A patient presents with generalized weakness, headache, and difficulty concentrating. Laboratory tests reveal normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. Which of the following conditions is most likely to cause these findings?

Correct Answer: A

Rationale: The patient in this scenario presents with normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. These findings are characteristic of anemia of chronic disease, which is commonly seen in patients with chronic kidney disease (CKD). In CKD, there is a decrease in renal production of erythropoietin, leading to reduced stimulation of erythropoiesis and subsequent anemia. The normocytic normochromic anemia pattern is typical in anemia of chronic disease, as opposed to microcytic hypochromic anemia seen in iron deficiency anemia and thalassemia. Aplastic anemia is characterized by pancytopenia, which is not described in the scenario. Therefore, the most likely cause of the patient's presentation is chronic kidney disease.

Correct Answer: A

Rationale: The correct nursing intervention to prioritize in this situation is providing education on techniques to improve latch and milk transfer. Cesarean section deliveries can sometimes pose challenges for breastfeeding initiation, but with proper education and support, many women can successfully breastfeed following a C-section. By teaching the client techniques to improve latch and milk transfer, the nurse can help address the client's concerns about breastfeeding difficulties and worries about insufficient milk supply. This proactive approach empowers the client to overcome breastfeeding challenges and increase their confidence in their ability to breastfeed successfully. Referring the client to a lactation consultant for specialized support may also be beneficial, but providing initial education on latch and milk transfer is crucial in this early postpartum period. Recommending formula feedings or discouraging breastfeeding may not be appropriate interventions, as they can affect the establishment of breastfeeding and undermine the client's breastfeeding goals.

Correct Answer: C

Rationale: Nurse Mae should utilize performance evaluations to ensure that the staff adheres to their job responsibilities. Performance evaluations are structured assessments that provide a holistic view of an employee's performance against established standards and job responsibilities. By conducting regular performance evaluations, Nurse Mae can objectively measure staff performance, identify areas of strengths and weaknesses, provide feedback for improvement, and set goals for professional development. This tool is essential for monitoring and managing staff performance effectively in a healthcare setting.

Correct Answer: A

Rationale: Actively listening to what is being said is a key component of effective communication that is culturally competent. By listening attentively and showing genuine interest in understanding the perspective of the speaker, you are better able to grasp the nuances of their communication style, values, and beliefs. This allows for more effective communication that takes into consideration the cultural context of the person you are communicating with. Developing active listening skills helps in building rapport, fostering understanding, and promoting mutual respect in cross-cultural interactions.

Correct Answer: A

Rationale: The clinical findings of inspiratory crackles (also known as rales) and dullness to percussion are most consistent with a diagnosis of pneumonia. Inspiratory crackles are abnormal lung sounds heard on auscultation and are typically due to the presence of fluid or mucus in the alveoli. Dullness to percussion can indicate consolidation of lung tissue, which is a common finding in pneumonia where the alveolar spaces are filled with inflammatory exudate. These findings suggest localized lung pathology and are commonly observed in patients with pneumonia. Hemoptysis and pleuritic chest pain (Choice B) are more suggestive of pulmonary embolism or pleurisy. Clubbing of the fingers and cyanosis (Choice C) are signs of chronic hypoxemia and are not specific to pneumonia. Decreased breath sounds and tracheal deviation (Choice D) are more indicative of conditions such as a pneumoth

Correct Answer: C

Rationale: The appropriate and recommended site for insulin injection to help avoid hypoglycemia is the abdominal wall subcutaneously. This site offers a consistent and reliable rate of absorption of insulin into the bloodstream. By injecting insulin into the abdominal wall subcutaneously, it allows for better control of blood sugar levels and reduces the risk of hypoglycemia. Additionally, it is important to rotate injection sites within the chosen area to prevent the development of lipohypertrophy (thickened, rubbery areas under the skin), which can affect insulin absorption.

Correct Answer: A

Rationale: Amitriptyline, being a tricyclic antidepressant, commonly causes anticholinergic side effects. These effects include dry mouth, constipation, blurred vision, urinary retention, and confusion. Anticholinergic effects are due to the drug's inhibition of the neurotransmitter acetylcholine, which can lead to the symptoms mentioned above. These side effects can be bothersome for patients taking amitriptyline, but they are generally manageable and often improve over time as the body adjusts to the medication. In the case of bulimia treatment, the benefits of using amitriptyline to address the underlying psychological issues often outweigh the side effects.

Correct Answer: B

Rationale: Major histocompatibility complex (MHC) class I molecules are responsible for presenting endogenous antigens, such as viral or intracellular proteins, to CD8+ T cells. These antigens are derived from within the cell, either synthesized within the cell itself or taken up from the cytoplasm. CD8+ T cells, also known as cytotoxic T cells, recognize antigens presented by MHC class I molecules and play a key role in cell-mediated immunity by destroying infected or abnormal cells.

Correct Answer: C

Rationale: Option C, summarizing key points and asking clarifying questions as needed, demonstrates effective communication during the handover process. This action ensures that the nurse fully understands the information being provided and helps to prevent misunderstandings or missing critical details. By summarizing key points, the nurse confirms their understanding and can ask for clarification on any areas that are unclear. Effective communication during handovers is essential for maintaining patient safety and continuity of care.