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A postpartum client presents with sudden onset of shortness of breath, chest pain, and cyanosis. Which nursing action is most appropriate?
- A. Placing the client in a semi-Fowler's position
- B. Administering supplemental oxygen therapy
- C. Notifying the healthcare provider immediately
- D. Assisting with chest physiotherapy to improve ventilation
Correct Answer: C
Rationale: The sudden onset of shortness of breath, chest pain, and cyanosis in a postpartum client could be indicative of a pulmonary embolism, a potentially life-threatening condition. Therefore, it is crucial to notify the healthcare provider immediately for further assessment and management. Prompt intervention is essential in this situation to prevent any potential complications and ensure the client receives appropriate care as soon as possible. Placing the client in a semi-Fowler's position or administering supplemental oxygen therapy may provide temporary relief, but the priority is to seek immediate medical attention. Consulting with the healthcare provider ensures that the client receives the necessary interventions promptly.
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A patient is reluctant to discuss personal health issues due to embarrassment. What is the nurse's best approach to encourage open communication?
- A. Dismiss the patient's concerns and proceed with asking personal health questions.
- B. Provide the patient with privacy and assurance of confidentiality to create a safe space for discussion.
- C. Ignore the patient's reluctance and proceed with asking personal health questions regardless.
- D. Tell the patient that embarrassment is unnecessary and they should be open about their health issues.
Correct Answer: B
Rationale: Providing the patient with privacy and assurance of confidentiality is essential to create a safe and trusting environment for open communication. By assuring the patient that their information will be kept confidential, the nurse can help alleviate the patient's fears and encourage them to feel more comfortable discussing their personal health issues. Dismissing the patient's concerns (option A), ignoring their reluctance (option C), or telling them that their embarrassment is unnecessary (option D) are not effective approaches and may further hinder open communication. It is crucial for the nurse to create a supportive and nonjudgmental atmosphere to build trust with the patient and facilitate honest discussions about their health concerns.
A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, a protozoan parasite that causes malaria. The patient's symptoms of fever, chills, headache, and myalgia align with the typical presentation of malaria. Additionally, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination is characteristic of Plasmodium species, particularly P. falciparum, which causes the most severe form of malaria.
A patient presents with a pruritic, annular rash with fine scaling and central clearing, affecting the trunk and proximal extremities. The patient reports recent exposure to a new soap and laundry detergent. Which of the following conditions is most likely responsible for this presentation?
- A. Tinea corporis (ringworm)
- B. Nummular eczema
- C. Pityriasis rosea
- D. Lichen planus
Correct Answer: B
Rationale: The presentation described is consistent with nummular eczema, also known as discoid eczema. Nummular eczema typically presents as circular or oval-shaped patches of eczematous rash with fine scaling and central clearing. It is often pruritic and can be triggered by exposure to irritants such as new soaps or laundry detergents. The distribution on the trunk and proximal extremities is also typical for nummular eczema. Tinea corporis (ringworm) would present with a more raised, scaly, and well-defined border with central clearing. Pityriasis rosea presents with a herald patch followed by smaller oval or round lesions in a "Christmas tree" distribution. Lichen planus would present with polygonal, purplish, flat-topped papules typically located on flexural surfaces and extremities.
A nurse is caring for a patient who is experiencing end-of-life symptoms. What action by the nurse demonstrates palliative care principles?
- A. Focusing solely on physical comfort and pain management
- B. Encouraging the patient to make decisions about life-sustaining treatments
- C. Providing emotional support and addressing psychosocial needs
- D. Withholding information about the patient's prognosis to avoid distress
Correct Answer: C
Rationale: Providing emotional support and addressing psychosocial needs demonstrates palliative care principles when caring for a patient experiencing end-of-life symptoms. Palliative care focuses on holistic care that encompasses physical, emotional, and spiritual support for patients and their families during times of serious illness. By addressing emotional needs and providing support, the nurse helps improve the patient's quality of life and comfort during this difficult time. This approach goes beyond just managing physical symptoms and pain, recognizing the importance of supporting the patient's overall well-being. Encouraging the patient to make decisions about life-sustaining treatments is also an important aspect of palliative care, but providing emotional support and addressing psychosocial needs is crucial in palliative care practice.
Take home medications given to Patient Lily includes digitalis therapy which was given to patient since she was pregnant. Which of the following would the nurse anticipate with patient's drug therapy?
- A. Switching to a more potent drug.
- B. Continuation of the same dosage.
- C. Need for change in medication.
- D. Addition of diuretic to the regimen.
Correct Answer: B
Rationale: Digitalis therapy, commonly prescribed for heart conditions, is known for its narrow therapeutic range and potential for toxicity. In the case of Patient Lily, who has been on digitalis therapy since she was pregnant, the nurse would anticipate the continuation of the same dosage to maintain the therapeutic effects and reduce the risks of toxicity. It is essential to monitor the patient's digitalis levels regularly and adjust the dosage if necessary based on the patient's response and any changes in their clinical status. Switching to a more potent drug, changing the medication, or adding a diuretic would not be appropriate without further assessment and consultation with the healthcare provider managing Lily's digitalis therapy.