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?

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Question 1 of 9

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.

Question 2 of 9

An advanced practice nurse has performed a Rinne test on a new patient. During the test, the patient reports that air-conducted sound is louder than bone-conducted sound. How should the nurse best interpret this assessment finding?

Correct Answer: A

Rationale: The correct answer is A: The patient's hearing is likely normal. This interpretation is based on the normal Rinne test result, where air-conducted sound is expected to be louder than bone-conducted sound. This finding indicates that the patient has intact air conduction and no significant conductive hearing loss. Option B is incorrect because tinnitus is not directly related to the Rinne test results. Option C is incorrect as otosclerosis would typically present with abnormal Rinne test results showing bone-conducted sound to be louder. Option D is incorrect as sensorineural hearing loss would not typically affect the Rinne test results in this way.

Question 3 of 9

Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?

Correct Answer: A

Rationale: The correct answer is A: Abdominal palpation. Palpating the abdomen can potentially cause rupture of the liver in patients with HELLP syndrome due to increased risk of liver hematoma. This can lead to severe bleeding and compromise the patient's condition. Checking deep tendon reflexes (C), auscultation of the heart and lungs (D), and venous sample of blood (B) are safe assessments that do not pose a risk of exacerbating the patient's condition. It is crucial to prioritize patient safety and avoid interventions that can harm the patient, making avoiding abdominal palpation the correct choice in caring for a patient with HELLP syndrome.

Question 4 of 9

A patient is being discharged home from the ambulatory surgery center after an incisional biopsy of a mass in her left breast. What are the criteria for discharging this patient home? Select all that apply.

Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct: 1. Ambulating is a crucial postoperative activity to prevent complications like blood clots. 2. Understanding when to ambulate ensures the patient follows proper recovery guidelines. 3. Proper ambulation aids in preventing postoperative complications and promotes healing. Summary of why other choices are incorrect: B. Having someone accompany the patient is important for support but not a strict criteria for discharge. C. While understanding activity restrictions is important, it is not a specific criteria for immediate discharge. D. Understanding care for the biopsy site is essential but not a strict criteria for immediate discharge. E. Removal of a urinary catheter is not typically related to discharge criteria for a breast biopsy.

Question 5 of 9

A patient with multiple food and environmental allergies tells the nurse that he is frustrated and angry about having to be so watchful all the time and wonders if it is really worth it. What would be the nurses best response?

Correct Answer: A

Rationale: The correct answer is A because it shows empathy and offers the patient an opportunity to express their feelings. By acknowledging the patient's frustration and anger, the nurse validates their emotions and creates a safe space for communication. This response promotes trust and understanding, which are crucial in building a therapeutic relationship. Choice B is incorrect because it immediately jumps to teaching coping strategies without addressing the patient's emotional state. Choice C is incorrect as it generalizes the patient's feelings without directly engaging with their specific concerns. Choice D is incorrect as it sounds dismissive and may make the patient feel judged or misunderstood. These responses lack the empathetic approach needed to effectively support the patient in this situation.

Question 6 of 9

A nurse has provided care to a patient. Whichentry should the nurse document in the patient’s record?

Correct Answer: C

Rationale: The correct answer is C because it provides specific, objective information about the patient's left knee incision, including its size and absence of concerning signs. This entry is relevant, concise, and focuses on a specific aspect of the patient's condition, aiding in continuity of care and treatment planning. Choice A is vague and lacks detail, making it insufficient for accurate patient care documentation. Choice B focuses on the patient's subjective feelings and does not provide objective assessment data. Choice D is judgmental and includes unnecessary information about the patient's behavior and family presence, which is not directly related to the patient's condition.

Question 7 of 9

A nurse is caring for an 87-year-old Mexican-American female patient who is in end-stage renal disease. The physician has just been in to see the patient and her family to tell them that nothing more can be done for the patient and that death is not far. The physician offers to discharge the patient home to hospice care, but the patient and family refuse. After the physician leaves, the patients daughter approaches you and asks what hospice care is. What would this lack of knowledge about hospice care be perceived as?

Correct Answer: C

Rationale: The correct answer is C: A barrier to hospice care for this patient. The lack of knowledge about hospice care can be perceived as a barrier to accessing this type of care for the patient and her family. Understanding hospice care is crucial in making informed decisions about end-of-life care options. This lack of knowledge does not necessarily indicate lack of education (choice A), language barrier (choice B), or inability to grasp American concepts of health care (choice D), as hospice care is a universal concept that transcends cultural and educational backgrounds.

Question 8 of 9

A patient newly diagnosed with breast cancer states that her physician suspects regional lymph node involvement and told her that there are signs of metastatic disease. The nurse learns that the patient has been diagnosed with stage IV breast cancer. What is an implication of this diagnosis?

Correct Answer: A

Rationale: Rationale for Correct Answer A: Stage IV breast cancer indicates distant metastasis, making the patient ineligible for curative surgery. Treatment for stage IV focuses on palliative care to manage symptoms and improve quality of life. Summary of Other Choices: B: Stage IV breast cancer is not considered highly treatable as it has spread beyond the breast and nearby lymph nodes, making it more challenging to cure. C: There is no evidence to suggest that stage IV breast cancer will self-resolve. The prognosis for metastatic breast cancer is typically poor. D: The 5-year survival rate for stage IV breast cancer is generally lower than 15%, making this choice incorrect.

Question 9 of 9

A patient with HIV infection has begun experiencing severe diarrhea. What is the most appropriate nursing intervention to help alleviate the diarrhea?

Correct Answer: C

Rationale: The correct answer is C: Increase the patient's oral fluid intake. This is because severe diarrhea can lead to dehydration, which can be dangerous for patients with HIV infection. By increasing oral fluid intake, the patient can stay hydrated and prevent further complications. Administering antidiarrheal medications on a scheduled basis (Choice A) may provide temporary relief but does not address the underlying issue of dehydration. Encouraging the patient to eat balanced meals (Choice B) and increase activity level (Choice D) may be important for overall health but do not directly address the immediate concern of dehydration caused by severe diarrhea.

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