A nurse is caring for a patient who refuses to comply with a prescribed treatment regimen. What ethical principle should guide the nurse's approach to addressing the patient's refusal?

Correct Answer: B

Rationale: The ethical principle of autonomy emphasizes respecting the patient's right to make their own decisions regarding their treatment. In this scenario, the patient has the right to refuse treatment, and the nurse should respect that decision while also providing information and guidance to help the patient make informed choices. By upholding the principle of autonomy, the nurse can support the patient's decision-making process and work collaboratively with them to address any concerns or barriers to compliance with the treatment regimen. This approach honors the patient's right to self-determination and promotes a trusting relationship between the nurse and the patient.

Correct Answer: B

Rationale: When a patient is unable to talk, the nurse can best communicate with the patient by using picture cards. Picture cards can help the patient convey their needs, feelings, or responses by pointing to the corresponding pictures. This method allows for effective communication and understanding between the patient and the nurse, even when verbal communication is not possible. It promotes patient autonomy and ensures that their needs are accurately communicated and addressed. Additionally, picture cards can be a useful tool in reducing frustration and anxiety for patients who are unable to communicate verbally.

Correct Answer: C

Rationale: In the emergency department setting, the initial diagnostic test typically performed for a patient suspected of having a stroke is a noncontrast computed tomography (CT) scan of the head. This imaging study is crucial in evaluating and diagnosing stroke because it can quickly identify whether the person is having a hemorrhagic stroke (bleeding in the brain) or an ischemic stroke (blood clot blocking a blood vessel). The results of the CT scan help guide immediate treatment decisions, such as administering clot-busting medications for ischemic strokes or preparing for surgical interventions for hemorrhagic strokes. Carotid ultrasound studies and transcranial Doppler flow studies may be performed after the initial CT scan to further assess the extent of damage and the underlying cause of the stroke. The 12-lead electrocardiogram is useful in assessing the heart's electrical activity but is not the primary test for diagnosing stroke.

Correct Answer: C

Rationale: Deep vein thrombosis (DVT) is a serious condition that requires prompt medical intervention. The presence of calf pain, swelling, and warmth in a postpartum client are concerning signs of a potential DVT. By notifying the healthcare provider immediately, appropriate diagnostic tests, such as ultrasound imaging, can be ordered to confirm the diagnosis. Timely treatment with anticoagulant medication can then be initiated to prevent complications such as pulmonary embolism. Applying warm compresses or encouraging ambulation may exacerbate the condition by promoting clot dislodgement, making immediate notification of the healthcare provider the most appropriate nursing action in this situation.

Correct Answer: C

Rationale: When a patient expresses concern about a medication looking different from what they had taken before, it is crucial for the nurse to verify the original prescription to ensure that the correct medication is being administered. Checking the original medication prescription will help the nurse confirm if there have been any changes or errors in the medication orders. This step is essential for patient safety and to prevent any potential medication errors. It is important to prioritize patient safety and well-being in such situations, and verifying the prescription is the appropriate action to take in this case.

Correct Answer: C

Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to offer emotional support and validate the patient's feelings about body image changes. End-stage renal disease can lead to significant physical changes such as edema and weight gain, which can impact a patient's body image and self-esteem. By providing emotional support and validating the patient's feelings, the nurse can help address the patient's distress and concerns, improving their overall psychological well-being. While providing education on dietary modifications (choice B) and prescribing diuretic medications (choice D) may be important aspects of managing fluid retention and edema, addressing the patient's emotional distress and body image concerns should be the initial priority in a palliative care setting. Encouraging the patient to accept their body changes (choice A) may overlook the emotional impact these changes have on the patient, making choice C the most appropriate intervention.

Correct Answer: B

Rationale: When a patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) for anemia management, the parameter that should be monitored closely by the nurse is the hemoglobin levels. Hemoglobin levels indicate the patient's response to ESA therapy and are essential in assessing the effectiveness of the treatment in addressing anemia. Monitoring hemoglobin levels helps ensure that the patient's anemia is controlled within the target range to avoid both the risks of under-treatment (resulting in persistent anemia) and over-treatment (increased risk of adverse outcomes such as hypertension, stroke, or cardiovascular events).

Correct Answer: A

Rationale: Nonverbal communication is as strong in conveying information because the nurse can effectively interpret and understand gestures made by the individual they are interacting with. Gestures such as hand movements, facial expressions, eye contact, and body posture can communicate a lot of information without the use of words. By observing these nonverbal cues, nurses can better comprehend the emotions, needs, and feelings of their patients or colleagues, leading to more effective communication and overall better care. Nonverbal communication, including gestures, plays a significant role in creating a holistic understanding of individuals' messages beyond just words.

Correct Answer: A

Rationale: Nurse Cris should employ the communication technique of summarizing to successfully capture the details of the meeting. Summarizing involves condensing the information provided into a concise and organized form, which would help Nurse Cris remember and retain the key points discussed during the meeting. By summarizing the details, Nurse Cris can ensure that no important information is missed and can also confirm understanding by reflecting back the main points discussed. This technique promotes effective communication by enhancing clarity and reinforcing comprehension.