Nokea
A patient becomes emotional while discussing their recent diagnosis. What is the nurse's most appropriate response?
- A. Ignore the patient's emotions and continue with the conversation.
- B. Acknowledge the patient's emotions and offer empathy and support.
- C. Tell the patient to stop being emotional and focus on the facts.
- D. Change the subject to avoid further emotional distress.
Correct Answer: B
Rationale: Acknowledging the patient's emotions and offering empathy and support is the most appropriate response in this situation. It is important for the nurse to show understanding and compassion towards the patient, especially when they are feeling emotional about a recent diagnosis. By acknowledging the patient's emotions, the nurse can create a supportive environment that facilitates open communication and helps the patient feel heard and valued. This approach can also help build trust between the patient and the nurse, leading to better outcomes in terms of patient care and overall well-being. Ignoring the patient's emotions, telling them to stop being emotional, or changing the subject may make the patient feel dismissed or isolated, which could negatively impact their mental and emotional state. Thus, offering empathy and support is key in helping the patient cope with their emotions and navigate through their diagnosis.
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A patient presents with a painless thyroid nodule and hoarseness of voice. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid cancer
Correct Answer: D
Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.
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.
During theh history taking, which of the following is the MOST common symptom of Scabies that the family would report to Nurse Emma?
- A. Rashes
- B. Scaling
- C. Swelling
- D. Itchiness
Correct Answer: D
Rationale: The most common symptom of scabies that the family would report to Nurse Emma is itchiness. Scabies is a contagious skin condition caused by the Sarcoptes scabiei mite, which burrows into the skin and lays eggs, leading to intense itching, especially at night. The itching is a result of the body's allergic reaction to the mites and their waste products. While rashes, scaling, and swelling can also occur with scabies, the hallmark and most bothersome symptom experienced by individuals with scabies is the intense itchiness, making it the most common symptom reported by affected individuals or their families during the history-taking process.
After a throurough assessment by the physician-specialist, an order for an immediate sonogram was made specific for the medical condition?
- A. Operation Room
- B. Intervention
- C. Laboratory
- D. CT Scan
Correct Answer: B
Rationale: In this scenario, the physician-specialist assessed the patient and determined that an immediate sonogram is needed for the medical condition. An intervention is a specific action taken in response to a medical need or condition. Ordering an immediate sonogram falls under the category of an intervention because it involves a timely and targeted diagnostic procedure to address the medical situation identified by the physician. The other options (A. Operation Room, C. Laboratory, D. CT scan) do not accurately represent the specific action of ordering a sonogram in response to the medical condition assessed by the physician.
A patient with diabetes mellitus presents with polyuria, polydipsia, nocturia, and fatigue. Laboratory findings reveal hyperglycemia, glycosuria, and ketonuria. What is the most likely diagnosis?
- A. Diabetic nephropathy
- B. Diabetic ketoacidosis (DKA)
- C. Hyperosmolar hyperglycemic state (HHS)
- D. Diabetic autonomic neuropathy
Correct Answer: B
Rationale: The presentation of a patient with diabetes mellitus showing symptoms of polyuria, polydipsia, nocturia, and fatigue along with laboratory findings of hyperglycemia, glycosuria, and ketonuria is indicative of diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. The increased glucose levels lead to glycosuria, causing osmotic diuresis resulting in polyuria, polydipsia, and nocturia. The body starts breaking down fats for energy in the absence of sufficient insulin, leading to the production of ketones causing ketonuria. The patient may also experience fatigue due to the metabolic abnormalities present in DKA.