Correct Answer: B

Rationale: A fibroadenoma is a benign breast tumor commonly found in young women. In most cases, a fibroadenoma does not require radiation therapy. However, the patient might be referred for a biopsy to confirm the diagnosis and rule out any potential malignancy. While fibroadenomas can be related to hormonal changes in the body, they are not directly linked to the use of oral contraceptives. Recognizing this implication of the patient's diagnosis is essential for providing appropriate care and follow-up.

Correct Answer: C

Rationale: Patients with Meniere's disease are often advised to limit their intake of salt as excess salt can worsen symptoms such as dizziness and vertigo. Shellfish tend to be high in sodium, so patients with Meniere's disease should be instructed to avoid or limit their consumption of shellfish to help manage their condition. It is important for the nurse to provide comprehensive diet education to the patient to help them minimize symptoms and improve their overall quality of life.

Correct Answer: A

Rationale: Challenging communication situations in nursing care typically involve patients who exhibit behaviors that make communication difficult or complex. In the given options, a child who is developmentally delayed (Option A) and an older-adult patient who is demanding (Option B) are examples of patients who may have challenging communication issues.

Correct Answer: B

Rationale: When delivering bad news to a patient, it is important to create an environment that is supportive, compassionate, and conducive to effective communication. Having the patient at eye level when discussing difficult information helps to establish a sense of equality and respect between the healthcare provider and the patient. This can increase the patient's comfort level and help them feel more connected and engaged in the conversation. Additionally, eye level communication allows for better non-verbal cues to be exchanged, such as eye contact and facial expressions, which are important for conveying empathy and understanding during such sensitive discussions. It is crucial for the patient to be met at eye level, both physically and emotionally, when discussing a poor prognosis like the diagnosis of leukemia.

Correct Answer: D

Rationale: Black or tarry stools can be caused by certain medications and supplements, such as iron supplements. Since the fecal occult test is negative, it indicates that bleeding is not occurring. Therefore, in this situation, it is important to consider factors that can affect the color of stool, including iron supplementation. Addressing this question can help determine the cause of the black stool and provide appropriate guidance or reassurance to the patient. This response shows a comprehensive understanding of potential causes and demonstrates a thoughtful approach in addressing the patient's concern.