach helps ensure that interventions are effective and appropriate for the individual's readiness for change. It is important to meet the patient where they are in their journey towards detoxification and offer support and guidance accordingly.
What is the primary purpose of a cervical collar in the management of trauma patients?
- A. Maintaining spinal alignment.
- B. Immobilizing the cervical spine.
- C. Providing comfort and support.
- D. Facilitating airway management.
Correct Answer: B
Rationale: The primary purpose of a cervical collar in the management of trauma patients is to immobilize the cervical spine. This is crucial in cases of suspected cervical spine injury to prevent any further damage and to maintain spinal stability. By providing support and restricting movement in the cervical spine region, a cervical collar helps prevent potential spinal cord injuries and associated neurological deficits. It is essential to immobilize the cervical spine until a thorough evaluation can be carried out to determine the extent of injury, as any movement of the spine during this period can worsen the damage.
A woman in active labor demonstrates persistent occiput posterior fetal position, leading to prolonged labor and severe back pain. What nursing intervention should be prioritized to facilitate fetal rotation and optimize labor progress?
- A. Assisting the mother into a hands-and-knees position
- B. Administering intravenous opioids for pain relief
- C. Preparing for immediate instrumental delivery
- D. Initiating continuous electronic fetal monitoring
Correct Answer: A
Rationale: Assisting the mother into a hands-and-knees position should be prioritized to facilitate fetal rotation and optimize labor progress in the case of persistent occiput posterior fetal position. This position helps in promoting fetal rotation to a more favorable position for delivery by allowing the baby's head to move into the anterior position. It can help alleviate back pain and may help reduce the duration of labor. This simple maneuver can sometimes correct the malposition without the need for interventions like instrumental delivery. It is a non-invasive and effective technique that can be easily implemented by healthcare providers to support the progression of labor.
As a whole health education in public helath aims the __________.
- A. Transfers information
- B. Make life changes
- C. Better health opportunities
- D. Change personality
Correct Answer: C
Rationale: Whole health education in public health aims to provide individuals and communities with opportunities to improve their overall health and well-being by promoting healthy behaviors, creating supportive environments, and offering resources for prevention and early intervention. This approach focuses on empowering people to make informed choices that lead to better health outcomes and reduce the risk of developing diseases such as hypertension. By increasing access to healthcare services, promoting healthy lifestyles, and addressing underlying social determinants of health, public health education seeks to create better health opportunities for everyone in the community.