A patient receiving palliative care for end-stage chronic obstructive pulmonary disease (COPD) experiences chronic cough and excessive sputum production. What intervention should the palliative nurse prioritize to address the patient's symptoms?

Correct Answer: B

Rationale: Encouraging the patient to practice controlled coughing techniques would be the most appropriate intervention to address the symptoms of chronic cough and excessive sputum production in a patient with end-stage COPD receiving palliative care. Controlled coughing techniques can help the patient effectively clear respiratory secretions and improve airway clearance without the need for additional medications or interventions. This approach focuses on optimizing the patient's ability to manage their symptoms and maintain comfort, which aligns with the goals of palliative care. Administering bronchodilator medications, prescribing mucolytic medications, or referring the patient to a respiratory therapist for breathing exercises may have limited effectiveness in this advanced stage of the disease, and controlled coughing techniques would be a more practical and patient-centered approach to symptom management.

Correct Answer: B

Rationale: When communicating with a patient experiencing delirium, the nurse's priority is to provide clear and simple explanations to minimize confusion. Delirium can cause disorientation, confusion, and impaired cognitive function, making it difficult for the patient to understand complex information. Using simple language and clear explanations can help the patient better comprehend the situation and reduce anxiety. It is essential for the nurse to speak calmly, use reassuring gestures, and maintain a supportive presence to effectively communicate with a delirious patient. This approach can help establish a sense of trust and foster a therapeutic nurse-patient relationship during the challenging experience of delirium.

Correct Answer: C

Rationale: Colposcopy with biopsy is the most appropriate diagnostic test for evaluating a woman with suspected cervical dysplasia. Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to examine the cervix for any abnormal areas. If abnormal tissue is identified during colposcopy, a biopsy will be taken to confirm the presence of cervical dysplasia and determine the severity. This allows for a more accurate diagnosis and appropriate management of the condition. Pap smear, although a screening test for cervical dysplasia, may not provide a definitive diagnosis and may require further evaluation with colposcopy and biopsy. Endometrial biopsy and transvaginal ultrasound are not indicated for evaluating cervical dysplasia specifically.

Correct Answer: D

Rationale: Follicular thyroid carcinoma is a type of thyroid cancer that arises from the follicular cells of the thyroid gland. Patients with follicular thyroid carcinoma may present with a palpable thyroid nodule, which in this case is causing signs of hyperthyroidism due to the overproduction of thyroid hormones by the malignant cells. Fine-needle aspiration biopsy revealing follicular cells with nuclear features suggestive of malignancy further supports the diagnosis of follicular thyroid carcinoma in this scenario.

Correct Answer: A

Rationale: Aplastic anemia is a condition characterized by a reduction in the number of all three blood cell types: red blood cells, white blood cells, and platelets. The patient's presentation of bone pain, fatigue, frequent infections, pancytopenia (decreased counts of all blood cell types), hypocellular bone marrow (reduced cellularity in the bone marrow), and absence of reticulocytes is indicative of aplastic anemia.

Correct Answer: A

Rationale: The presentation of chest pain, dyspnea, hypotension, right ventricular dilation, and hypokinesis on echocardiogram is highly suggestive of a pulmonary embolism. In pulmonary embolism, a blood clot obstructs the pulmonary artery or one of its branches, leading to increased pressure in the right ventricle, which can cause right ventricular dilation and dysfunction. This results in the classic signs of right heart strain on echocardiogram. The patient may also present with symptoms of acute right heart failure, such as chest pain, dyspnea, and signs of hypotension. It is crucial to consider pulmonary embolism as a potential cause of these symptoms, given the high morbidity and mortality associated with this condition.

Correct Answer: B

Rationale: CPAP therapy is considered the gold standard treatment for obstructive sleep apnea (OSA) and is the most appropriate intervention for managing OSA and improving symptoms. CPAP therapy involves using a machine that delivers a continuous flow of air through a mask worn over the nose or mouth during sleep. This air pressure helps keep the airway open, preventing the collapse that causes apneas and snoring during sleep.

Correct Answer: B

Rationale: Phlebitis is the most common complication that patients may contract while on IV therapy. Phlebitis is the inflammation of the vein where the IV is inserted, which can cause redness, pain, and swelling along the vein. It can be caused by mechanical irritation, chemical irritation, or infection from the IV catheter. Prompt removal of the IV catheter and appropriate treatment are necessary to manage phlebitis and prevent further complications. While embolism, cardiac overload, and aneurysm are potential complications of IV therapy, phlebitis is more commonly seen in clinical practice.

Correct Answer: A

Rationale: Illiterate clients may have difficulty understanding spoken or written information. Using symbols and images can help convey important messages and instructions in a visual way that can be easily understood without relying on literacy skills. This communication intervention is effective in ensuring that the client understands the information being provided, promoting better adherence to treatment plans and overall health outcomes.