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A patient presents with a well-demarcated, hyperpigmented patch with irregular borders and asymmetric color distribution on the face. The lesion has increased in size over the past few months. Which of the following conditions is most concerning for this presentation?
- A. Melanocytic nevus (mole)
- B. Lentigo simplex
- C. Seborrheic keratosis
- D. Melanoma
Correct Answer: D
Rationale: The presentation described, including a well-demarcated, hyperpigmented patch with irregular borders, asymmetric color distribution, and increase in size over a short period, is concerning for melanoma. Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment in the skin. The irregular borders, color variation, and growth over time are classic signs of melanoma. Melanomas are potentially dangerous and should be evaluated promptly by a healthcare provider for proper diagnosis and treatment. It is important to distinguish melanoma from other benign lesions like melanocytic nevus (mole), lentigo simplex, and seborrheic keratosis, as early detection and treatment of melanoma can significantly impact patient outcomes.
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In order to determine the patient's ability to concentrate and focus, which would be the PRIORITY nursing action?
- A. Asked for the academic performance
- B. Conduct paper and pencil test
- C. Assess the mental status of the patient
- D. Refer the patient to the psychiatrist
Correct Answer: C
Rationale: Assessing the mental status of the patient is the PRIORITY nursing action to determine the patient's ability to concentrate and focus. This assessment includes evaluating the patient's level of alertness, orientation, memory, thought processes, and mood. By observing the patient's mental status, the nurse can gain valuable information about the patient's cognitive function, attention span, and ability to concentrate. This assessment will help guide further interventions and care planning for the patient. Asking for academic performance or conducting paper and pencil tests may be useful tools to assess concentration and focus, but they should come after a comprehensive evaluation of the patient's mental status. Referring the patient to a psychiatrist may be necessary based on the assessment findings, but it should not be the first step in determining the patient's ability to concentrate and focus.
A woman in active labor demonstrates persistent occiput posterior fetal position, contributing 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: Placing the mother in a hands-and-knees position can help facilitate fetal rotation from occiput posterior to the desired occiput anterior position. This position utilizes gravity to assist in the repositioning of the baby, ultimately helping to alleviate back pain and promoting more efficient labor progress. It allows the baby's head to descend properly into the pelvis, potentially reducing the risk of a prolonged labor or the need for instrumental delivery. Additionally, being in this position can help the mother feel more comfortable and empowered during labor. Overall, assisting the mother into a hands-and-knees position is a non-invasive, low-risk intervention that can have a positive impact on both the mother and baby's well-being during labor.
Nurse Harper observes Evelyn has knowledge deficit regarding fetal nutrition. Nurse Harper has to explain that the MAIN SOURCE of nutrition for the baby is which of the following?
- A. Amniotic fluid
- B. Uterus
- C. Placenta
- D. Chorionic villi
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.
Nurse Nilda immediately responds to any cry from her pediatric patients because it is, which of the following reasons?
- A. to attend to her patients who cannot communicate verbally
- B. to check if the child is hungry or wet
- C. to lessen the noise overload in the Unit
- D. a powerful influence over that individual's interactions with others for the remainder of his/her 1ife
Correct Answer: A
Rationale: Nurse Nilda immediately responds to any cry from her pediatric patients to attend to her patients who cannot communicate verbally. Crying is one of the few ways infants and young children communicate their needs and discomforts. By responding promptly to their cries, Nurse Nilda can assess and address potential issues such as hunger, pain, discomfort, or other needs that the child may have. This enhances the quality of care provided and helps in comforting and soothing the child, ultimately promoting their well-being and building trust between the nurse and the patient.
Nurse Chona saw Patient Noel reading his own chart and question the nurse why (-) smoking and (-) liquor was recorded when he does not smoke and drink alcohol? What is the INITIAL explanation of Nurse Chona on the record?
- A. Get the chart from him and reprimand him from reading the chart
- B. The sign of negative before the word means he is not drinking alcohol or smoking cigarette.
- C. Ask patient Noel to apologize for reading the chart.
- D. Tell Noel that alcohol and liquor are important factors in diagnosing his ailment.
Correct Answer: B
Rationale: Nurse Chona should explain to Patient Noel that the sign of negative before the word means that he is not drinking alcohol or smoking cigarettes. This is a simple misunderstanding and clarification should help clear up any confusion. It is important to uphold patient confidentiality and respect their autonomy, rather than reprimanding the patient for looking at their own chart. It is also essential to address any discrepancies in the patient's medical record to ensure accurate information is documented for proper treatment and care.