A patient in the ICU develops acute kidney injury (AKI) secondary to sepsis. What intervention should the healthcare team prioritize to manage the patient's renal function?

Correct Answer: A

Rationale: In a patient with acute kidney injury (AKI) secondary to sepsis in the ICU, the healthcare team should prioritize initiating continuous veno-venous hemofiltration (CVVH) for renal replacement therapy. CVVH is a form of continuous renal replacement therapy that helps support renal function by removing waste products, excess fluids, and electrolytes from the blood while providing hemodynamic stability. This intervention is crucial in managing fluid overload, electrolyte disturbances, and uremia associated with AKI in critically ill patients. It can also help improve overall outcomes and prevent further complications related to renal dysfunction in this setting. Administering diuretics, implementing fluid restriction, or performing a renal biopsy may not directly address the acute renal failure and may not provide the necessary renal support needed in this urgent situation.

Correct Answer: A

Rationale: The presentation of a palpable, non-tender mass in the right neck, just below the angle of the mandible, along with ultrasound imaging findings of a well-defined, hypoechoic lesion with cystic components, is classic for a branchial cleft cyst. Branchial cleft cysts are congenital anomalies that arise from remnants of the branchial clefts or pouches during embryonic development. They are typically located along the anterior border of the sternocleidomastoid muscle, just below the mandible. Ultrasound imaging often shows a cystic lesion with well-defined borders and hypoechoic content, which is consistent with the described findings. Thyroglossal duct cysts usually present as midline neck masses that move with swallowing or tongue protrusion, not in the location described in the scenario. Lymphadenopathy would present as enlarged lymph nodes that may be tender and associated with systemic symptoms.

Correct Answer: A

Rationale: The presentation described is consistent with acute angle-closure glaucoma. This condition typically presents with sudden-onset severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea due to corneal edema and a mid-dilated, non-reactive pupil due to pupillary block from the forward displacement of the iris. Acute angle-closure glaucoma is considered a medical emergency as it can lead to permanent vision loss if not promptly treated. Prompt management involves reducing intraocular pressure to prevent further damage to the optic nerve.

Correct Answer: C

Rationale: In qualitative research, a focus group discussion is a technique where a group of participants are brought together to discuss specific topics in depth. In this case, Nurse Carmi's plan to gather 6 participants who are victims of domestic violence aligns well with the focus group discussion technique. By involving multiple participants who have experienced domestic violence, she can facilitate a dynamic conversation to gather rich data and insights. This approach allows for the exploration of diverse perspectives, experiences, and opinions within the group setting, providing a deeper understanding of the issue at hand. Additionally, focus group discussions can be more cost-effective and efficient than conducting individual interviews when working with a small group of participants. Therefore, conducting a focus group discussion would be an appropriate qualitative research technique for Nurse Carmi's plan to gather data from victims of domestic violence for her questionnaires.

Correct Answer: C

Rationale: The nurse should prioritize removing the old dressing and applying a new dressing using sterile technique to minimize the risk of infection during a central venous catheter (CVC) dressing change. This is because the most critical step in preventing infection is maintaining a clean and sterile environment around the CVC insertion site. By using sterile technique, the nurse can reduce the introduction of microorganisms that could potentially lead to infection. Wearing sterile gloves and cleaning the insertion site with an alcohol-based antiseptic solution are important steps as well, but the key priority lies in applying the new dressing using sterile technique to prevent contamination and reduce the risk of infection.

Correct Answer: D

Rationale: A correlational research design is most appropriate when the aim is to find a relationship between two variables. Correlational studies examine how variables are related to each other without manipulating them. This design allows researchers to determine the strength and direction of the relationship between variables, providing valuable insights into the potential associations between different factors. Phenomenological studies focus on understanding individuals' experiences, exploratory studies investigate a topic without predefined hypotheses, and experimental studies involve manipulating variables to observe their effects. Therefore, in the context of aiming to find a relationship between two variables, a correlational research design is the most suitable choice.

Correct Answer: C

Rationale: The correct action for the nurse to take when observing signs of distress and discomfort in a patient during assessment is to offer emotional support and actively listen to the patient's concerns. Ignoring the patient's distress may lead to worsening of the patient's condition and can be detrimental to the patient's well-being. Documenting the findings and informing the healthcare provider later is important but should not be the immediate response when a patient is in distress. Administering pain medication without further assessment is also not appropriate as the nurse needs to understand the underlying cause of the distress before providing appropriate interventions. Offering emotional support and actively listening to the patient's concerns can help the nurse understand the patient's needs, provide comfort, and potentially address the root cause of the distress.

Correct Answer: B

Rationale: The presentation of a pruritic, erythematous rash with edematous plaques and vesicles on the hands and fingers in a patient with a history of exposure to detergents and frequent hand washing is most indicative of contact dermatitis. Contact dermatitis can be caused by direct contact with irritants such as detergents or chemicals, leading to skin irritation and inflammation. In this case, the history of exposure to detergents and hand washing suggests that the rash is likely due to irritant contact dermatitis. Atopic dermatitis, psoriasis, and pityriasis rosea do not typically present with the same pattern of rash in response to irritant exposure.

Correct Answer: C

Rationale: The public health nurse's participation in the essential services that are relevant and accessible to the family and the community includes informing, educating, and empowering the people about health. This is a critical aspect of the role of a public health nurse as it involves engaging with individuals and communities to provide them with accurate information about health promotion, disease prevention, and access to healthcare services. By informing, educating, and empowering the people about health, public health nurses can help individuals and communities make informed decisions about their health and well-being, leading to improved health outcomes and overall community health.