A 16-year-old has come to the clinic and asks to talk to a nurse. The nurse asks the teen what she needs and the teen responds that she has become sexually active and is concerned about getting HIV. The teen asks the nurse what she can do keep from getting HIV. What would be the nurses best response?

Correct Answer: D

Rationale: The correct answer is D because it emphasizes the importance of consistent and correct condom use in preventing HIV transmission. Here's the rationale: 1. Abstinence is the most effective way to prevent HIV, but since the teen is sexually active, abstinence may not be feasible for her. 2. Using condoms consistently and correctly is the next best method for preventing HIV transmission during sexual activity. 3. Choice A is incorrect because it implies that using condoms is not effective, which is not true. 4. Choice B is incorrect because it only mentions female condoms, while both male and female condoms can be effective in preventing HIV. 5. Choice C is incorrect because while new prevention methods are being researched, the established method of consistent condom use remains the most effective.

Correct Answer: C

Rationale: The correct answer is C: Impaired verbal communication. In ALS, motor neurons deteriorate leading to muscle weakness and atrophy, including those involved in speech production. This results in impaired verbal communication. Chronic confusion (A) is not a common manifestation of ALS. Impaired urinary elimination (B) and bowel incontinence (D) are not typically associated with ALS, as it primarily affects motor neurons, not autonomic functions.

Correct Answer: C

Rationale: The correct answer is C: Weight does not change. When a patient's energy requirements are completely met by kcal intake, their weight should remain stable as there is a balance between energy intake and expenditure. This indicates that the body is receiving adequate energy for its needs, leading to weight maintenance. A: Weight increases - This would indicate an excess of energy intake over expenditure, leading to weight gain. B: Weight decreases - This would indicate a deficit in energy intake compared to expenditure, resulting in weight loss. D: Weight fluctuates daily - Daily weight fluctuations are normal and can be influenced by factors like hydration levels, food intake, and exercise, but a stable weight over time indicates a balance between energy intake and expenditure.

Correct Answer: C

Rationale: The correct choice is C because if no urine is obtained, it indicates that the catheter is not in the urethra. The nurse should remove the catheter, wipe with alcohol to maintain cleanliness, and reinsert after lubrication to ensure proper placement in the urethra. This step-by-step approach allows for a more accurate catheter insertion and prevents potential complications. Choice A is incorrect as discarding the catheter and starting over without addressing the issue does not solve the problem. Choice B is incorrect as filling the balloon with sterile water is not relevant to the situation of catheter misplacement. Choice D is incorrect as leaving the catheter in the vagina can lead to infection and is not a recommended practice.

Correct Answer: A

Rationale: The correct answer is A: At the time of menses. This is because breasts are less lumpy and tender during this time, making it easier to detect abnormalities. Performing BSE at other times may lead to false alarms due to hormonal changes. Choice B is incorrect because timing matters for accurate results. Choice C is incorrect as weekly BSE is unnecessary and may cause unnecessary anxiety. Choice D is incorrect as breasts are more lumpy and tender post-menses, potentially making it harder to detect abnormalities.

Correct Answer: D

Rationale: The correct answer is D because neurogenic dysphagia is caused by neurological conditions affecting swallowing function, such as a stroke. In a stroke, damage to the brain can impair the coordination of swallowing muscles, leading to dysphagia. Choice A is incorrect because benign peptic stricture is a narrowing of the esophagus due to chronic acid reflux, not a neurological issue. Choice B is incorrect because muscular dystrophy is a genetic disorder that affects muscle strength and does not directly impact the neurological control of swallowing. Choice C is incorrect because myasthenia gravis is an autoimmune disorder that affects neuromuscular transmission but is not typically associated with neurogenic dysphagia.

Correct Answer: A

Rationale: The correct answer is A because hospice care is centered on a holistic approach that considers the physical, emotional, social, and spiritual needs of both the patient and their family. This principle recognizes that caring for a terminally ill patient involves supporting the entire family unit. Choice B is incorrect because family support is integral to hospice care. Choice C is incorrect because hospice care extends beyond just the patient to include their loved ones. Choice D is incorrect because the care team should address all aspects of care for both the patient and their family, not prioritize one over the other.

Correct Answer: B

Rationale: The correct answer is B: Constipation. When a patient is receiving opioids, constipation is a common side effect due to decreased gut motility. It is a priority assessment because untreated constipation can lead to serious complications such as bowel obstruction. Monitoring for constipation allows for early intervention with stool softeners or laxatives to prevent complications. Incorrect choices: A: Clostridium difficile - While important to consider in patients on antibiotics, it is not directly related to opioid use. C: Hemorrhoids - Although opioids can contribute to constipation which may exacerbate hemorrhoids, it is not the priority assessment. D: Diarrhea - Opioids typically cause constipation, so diarrhea is less likely to be a priority concern in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Ability of technology to prolong life beyond meaningful quality of life. In palliative care, the focus is on improving the quality of life for patients with serious illnesses. The use of technology to prolong life can sometimes conflict with this goal, leading to ethical dilemmas. Technology may extend life without considering the patient's comfort or dignity, raising questions about the meaningfulness of prolonging life in such situations. This issue is particularly challenging in palliative care as it requires balancing the benefits of technology with the patient's quality of life. Other choices are incorrect: A: The increase in cultural diversity in the United States - While cultural diversity can present challenges in palliative care, it is not the most often presented challenging ethical issue. B: Staffing shortages in health care and questions concerning quality of care - Staffing shortages are important issues in healthcare, but they do not directly relate to the ethical dilemmas specific to palliative care. C: Increased costs of health care coupled with