A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?

Correct Answer: A

Rationale: The correct answer is A: Cottage cheese-like discharge. Candida albicans is a common cause of vulvovaginal candidiasis, characterized by itching and cottage cheese-like discharge. This type of discharge is specific to a yeast infection. Yellow-green discharge (choice B) is indicative of trichomoniasis, gray-white discharge (choice C) is seen in bacterial vaginosis, and watery discharge with a fishy odor (choice D) is characteristic of bacterial vaginosis or trichomoniasis. Therefore, the presence of cottage cheese-like discharge is a key indicator of a Candida albicans infection.

Correct Answer: A

Rationale: The correct answer is A: Cottage cheese-like discharge. Candida albicans is a common cause of vulvovaginal candidiasis, characterized by itching and cottage cheese-like discharge. This type of discharge is specific to a yeast infection. Yellow-green discharge (choice B) is indicative of trichomoniasis, gray-white discharge (choice C) is seen in bacterial vaginosis, and watery discharge with a fishy odor (choice D) is characteristic of bacterial vaginosis or trichomoniasis. Therefore, the presence of cottage cheese-like discharge is a key indicator of a Candida albicans infection.

Correct Answer: D

Rationale: The correct answer is D: Incentives to palliative care. Palliative care focuses on improving the quality of life for patients with serious illnesses by addressing their physical, emotional, and spiritual needs. As the American population ages, the emphasis on palliative care in long-term care facilities is crucial. Regulations emphasizing incentives for palliative care ensure that patients receive appropriate symptom management, comfort care, and support to enhance their overall well-being. Choice A: Ongoing acute care is not the correct answer because palliative care is different from acute care, which focuses on treating the underlying medical condition. Choice B: Restorative measures are not the correct answer as palliative care aims to improve quality of life rather than focusing on restoring physical function. Choice C: Mobility and socialization are important aspects of care in long-term facilities, but palliative care goes beyond these aspects to provide holistic support for patients facing serious illnesses.

Correct Answer: C

Rationale: The correct answer is C: Work with the team to negotiate informed consent. In this scenario, the nurse should prioritize respecting the patient's cultural beliefs while also ensuring the patient's autonomy and right to make decisions about his own healthcare. By working with the healthcare team to negotiate informed consent, the nurse can involve both the patient and his eldest son in the decision-making process, ensuring that the patient's preferences are respected while also upholding ethical principles of patient autonomy and beneficence. This approach promotes collaboration and respect for cultural values while still safeguarding the patient's rights. Choice A is incorrect because it does not involve the patient in the decision-making process and could undermine his autonomy. Choice B is incorrect as it disregards the patient's cultural beliefs and preferences. Choice D is incorrect as it may violate the patient's right to information and involvement in his own care.

Correct Answer: B

Rationale: The correct answer is B because Rh incompatibility occurs when an Rh-negative mother carries an Rh-positive fetus. If fetal blood enters the mother's circulation during pregnancy or childbirth, the mother's immune system can produce antibodies against Rh-positive red blood cells, leading to potential harm to future pregnancies. Choices A, C, and D are incorrect because Rh incompatibility does not occur when the fetus is Rh-negative, the father is Rh-positive, or both the father and fetus are Rh-negative.

Correct Answer: A

Rationale: The correct answer is A. Postoperative day 6 following tympanoplasty and mastoidectomy is still within the early phase of recovery, where occasional sharp, shooting pains in the affected ear can be expected due to the healing process. Here's a step-by-step rationale: 1. Timing: It is only day 6 post-surgery, so it is normal to experience some pain as part of the healing process. 2. Nature of pain: Sharp, shooting pains are common post-surgery due to tissue healing and nerve regeneration. 3. Lack of other symptoms: The patient did not report any other concerning symptoms like fever or discharge, which would be more indicative of an infection. 4. Unlikely complications: Spontaneous rupture of the tympanic membrane or unsuccessful surgery would typically present with more severe and consistent symptoms. Summary: - B: Unlikely as there are no other signs of infection. - C: Unlikely as the pain is described as occasional and sharp. - D:

Correct Answer: A

Rationale: The correct answer is A: Ineffective Airway Clearance. In a patient with AIDS and PCP, maintaining clear airways is crucial to prevent respiratory distress and hypoxia. Pneumocystis pneumonia can cause thick secretions and mucus plugging, leading to difficulty breathing. Ensuring effective airway clearance is a priority to optimize oxygenation and prevent respiratory complications. Impaired oral mucous membranes (B) and imbalanced nutrition (C) are important considerations but not as immediate as airway clearance. Activity intolerance (D) may be a concern for the patient but ensuring adequate oxygenation takes precedence.

Correct Answer: B

Rationale: The correct answer is B: Administration of methotrexate. This is the priority intervention for an intact tubal pregnancy to prevent further growth and potential rupture of the fallopian tube. Methotrexate is a medication used to stop the growth of the pregnancy tissue. Assessment of pain level (A) is important but not the priority as immediate intervention to address the ectopic pregnancy is crucial. Administration of Rh immune globulin (C) is not the priority in this situation, as it is typically given after a miscarriage or abortion to prevent Rh sensitization. Explanation of common side effects (D) is important for patient education, but it is not the immediate priority when dealing with an ectopic pregnancy.

Correct Answer: D

Rationale: Correct Answer: D - Removing all of the patient’s metallic jewelry. Rationale: 1. Safety: Metallic objects can be attracted by the MRI magnet, causing harm to the patient and disrupting the imaging process. 2. Artifact Prevention: Metallic objects can produce artifacts on the MRI images, affecting the diagnostic quality. 3. Patient Comfort: Removing jewelry ensures the patient's comfort during the scan, avoiding discomfort or injury. Summary of Incorrect Choices: A: Not eating or drinking before an MRI is important, but it is not the most crucial action compared to patient safety and image quality. B: Colon cleansing may be necessary for certain types of MRI scans, but it is not universally required and is not the most important action. C: Pain medication may be important for patient comfort, but it is not essential for the actual MRI procedure and does not impact safety or image quality.