A patient receiving palliative care for end-stage liver cancer experiences severe nausea and vomiting despite antiemetic therapy. What should the palliative nurse consider when addressing the patient's symptoms?

Correct Answer: B

Rationale: When a patient receiving palliative care for end-stage cancer experiences severe nausea and vomiting despite current antiemetic therapy, the palliative nurse should consider switching to a different antiemetic medication with a different mechanism of action. This approach is based on the concept of individual variability in response to medications, as well as the potential development of tolerance to a particular drug. Switching to a different antiemetic with a new mechanism of action can provide the patient with a fresh chance at better symptom control by targeting different receptors or pathways involved in nausea and vomiting. It is important to consult the healthcare team and consider the patient's overall condition and medication history before making any changes in the treatment plan.

Correct Answer: C

Rationale: Osteoporosis is a condition characterized by an imbalance between bone resorption (breakdown of bone tissue) and bone formation, leading to bone thinning and increased risk of fractures. In osteoporosis, bones become weak and porous, making them more prone to fractures even with minor trauma. This condition is common in postmenopausal women and older individuals. Risk factors for osteoporosis include age, gender, family history, lack of physical activity, low calcium and vitamin D intake, smoking, excessive alcohol consumption, and certain medications. Treatment typically involves lifestyle modifications, including adequate calcium and vitamin D intake, weight-bearing exercises, and sometimes medication to help slow down bone loss and reduce fracture risk. Early detection and management of osteoporosis are crucial to prevent fractures and maintain bone health.

Correct Answer: C

Rationale: The health care team will try the oral route first for Ms. C for delivering nutrition and fluid because it is the most natural and least invasive method. If the patient is able to tolerate oral intake and has adequate oral intake, it is typically the preferred route. Only if she is unable to meet her nutritional needs orally or has difficulty swallowing, then alternative routes such as nasogastric tube, gastrostomy tube, or intravenous routes may be considered. It's important to promote oral intake whenever possible to maintain the patient's quality of life and prevent complications associated with more invasive methods.

Correct Answer: C

Rationale: The main source of nutrition for the baby during pregnancy is the placenta. The placenta is an organ that develops inside the uterus during pregnancy and provides essential nutrients and oxygen from the mother's blood to the baby through the umbilical cord. It acts as a barrier, protecting the baby from harmful substances while allowing necessary nutrients to pass through. The amniotic fluid serves as a protective cushion for the baby, the uterus provides the space for the baby to grow, and chorionic villi are small, hair-like structures on the placenta that aid in the exchange of nutrients and waste between the mother and the baby. However, the primary source of nutrition for the baby is the placenta, making option C the correct answer in this scenario.

Correct Answer: B

Rationale: Triangulation is the technique that refers to the use of multiple referents to draw conclusions about what constitutes the truth. In the context provided in the question, Nurse Tarly is organizing a study to investigate the "Caring behavior of Staff-Nurses and Satisfaction of Women with Ostomy". By gathering data from various sources such as observation, interviews, and surveys, Nurse Tarly can triangulate the information to gain a comprehensive understanding of the situation. Triangulation helps to validate findings, enhance the credibility of the study, and provide a more well-rounded view of the issue at hand.

Correct Answer: D

Rationale: Public Health Nursing is a specialized field of nursing that focuses on promoting and protecting the health of populations and communities rather than individuals. One of the key principles of Public Health Nursing is the emphasis on health promotion and disease prevention strategies. This involves educating and empowering individuals, families, and communities to adopt healthy behaviors and lifestyles in order to prevent illness and improve overall well-being. Public Health Nurses work to address the root causes of health disparities and advocate for policies and programs that promote the health of entire populations. While providing care to sick individuals may be a component of Public Health Nursing, the primary focus is on preventing illness and promoting health at the community level.

Correct Answer: B

Rationale: Sundowning is a phenomenon commonly seen in elderly individuals, particularly those with cognitive impairments like dementia, where they become more restless, anxious, confused, or agitated during late afternoon and evening hours, typically around sunset. This change in behavior can manifest as increased confusion, wandering, aggression, or vocalization. The exact cause of sundowning is not completely understood but may involve a combination of factors such as disruptions in the sleep-wake cycle, fatigue, decreased lighting, and hormonal imbalances. Managing sundowning behaviors may involve environmental modifications, maintaining a regular routine, ensuring proper lighting, and addressing any underlying medical conditions contributing to the behavior changes.

Correct Answer: D

Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.

Correct Answer: D

Rationale: The presentation described, including a well-demarcated, hyperpigmented patch with irregular borders, asymmetric color distribution, and increase in size over a short period, is concerning for melanoma. Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment in the skin. The irregular borders, color variation, and growth over time are classic signs of melanoma. Melanomas are potentially dangerous and should be evaluated promptly by a healthcare provider for proper diagnosis and treatment. It is important to distinguish melanoma from other benign lesions like melanocytic nevus (mole), lentigo simplex, and seborrheic keratosis, as early detection and treatment of melanoma can significantly impact patient outcomes.