A new medical resident assessed a patient who is starting withdrawal from benzodiazepine. The resident writes orders for Ativan. What is your best response?

Correct Answer: D

Rationale: The correct response is option D, which is to point out to the resident that the patient is dependent on benzodiazepines. This is the best choice because giving Ativan (another benzodiazepine) to a patient in benzodiazepine withdrawal can potentially exacerbate the withdrawal symptoms or lead to further dependency. It is crucial to address the resident's error to prevent harm to the patient. Option A, asking the attending physician to review the orders, is not the best choice in this situation because the resident's error needs to be addressed promptly to prevent harm to the patient. Option B, administering the medication as prescribed, is incorrect because it could worsen the patient's condition. Option C, asking the resident to clarify the orders, is not the ideal response as the issue is not about clarity but about the appropriateness of the prescribed medication. In an educational context, this scenario highlights the importance of thorough patient assessment, understanding of pharmacology, and critical thinking skills in medical practice. It emphasizes the necessity of advocating for patient safety and speaking up when errors are identified, even if it involves addressing a more senior colleague's mistake.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Curtain-like shadow across visual field, which should be immediately reported to the physician. This symptom could indicate a serious condition such as retinal detachment, which requires urgent medical attention to prevent permanent vision loss. Option A) Change in color vision could be related to various conditions, but it is not typically considered an emergency situation unless it is sudden and accompanied by other concerning symptoms. Option B) Crusty yellow drainage on eyelashes is more indicative of a less urgent issue such as conjunctivitis or a blocked tear duct, which would not require immediate reporting to the physician. Option C) Increased lacrimation, or increased tearing, can be caused by minor irritants or allergies and does not usually require immediate medical attention unless it is persistent and severe. In an educational context, it is crucial for healthcare professionals, especially those working in ophthalmology or general medical-surgical settings, to be able to recognize urgent symptoms that require immediate intervention. Understanding the significance of certain symptoms and knowing when to escalate them to the physician is essential for providing timely and appropriate care to patients. This case highlights the importance of prompt reporting and action in potentially sight-threatening conditions.

Correct Answer: A

Rationale: The priority nursing diagnosis in this scenario is option A) Social Interaction, Impaired related to perceived inability to interact. This is the correct answer because the patient's primary concern is her hearing loss impacting her ability to engage in social interactions, leading to feelings of embarrassment and isolation. Addressing this issue is crucial to improving her quality of life and mental well-being. Option B) Disturbed Sensory Perception related to progressive hearing loss is not the priority nursing diagnosis in this case because the patient's main distress is not solely related to the physical aspect of hearing loss but rather the social and emotional consequences of it. Option C) Knowledge Deficit related to pathophysiological processes is not the priority nursing diagnosis as the patient's main issue is not lack of understanding about her condition but rather the psychosocial impact of her hearing loss. Option D) Coping, Ineffective related to change in sensory abilities is not the priority nursing diagnosis because while coping mechanisms are important, the patient's most pressing concern is her impaired social interactions due to her hearing loss. In an educational context, it is essential for nurses to prioritize nursing diagnoses based on the patient's immediate needs and concerns. Understanding the psychosocial implications of a health condition is vital in providing holistic care and addressing the patient's overall well-being. In this case, focusing on improving the patient's social interactions and reducing feelings of embarrassment and isolation will have a significant impact on her quality of life.

Correct Answer: C

Rationale: The start of the luteal phase of the menstrual cycle is marked by ovulation, which is option C. This is because the luteal phase begins after ovulation when the ruptured follicle transforms into the corpus luteum, which produces progesterone to prepare the endometrium for possible implantation of a fertilized egg. Option A, menstruation, marks the beginning of the menstrual cycle, not the luteal phase. Pelvic pain (Option B) and cramping (Option D) are common symptoms associated with menstruation and may occur during the follicular phase, which precedes ovulation. Understanding the menstrual cycle is crucial for healthcare professionals, especially in fields like medical-surgical nursing, where knowledge of reproductive health is important in providing holistic care to patients. Recognizing the phases of the menstrual cycle can aid in assessing and addressing gynecological concerns, supporting patients through fertility treatments, and recognizing potential pregnancy-related issues. This knowledge is essential for providing comprehensive care to female patients across the lifespan.

Correct Answer: A

Rationale: In a patient diagnosed with a hydatidiform mole, the correct expectation would be A) A positive hCG. This is because a hydatidiform mole is a type of gestational trophoblastic disease characterized by abnormal growth of trophoblastic cells, leading to elevated human chorionic gonadotropin (hCG) levels. Option B) Weight loss and wasting as with other malignancies is incorrect because hydatidiform mole is not a malignancy but a benign gestational trophoblastic disease. Option C) Braxton-Hicks contractions are false labor contractions and are not associated with hydatidiform mole. Option D) A cough is unrelated to the diagnosis of hydatidiform mole. Educationally, understanding the expected clinical manifestations of hydatidiform mole is crucial for healthcare providers in providing appropriate care and monitoring for complications. Knowledge of hCG levels as a key diagnostic feature helps in prompt recognition and management of this condition.