A patient presents with sudden-onset weakness and sensory loss on one side of the body along with difficulty speaking and understanding speech. Imaging reveals an acute infarction involving the right middle cerebral artery territory. Which of the following neurological conditions is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The patient is presenting with sudden-onset weakness and sensory loss on one side of the body along with difficulty speaking and understanding speech, which are classic symptoms of a stroke. The involvement of the right middle cerebral artery territory on imaging suggests an acute infarction, confirming an ischemic stroke. Ischemic stroke occurs due to a blockage or obstruction within a blood vessel supplying blood to the brain, leading to a lack of oxygen and nutrients reaching brain tissue. This results in neurological deficits corresponding to the affected area of the brain. In contrast, a transient ischemic attack (TIA) would present with similar symptoms but resolve within 24 hours without evidence of acute infarction on imaging. Intracerebral hemorrhage and subarachnoid hemorrhage involve bleeding into the brain tissue or the space surrounding the brain, respectively, resulting in different clinical presentations.

Correct Answer: B

Rationale: The stomach is responsible for producing hydrochloric acid and intrinsic factor. Hydrochloric acid helps in the breakdown of proteins during digestion, while intrinsic factor aids in the absorption of vitamin B12 in the small intestine. These two components are crucial for the proper functioning of the digestive system, particularly in breaking down food and absorbing essential nutrients. The liver is involved in bile production, the pancreas in the production of digestive enzymes, and the small intestine in nutrient absorption, but the specific functions related to hydrochloric acid and intrinsic factor are primarily attributed to the stomach.

Correct Answer: A

Rationale: The recommended position for a conscious patient experiencing an acute asthma exacerbation is the High-Fowler's position. This position involves the patient sitting upright or almost upright at about a 90-degree angle. The High-Fowler's position helps improve ventilation by expanding the lungs and maximizing airflow in and out of the airways. It also reduces the work of breathing in patients with asthma by allowing gravity to assist in moving air in and out of the lungs more easily. Additionally, this position can help alleviate shortness of breath and improve oxygenation in patients experiencing an asthma exacerbation.

Correct Answer: A

Rationale: Option A is the most appropriate nursing intervention to facilitate effective communication with the 80-year-old male patient. This approach involves waiting for the patient to be fully awake before discussing important information about the surgery and potential post-surgery events with both the patient and family. This allows the patient to fully comprehend the information provided and ask any necessary questions. Effective communication is crucial in promoting patient understanding and cooperation, especially in older adults who may require additional time to process information due to factors such as age-related cognitive changes. It is important to ensure that the patient receives clear and accurate information to support their recovery process and reduce anxiety.

Correct Answer: B

Rationale: The most appropriate response from the nurse when a patient expresses frustration with the treatment plan proposed by the healthcare team is to empathize with the patient's frustration and explore their concerns further. It is important to actively listen to the patient, acknowledge their feelings, and address any questions or uncertainties they may have about the treatment plan. By engaging in open communication and demonstrating empathy, the nurse can foster a therapeutic relationship with the patient and work towards finding a solution that is mutually agreeable and beneficial for the patient's well-being. Dismissing the patient's concerns (Option A) or ignoring their frustration (Option C) can lead to a breakdown in communication and trust, which may ultimately impact the patient's compliance with the treatment plan. Similarly, telling the patient that they have no choice but to follow the treatment plan (Option D) can be perceived as dismissive and confrontational, which is not conducive to promoting patient-centered care.

Correct Answer: B

Rationale: The patient can tell all information to the nurse once the feeling of security is established in the nurse-patient relationship. Open communication and sharing of information are essential components of nursing care. Patients are more likely to disclose personal information, concerns, and feelings when they trust their nurse and feel secure in the relationship. Building trust and creating a safe and supportive environment are crucial for effective therapeutic communication and holistic patient care. It is important for the nurse to establish a trusting relationship with the patient to encourage open communication and provide patient-centered care.

Correct Answer: B

Rationale: Refeeding syndrome is a potentially dangerous condition that can occur in malnourished individuals when nutrition is reintroduced too quickly. It is characterized by shifts in electrolytes, fluid imbalance, and metabolic abnormalities. Monitoring for decreased bowel sounds, nausea, bloating, and abdominal distention is the priority action to prevent complications associated with refeeding syndrome. These symptoms can indicate gastrointestinal issues such as ileus or overfeeding, which can lead to further complications. Early recognition and intervention can help prevent serious consequences of refeeding syndrome.

Correct Answer: A

Rationale: IgA is the primary immunoglobulin class involved in providing passive immunity to newborn infants through breast milk. IgA antibodies are highly concentrated in colostrum and breast milk, offering important protection to newborns against infections. IgG antibodies can also be passed from the mother to the fetus through the placenta, providing passive immunity during pregnancy, but IgA is the main immunoglobulin class transferred through breast milk for protecting the infant's gastrointestinal and respiratory tracts. IgE is mainly involved in allergies and hypersensitivity reactions, while IgM is an early responder in the immune response to infections.

Correct Answer: B

Rationale: Autonomy is the ethical principle that respects an individual's right to make their own decisions about their medical treatment, even if it goes against medical advice or the preferences of others. In this case, the 70-year-old patient has voluntarily decided not to have the pacemaker inserted despite the physician's recommendation. The fact that the patient's decision is respected by the family reflects the importance of honoring the patient's autonomy and right to make decisions about their own healthcare.