A patient expresses frustration with the healthcare system's inefficiencies. What is the nurse's best response?
- A. Dismiss the patient's frustration and assure them that the system is functioning optimally.
- B. Listen actively to the patient's concerns, acknowledge the challenges, and offer support.
- C. Ignore the patient's frustration and proceed with providing care.
- D. Tell the patient that their frustration is unwarranted and unnecessary.
Correct Answer: B
Rationale: The nurse's best response when a patient expresses frustration with the healthcare system's inefficiencies is to listen actively to the patient's concerns, acknowledge the challenges they are facing, and offer support. It is important for the nurse to validate the patient's feelings and demonstrate empathy, rather than dismissing or ignoring their frustrations. By offering support and showing understanding, the nurse can help the patient feel heard and valued, which is an essential aspect of providing patient-centered care. This approach can also help to strengthen the nurse-patient relationship and build trust, ultimately leading to better outcomes for the patient's overall healthcare experience.
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A patient presents with painless, progressive visual field loss, particularly in the peripheral vision, in both eyes. Gonioscopy reveals an open iridocorneal angle. Which of the following conditions is most likely responsible for this presentation?
- A. Open-angle glaucoma
- B. Closed-angle glaucoma
- C. Age-related macular degeneration
- D. Diabetic retinopathy
Correct Answer: A
Rationale: The presentation of painless, progressive visual field loss, especially in the peripheral vision, along with an open iridocorneal angle is characteristic of open-angle glaucoma. Open-angle glaucoma is a type of glaucoma where there is no physical obstruction to the outflow of aqueous humor from the eye, but there is gradual damage to the optic nerve over time. The gradual loss of peripheral vision is a common early symptom of open-angle glaucoma. It is essential to diagnose and manage open-angle glaucoma promptly to prevent irreversible vision loss.
A patient with advanced cancer experiences dyspnea and anxiety during episodes of breathlessness. Which intervention should the palliative nurse prioritize to address the patient's symptoms?
- A. Administer oxygen therapy to relieve dyspnea.
- B. Teach the patient pursed-lip breathing techniques.
- C. Recommend opioid medications for symptom management.
- D. Refer the patient to a respiratory therapist for breathing exercises.
Correct Answer: C
Rationale: Opioid medications are considered the first-line pharmacological treatment for dyspnea in palliative care patients with advanced cancer. Opioids help relieve dyspnea by reducing respiratory drive and the sensation of breathlessness, providing effective symptom management. In this case, addressing the patient's dyspnea with opioid medications would likely also help alleviate their anxiety related to breathlessness. Administering oxygen therapy (choice A) may not be effective at relieving dyspnea in this situation, as dyspnea in advanced cancer patients is often not primarily due to low oxygen levels. Teaching pursed-lip breathing techniques (choice B) and referring the patient to a respiratory therapist for breathing exercises (choice D) may be helpful complementary interventions, but opioid medications should be the priority for symptom management.
A 28-year-old woman presents with lower abdominal pain, dyspareunia, and dysmenorrhea that worsens during menstruation. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which condition is most likely to be responsible for these findings?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Pelvic inflammatory disease (PID)
- D. Uterine fibroids
Correct Answer: B
Rationale: The clinical presentation of lower abdominal pain, dyspareunia (pain during sexual intercourse), dysmenorrhea (painful periods), and tender nodules along the uterosacral ligaments is highly suggestive of endometriosis. Endometriosis is a condition where the tissue that lines the uterus (endometrium) grows outside the uterus, commonly on the pelvic organs such as the ovaries, fallopian tubes, and the peritoneum. The characteristic tender nodules along the uterosacral ligaments are known as "nodularity" and are a classic finding in endometriosis.
A woman in active labor is diagnosed with a prolapsed umbilical cord. What is the priority nursing action?
- A. Elevate the mother's hips to relieve pressure on the cord.
- B. Prepare for immediate cesarean section.
- C. Administer intravenous fluids rapidly.
- D. Perform a vaginal examination to assess cervical dilation.
Correct Answer: B
Rationale: A prolapsed umbilical cord is a medical emergency during labor because it can cause compression of the umbilical cord, leading to decreased oxygen supply to the fetus. The priority nursing action in this situation is to prepare for an immediate cesarean section. This is necessary to quickly deliver the baby and relieve pressure on the cord, preventing potential fetal distress or death. Elevating the mother's hips may help reduce pressure on the cord temporarily, but it is not the definitive treatment for a prolapsed cord. Administering intravenous fluids rapidly may be necessary, but it is not the priority intervention when the fetus is at risk due to a prolapsed cord. Performing a vaginal examination to assess cervical dilation is contraindicated in the presence of a prolapsed umbilical cord as it can further compress the cord and worsen the situation.
Given her problems of hyper vigilance and worry that something terrible will happen to her child, nursing interventions should be aimed at addressing her needs for _______.
- A. Love and belongingness
- B. psychological security
- C. biological integrity
- D. self-esteem
Correct Answer: B
Rationale: Nursing interventions should be aimed at addressing the mother's needs for psychological security. Hyper vigilance and excessive worry about her child's safety indicate a lack of security in her mind. By providing support, reassurance, and education, nurses can help the mother feel more secure in her role as a parent and reduce her feelings of anxiety and distress. Establishing trust and building a therapeutic relationship can also contribute to enhancing the mother's psychological security and well-being.