A 35-year-old mother of three young children has been diagnosed with stage II breast cancer. After discussing treatment options with her physician, the woman goes home to talk to her husband, later calling the nurse for clarification of some points. The patient tells the nurse that the physician has recommended breast conservation surgery followed by radiation. The patients husband has done some online research and is asking why his wife does not have a modified radical mastectomy to be sure all the cancer is gone. What would be the nurses best response?

Correct Answer: D

Rationale: The correct answer is D: According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy. 1. Breast conservation surgery followed by radiation is a standard treatment option for early-stage breast cancer. 2. Studies have shown that breast conservation surgery combined with radiation therapy is equally effective in terms of long-term survival rates compared to mastectomy. 3. Current guidelines recommend considering breast conservation surgery as a viable option for patients with early-stage breast cancer. 4. Modified radical mastectomy is not necessarily needed to ensure complete removal of cancer, as breast conservation surgery followed by radiation can achieve the same goal. 5. Therefore, the nurse should reassure the patient's husband that the recommended treatment plan is based on current guidelines and is as effective as a modified radical mastectomy.

Correct Answer: D

Rationale: The correct answer is D: Asthma. Atopic dermatitis is associated with a heightened immune response and inflammation, which can predispose individuals to developing asthma. Both conditions involve an overactive immune response and can coexist in patients due to shared genetic and environmental factors. Asthma commonly presents alongside atopic dermatitis in individuals with atopic tendencies. Bronchitis (choice A) is a respiratory condition caused by inflammation of the bronchial tubes and is not directly linked to atopic dermatitis. Systemic lupus erythematosus (choice B) and rheumatoid arthritis (choice C) are autoimmune diseases that primarily affect the joints and other organs, but they are not typically associated with atopic dermatitis.

Correct Answer: B

Rationale: The correct answer is B (2, 4, 1, 3, 5) because it follows the correct sequential order for initiating feeding. First, you need to prepare the food (2), then set up the feeding area (4), followed by inviting the person to eat (1), serving the food (3), and finally allowing them to eat (5). The other choices do not adhere to the logical sequence required for initiating feeding. Choice A and D have incorrect sequences of steps, while Choice C has steps 1 and 4 switched, which disrupts the proper order of initiating feeding.

Correct Answer: A

Rationale: The correct answer is A: Stop the infusion of magnesium. A magnesium level of 6 mg/dL is above the therapeutic range (4-7 mg/dL) for preeclamptic patients receiving magnesium sulfate. Continuing the infusion can lead to magnesium toxicity, causing respiratory depression, cardiac arrest, and neuromuscular blockade. Stopping the infusion is crucial to prevent further complications. Assessing the patient's respiratory rate (B) and deep tendon reflexes (C) are important, but stopping the infusion takes priority to prevent harm. Notifying the health care provider (D) is important but may delay immediate action to address the high magnesium level.

Correct Answer: A

Rationale: The correct answer is A: immediate birth is required. The Kleihauer–Betke test is used to detect fetal-maternal hemorrhage in situations where there is a risk of fetal blood entering the maternal circulation, such as trauma during pregnancy. A positive result indicates a significant fetal-maternal hemorrhage, which can lead to Rh incompatibility and severe fetal anemia. Immediate birth is required to prevent complications and ensure the safety of both the mother and the baby. Choice B is incorrect as transferring the patient to the critical care unit does not address the underlying issue of fetal-maternal hemorrhage. Choice C is incorrect as RhoGAM is typically administered to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive babies, which is not the primary concern in this scenario. Choice D is incorrect as a tetanus shot is not directly related to the positive Kleihauer–Betke test result indicating fetal-maternal hemorrhage.

Correct Answer: B

Rationale: The correct answer is B: Those who develop critical thinking skills. Critical thinking skills enable nurses to assess situations, analyze information, and communicate effectively with patients. By using critical thinking, nurses can tailor their communication style to each patient's needs, leading to better understanding and rapport. A: Learning effective psychomotor skills is important but does not directly correlate with being a good communicator. C: Liking different kinds of people is beneficial for interpersonal relationships, but it does not necessarily make one a better communicator. D: Maintaining perceptual biases hinders effective communication as it can lead to misunderstandings and barriers in the communication process.

Correct Answer: B

Rationale: The correct answer is B: Human papillomavirus (HPV). HPV is the most important risk factor for cervical cancer as it is responsible for almost all cases. Step 1: HPV infection can lead to changes in cervical cells, increasing the risk of cancer. Step 2: Early detection and vaccination against HPV can prevent cervical cancer. Step 3: Other factors like late childbearing, postmenopausal bleeding, and tobacco use may be associated with increased risk but are not as directly linked to cervical cancer development.

Correct Answer: A

Rationale: The correct answer is A: Gay, bisexual, and other men who have sex with men. This group currently has the highest risk of contracting HIV due to various factors such as higher prevalence within this population, risky sexual behaviors, and limited access to healthcare services. Men who have sex with men have been disproportionately affected by HIV/AIDS since the beginning of the epidemic. Recreational drug users and blood transfusion recipients have lower overall risk compared to men who have sex with men. Health care providers, although at risk of occupational exposure, have lower risk compared to the other groups mentioned.

Correct Answer: A

Rationale: The correct answer is A: Limit fluid and caffeine intake before bed. This recommendation addresses the issue of nocturia (frequent urination at night) by reducing the amount of urine produced before bedtime, therefore decreasing the need to get up during the night. Caffeine is a diuretic, so limiting its intake can also help reduce the frequency of urination. Choices B, C, and D do not directly address the underlying cause of nocturia and falling. Leaving the bathroom light on (choice B) may help with visibility but does not address the urinary problem. Kegel exercises (choice C) focus on pelvic floor muscles, not bladder muscles. Clearing the path to the bathroom (choice D) can prevent falls but does not address the urinary issue.