A patient presents with chest pain that worsens with inspiration and is relieved by sitting forward. There is also evidence of deep vein thrombosis (DVT) in the lower extremity. Which cardiovascular disorder is most likely responsible for these symptoms?

Correct Answer: B

Rationale: The patient's presenting symptoms of chest pain worsened by inspiration and relieved by sitting forward, with associated DVT in the lower extremity, suggest a high likelihood of pulmonary embolism. Chest pain that worsens with inspiration due to pleuritic involvement is a classic symptom of pulmonary embolism. Additionally, the presence of DVT in the lower extremity represents a risk factor for the development of pulmonary embolism, as clots originating in the deep veins can travel to the pulmonary circulation to cause an obstruction. Patients with pulmonary embolism may also exhibit signs of right heart strain, such as tachycardia, tachypnea, and sometimes hemoptysis.

Correct Answer: D

Rationale: Public Health Nursing is a specialized field of nursing that focuses on promoting and protecting the health of populations and communities rather than individuals. One of the key principles of Public Health Nursing is the emphasis on health promotion and disease prevention strategies. This involves educating and empowering individuals, families, and communities to adopt healthy behaviors and lifestyles in order to prevent illness and improve overall well-being. Public Health Nurses work to address the root causes of health disparities and advocate for policies and programs that promote the health of entire populations. While providing care to sick individuals may be a component of Public Health Nursing, the primary focus is on preventing illness and promoting health at the community level.

Correct Answer: B

Rationale: Acknowledging the patient's emotions and offering empathy and support is the most appropriate response in this situation. It is important for the nurse to show understanding and compassion towards the patient, especially when they are feeling emotional about a recent diagnosis. By acknowledging the patient's emotions, the nurse can create a supportive environment that facilitates open communication and helps the patient feel heard and valued. This approach can also help build trust between the patient and the nurse, leading to better outcomes in terms of patient care and overall well-being. Ignoring the patient's emotions, telling them to stop being emotional, or changing the subject may make the patient feel dismissed or isolated, which could negatively impact their mental and emotional state. Thus, offering empathy and support is key in helping the patient cope with their emotions and navigate through their diagnosis.

Correct Answer: A

Rationale: The theory that categorizes professionals as Novice to experts is by Patricia Benner. Patricia Benner developed the Novice to Expert model, which describes how individuals progress through five levels of proficiency in a skill or field. The five levels are Novice, Advanced Beginner, Competent, Proficient, and Expert. Benner's model is widely used in nursing education and research to understand how nurses develop their clinical skills and expertise over time.

Correct Answer: A

Rationale: In this critical situation, the safety of the wife is of utmost importance. Whenever a healthcare provider becomes aware of a direct threat to someone's safety, especially related to potential harm or violence, it is their ethical and legal responsibility to report this information to the appropriate authorities promptly. In this case, the nurse should alert the proper authorities, such as law enforcement or a mental health crisis team, to ensure that immediate steps are taken to protect the wife from harm. Confidentiality should be breached in situations where there is a clear threat to an individual's safety. Keeping the information confidential in this scenario could result in serious harm or even loss of life. The nurse must act quickly to protect the potential victim.

Correct Answer: A

Rationale: The most appropriate nursing intervention to alleviate breast engorgement and discomfort in a breastfeeding client is to encourage frequent breastfeeding or pumping sessions. Engorgement occurs when the breasts become overly full of milk, causing them to become swollen, firm, and painful. By ensuring that the baby breastfeeds frequently, the client can effectively empty the breasts, which helps to relieve engorgement and discomfort. Encouraging the client to breastfeed on demand and ensuring proper latching can help prevent further engorgement issues. Pumping can also be useful if the baby is unable to feed directly from the breast or to relieve engorgement between feedings. This intervention addresses the root cause of the problem and promotes the client's comfort and breastfeeding success. Applying cold packs, using a supportive bra or breast binder, and administering oral analgesics may provide some relief for discomfort but do not address the underlying issue of engorgement.

Correct Answer: B

Rationale: In the community setting, the essential record about the patient is the patient's chart. This chart contains all important information about the patient, including medical history, treatment plans, medications, progress notes, and any other pertinent information related to the patient's care. It serves as a crucial document for healthcare providers to track and monitor the patient's health status, facilitate communication among team members, ensure continuity of care, and make informed clinical decisions. The patient's chart is a comprehensive and centralized source of information that guides the delivery of quality care in the community setting.

Correct Answer: A

Rationale: The primary intervention that should be prioritized for managing a catheter-related bloodstream infection (CRBSI) associated with a central venous catheter is to remove the central venous catheter. CRBSI is a serious complication that can lead to severe infections and sepsis. The removal of the catheter is crucial to eliminate the source of the infection and prevent further dissemination of the pathogens into the bloodstream. Once the catheter is removed, the healthcare team can consider other interventions such as administering targeted antibiotics based on culture results, performing blood cultures to identify the causative organism, and implementing sterile dressing changes and catheter care protocols. However, immediate removal of the catheter takes precedence in managing CRBSI to prevent worsening of the infection and improve patient outcomes.

Correct Answer: B

Rationale: Loop diuretics, such as furosemide, are potent diuretics commonly used to manage conditions like edema, heart failure, and hypertension. Loop diuretics work by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidney, leading to increased diuresis. However, this mechanism of action can also lead to increased excretion of other electrolytes, such as magnesium.