A patient receiving palliative care for end-stage renal disease is experiencing symptoms of depression. Which intervention should the palliative nurse prioritize?

Correct Answer: C

Rationale: The correct answer is C because providing emotional support and offering counseling or therapy sessions address the root cause of the patient's depression in a holistic manner. This intervention allows the patient to express their emotions, process their feelings, and receive guidance on coping strategies. Encouraging social activities (A) may not directly address the underlying emotional issues. Referring to a psychiatrist for medication (B) should be considered if counseling alone is insufficient. Exploring spiritual beliefs (D) is important but may not be the most immediate priority for addressing depression in this context.

Correct Answer: D

Rationale: The correct answer is D because Nurse Florence was asked why she requested permission to enroll in the Graduate Program for the second semester, not about her interest in Pediatric Nursing. A: Having an impressive resume to be competitive aligns with career advancement. B: Connecting with people professionally can lead to networking opportunities. C: Investing for the future implies long-term career growth. Therefore, D is the least relevant response to the question asked.

Correct Answer: C

Rationale: The correct answer is C because the documentation lacks essential details regarding the contents of the complaints, reasons for refusing the meal, and the nature of the fall. This information is crucial for understanding the patient's condition and providing appropriate care. Choice A is not directly related to the documentation provided. Choice B is about referrals and medications, which are not mentioned in the documentation. Choice D is about eating time and medications for pain, which are also not relevant to the documentation provided. Therefore, the correct answer is C as it addresses the specific missing information in the nurse's notes.

Correct Answer: B

Rationale: The correct initial step before starting TPN is to evaluate the patient's tolerance to glucose. This is crucial to ensure the patient can metabolize the glucose effectively and avoid complications such as hyperglycemia. Assessing affordability (A) is important but not the immediate concern. Identifying allergies (C) should be done but is not the first step. Assessing the patient's understanding (D) is important but not as critical as evaluating glucose tolerance before starting TPN.

Correct Answer: A

Rationale: The correct answer is A: Scabies. This presentation is classic for scabies infestation caused by the Sarcoptes scabiei mite. The intensely pruritic linear burrows are pathognomonic. Close contact with an individual with scabies increases the likelihood of transmission. The other choices, B: Pediculosis, C: Tinea corporis, and D: Contact dermatitis, do not typically present with linear burrows on the hands and wrists. Pediculosis presents with lice infestation, Tinea corporis with circular lesions, and contact dermatitis with erythema and edema.

Correct Answer: D

Rationale: The correct answer is D: Tilt the head slightly forward and angle the bottle toward the side of the nostril. This method allows for proper administration of the spray into the nasal passage, ensuring effective delivery of the medication. Tilted head helps direct the spray towards the nasal cavity without causing discomfort or leakage. It also helps prevent the medication from dripping down the back of the throat. Choices A, B, and C are incorrect: A: Finishing instillation in one nostril before moving to the other can lead to uneven distribution of medication and reduced effectiveness. B: Inhaling quickly may cause irritation and discomfort to the mucous membranes due to the forceful intake of the spray. C: Blowing the nose after spraying can expel the medication before it has a chance to be absorbed, decreasing its efficacy.

Correct Answer: B

Rationale: The correct answer is B: Acute myocardial infarction (MI) is the most common cause of cardiogenic shock. During an MI, there is significant damage to the heart muscle, leading to a decrease in cardiac output and subsequent shock. This results in inadequate tissue perfusion and oxygen delivery. Choices A, C, and D are incorrect because decreased hemoglobin level (A) may lead to anemia but is not the most common cause of cardiogenic shock. Hypotension (C) is a symptom of shock, not the cause. Coronary artery disease (D) is a risk factor for MI but not the direct cause of cardiogenic shock.

Correct Answer: A

Rationale: The correct answer is A: Bleeding. Chemotherapy can lead to low platelet counts (thrombocytopenia), increasing the risk of bleeding. The priority goal of the nurse is to prevent bleeding by taking precautions such as avoiding invasive procedures, using soft toothbrushes, and monitoring for signs of bleeding. Infection (B) is important but not the priority as bleeding can be life-threatening. Hypotension (C) is not directly related to thrombocytopenia. Diarrhea (D) is a potential side effect of chemotherapy but is not the priority when considering thrombocytopenia.

Correct Answer: D

Rationale: The correct answer is D: Diabetes insipidus. This condition is characterized by excessive thirst, large volumes of dilute urine, low urine osmolality, hypernatremia, and elevated serum osmolality. The underlying cause is a deficiency in or insensitivity to antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Hyperthyroidism (choice A) and hypothyroidism (choice B) do not directly affect urine concentration. While diabetes mellitus (choice C) can also present with polyuria and polydipsia, it would typically have high urine osmolality due to the presence of glucose. Therefore, diabetes insipidus is the most likely endocrine disorder responsible for these specific symptoms.