A patient presents with progressive hearing loss, tinnitus, and vertigo. Audiometric testing reveals sensorineural hearing loss with a "carrot-shaped" configuration. Which of the following conditions is most likely responsible for this presentation?

Correct Answer: C

Rationale: Ménière's disease is characterized by the triad of symptoms including progressive sensorineural hearing loss, tinnitus, and vertigo. The audiometric testing in Ménière's disease often shows a "carrot-shaped" configuration, which refers to low-frequency hearing loss initially and eventually spreading to involve higher frequencies. This distinctive pattern of hearing loss helps differentiate Ménière's disease from other causes like Presbycusis (age-related hearing loss) or Noise-induced hearing loss. Acoustic neuroma can present with unilateral sensorineural hearing loss but typically does not exhibit the specific "carrot-shaped" configuration seen in Ménière's disease.

Correct Answer: A

Rationale: The nurse recommends regular monitoring of the patient's blood cholesterol levels to prevent complications from their heart disease. High levels of cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart problems such as heart attacks and strokes. Monitoring cholesterol levels allows healthcare providers to assess the patient's risk and make appropriate recommendations for managing their heart disease. Regular monitoring can help track the effectiveness of lifestyle changes or medications in lowering cholesterol levels and reducing the risk of complications.

Correct Answer: B

Rationale: The nurse should monitor the International Normalized Ratio (INR) closely during anticoagulant therapy for the prevention of VTE. The INR measures the clotting ability of the blood and is used to monitor the effectiveness of anticoagulant therapy, such as warfarin. Maintaining the INR within the target therapeutic range is crucial to prevent both excessive bleeding due to over-anticoagulation and clotting events due to under-anticoagulation. Close monitoring of the INR helps healthcare providers adjust the anticoagulant dosage as needed to ensure optimal therapeutic outcomes and minimize risks. Platelet count, serum sodium levels, and blood urea nitrogen (BUN) are important laboratory parameters to monitor for other medical conditions but are not specific to anticoagulant therapy.

Correct Answer: D

Rationale: A directional hypothesis predicts the direction of the relationship between variables. In this case, the statement "A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients" clearly indicates the direction of the expected relationship. This hypothesis suggests that there will be a positive or negative relationship between the caring behaviors of staff nurses and the satisfaction of ostomized patients. The terms "significant relationship" and "degree of satisfaction" indicate that the hypothesis is specific and measurable, making it suitable for testing through research methods.

Correct Answer: B

Rationale: The term "collaborative" best fits the situation where a member of the Research Committee wishes to conduct a study involving an interdisciplinary team of colleagues. Collaboration refers to individuals, in this case, researchers or professionals from different disciplines coming together, sharing their expertise, and working collectively towards a common goal or project. In an interdisciplinary study, involving a collaborative approach enhances the diversity of perspectives, skills, and knowledge brought to the research, leading to more comprehensive and well-rounded outcomes. This type of study fosters cooperation, communication, and synergy among team members, thereby promoting innovation and understanding across different areas of expertise.

Correct Answer: D

Rationale: Quality improvement focuses on proactive measures rather than reactive responses. The medical director would be more interested in establishing processes and systems that prevent issues from occurring in the first place, rather than just reacting to problems as they arise. Continuous improvement involves identifying problems, analyzing root causes, and implementing long-term solutions to prevent the issues from recurring. Therefore, reacting to correct or bad situations is not a characteristic of quality improvement that the medical director would prioritize.

Correct Answer: A

Rationale: The appropriate nursing intervention in this case is to encourage the mother to walk to facilitate labor progression. The patient is in early labor with contractions every 5 minutes, lasting 45 seconds each, and her cervix is dilated to 3 cm. Encouraging the mother to walk can help gravity assist the descent of the baby and promote cervical dilation. Walking can also help alleviate some discomfort and encourage labor progression. It is important to promote natural, non-invasive methods to support the progress of labor before considering medical interventions such as oxytocin or cesarean section. Relaxation techniques can also be beneficial in managing pain during labor.

Correct Answer: C

Rationale: Sudden, severe chest pain and dyspnea in a postpartum client could be indicative of a potential serious condition, such as a pulmonary embolism or postpartum cardiomyopathy, which require immediate medical attention. Therefore, the most appropriate nursing action would be to notify the healthcare provider immediately for further evaluation and management. Placing the client in a semi-Fowler's position may provide some comfort but does not address the underlying cause of the symptoms. Administering supplemental oxygen therapy may be necessary once the healthcare provider assesses the client. Encouraging deep breathing exercises may not be appropriate if the client is experiencing severe chest pain and dyspnea, as it could worsen the situation.

Correct Answer: B

Rationale: The nurse's best response when a patient asks about alternative treatment options is to provide the patient with information about those options, including their benefits and risks. It is important for the nurse to support the patient in their exploration of different treatment approaches and empower them to make informed decisions about their care. Dismissing the question, ignoring it, or discouraging alternative treatments are not appropriate responses and may hinder the patient's ability to make choices that align with their values and preferences. Therefore, providing information and facilitating an open discussion about alternative treatments is the most appropriate approach for the patient's best interest.