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: A

Rationale: Betamethasone (Celestone) is a corticosteroid medication that is commonly used to promote fetal lung maturity in pregnant women at risk of preterm delivery. Administering betamethasone to the mother helps accelerate the production of surfactant in the fetal lungs, which is essential for proper lung function and development. This medication is typically given to pregnant women between 24 and 34 weeks of gestation to reduce the risk of respiratory distress syndrome in preterm infants. It does not prevent premature closure of the ductus arteriosus, delay delivery, or stop premature uterine contractions.

Correct Answer: B

Rationale: In a situation where a patient's temperature is dropping below the normal range during surgery, the nurse should prioritize actively warming the patient to prevent hypothermia. Administering a warming blanket or using a forced-air warming device are effective methods to increase the patient's body temperature and prevent any complications that may arise from hypothermia. Increasing the ambient room temperature can help, but it may not be as direct or effective as applying targeted heat sources to the patient. Documenting the temperature trend in the patient's chart is important for record-keeping purposes, but immediate action to address the dropping temperature is necessary. Continuously monitoring the patient's temperature closely is important, but action should be taken promptly to prevent further decline.

Correct Answer: D

Rationale: The most common symptom of scabies that the family would report to Nurse Emma is itchiness. Scabies is a contagious skin condition caused by the Sarcoptes scabiei mite, which burrows into the skin and lays eggs, leading to intense itching, especially at night. The itching is a result of the body's allergic reaction to the mites and their waste products. While rashes, scaling, and swelling can also occur with scabies, the hallmark and most bothersome symptom experienced by individuals with scabies is the intense itchiness, making it the most common symptom reported by affected individuals or their families during the history-taking process.

Correct Answer: C

Rationale: The patient's presentation of thyroid nodule with compression symptoms like difficulty swallowing and breathing, along with fine-needle aspiration biopsy showing a follicular pattern and colloid-filled spaces, is highly suggestive of a follicular adenoma. Follicular adenomas are benign thyroid tumors that can cause compression symptoms due to their growth and size, leading to pressure on surrounding structures in the neck area. The presence of colloid-filled spaces in the biopsy is characteristic of follicular adenomas.

Correct Answer: C

Rationale: Nitroglycerin sublingual tablets are meant to be dissolved under the tongue to allow for rapid absorption into the bloodstream. Placing the tablet under the tongue helps to bypass the first-pass metabolism in the liver, leading to a quicker onset of action and chest pain relief. Chewing, swallowing, or applying the tablet to the skin will result in decreased effectiveness or delayed onset of action. Therefore, it is important for the patient to be instructed to place the nitroglycerin tablet under the tongue and allow it to dissolve for optimal therapeutic benefit.

Correct Answer: A

Rationale: Acute Respiratory Distress Syndrome (ARDS) is a severe form of acute lung injury that is characterized by hypoxemia, bilateral pulmonary infiltrates, and noncardiogenic pulmonary edema. When managing a patient with ARDS in the ICU, the priority intervention is to provide adequate oxygenation and ventilation. Mechanical ventilation is often necessary to support gas exchange in these patients.

Correct Answer: C

Rationale: Allowing people's participation to confirm the health problems would yield better results in facilitating the recognition of the community's health issues. By involving the community members themselves in the process of identifying and acknowledging their health problems, there is a higher likelihood of garnering accurate and relevant information. This participatory approach fosters a sense of ownership and empowerment among the community members, making them more likely to actively engage in addressing the identified health concerns. Additionally, community participation can help build trust between the nurse and the residents, leading to more effective communication and collaboration in improving overall health outcomes.

Correct Answer: A

Rationale: While it is important for nurse leaders to seek input and feedback from staff members, the inappropriate aspect of this action lies in the lack of clarity. The option contains a typographical error "natter" instead of "matter," which may lead to confusion and hinder effective communication. Additionally, the word choice of "opinion" instead of a more structured and strategic approach like "feedback" or "input" could be improved for professional communication in the workplace. Therefore, this action may not be considered appropriate in a work setting due to potential misunderstandings that can arise from the lack of clarity in communication.