Correct Answer: A

Rationale: In a patient with acute gastrointestinal bleeding requiring urgent intervention, the healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques. Endoscopy allows for direct visualization of the source of bleeding in the gastrointestinal tract, enabling targeted interventions such as clipping, cauterization, or injection of epinephrine to achieve hemostasis. This approach is effective in managing acute bleeds and can help stop the bleeding quickly, reducing the need for more invasive procedures or surgeries. Administering proton pump inhibitors (PPIs) may be considered for acid-related bleeding, but it is not the primary intervention for acute bleeding requiring urgent management. Strict bed rest may not be necessary and can increase the risk of complications such as deep vein thrombosis. Transfusion of fresh frozen plasma may be indicated if there is evidence of coagulopathy, but addressing the bleeding source should be the initial priority to

Correct Answer: B

Rationale: It is important for the nurse to have a direct and easily accessible means of communication with the patient who is expected to be in and out of the hospital due to their chronic illness like leukemia. By asking for the patient's phone number, the nurse can quickly reach out to them for updates, clarification, or any urgent matters that may arise. This direct communication line helps in ensuring continuity of care and addressing the patient's needs promptly. This approach is more practical and efficient compared to options such as asking the patient to call the hospital number listed in the yellow pages or relying on chart information which may not always be up to date. Writing down the number and giving it to the ward clerk may cause unnecessary delays in communication.

Correct Answer: D

Rationale: Restlessness caused by pain often manifests as increased perspiration and constant change of position. When a person is in pain, they may become sweaty or clammy due to increased sympathetic nervous system activity. Additionally, they may constantly shift or fidget in an attempt to find a more comfortable position that can alleviate the pain they are experiencing. Therefore, it is crucial for Nurse Chona to accurately document these behaviors as signs of pain-related restlessness. Difficulty of breathing (Option A), increased respiratory rate and blood pressure (Option B), and increased heart rate (Option C) are more indicative of hypoxia or respiratory distress rather than pain-related restlessness.

Correct Answer: B

Rationale: The best response for the nurse in this situation would be to listen actively to the patient's concerns, acknowledge the lack of information, and offer to address the issue. It is important for healthcare providers to validate the patient's feelings and actively work towards resolving any issues that are causing frustration. By being empathetic and willing to address the problem, the nurse can help improve the patient's experience and build trust in the healthcare team. Dismissing or ignoring the patient's frustration can lead to further dissatisfaction and breakdown in communication. It is crucial for healthcare providers to prioritize open communication and address any concerns or lack of information promptly.

Correct Answer: D

Rationale: All of the components -explanation of the procedure and alternatives to the procedure (I), discussion of potential risks and benefits of the procedure (II), and confirmation that the patient understands the risks, benefits, and any alterations (III) -are essential parts of informed consent. Providing information about the procedure and its alternatives, disclosing potential risks and benefits, and ensuring that the patient comprehends this information are crucial to obtaining valid informed consent prior to any medical procedure.