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: Toll-like receptors (TLRs) are a group of cellular receptors responsible for recognizing pathogen-associated molecular patterns (PAMPs), which are molecular components commonly found on pathogens like bacteria and viruses. When TLRs recognize these PAMPs, they initiate signaling pathways that trigger the innate immune response, leading to inflammation, antimicrobial defense, and the activation of adaptive immunity. B cell receptors (BCRs) and T cell receptors (TCRs) are involved in adaptive immune responses and recognize specific antigens rather than PAMPs. Fc receptors primarily bind to the Fc portion of antibodies and are involved in antibody-mediated immune responses. Thus, TLRs specifically play a critical role in sensing and responding to pathogens through the recognition of PAMPs.

Correct Answer: A

Rationale: Confirmability is the criteria of trustworthiness that refers to the degree to which the findings of a study are based on the data itself and not on the biases, motivations, or interests of the researchers. In this scenario, returning to the participants to confirm the accuracy of the emerged themes is a way to ensure the confirmability of the study findings. By involving the participants in the validation process, the researchers are seeking to verify that the themes identified truly reflect the experiences of the pregnant women in labor as reported by the participants. This practice enhances the credibility and trustworthiness of the study's findings by confirming their alignment with the participants' perspectives and experiences.

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.

Correct Answer: A

Rationale: Von Willebrand disease is a hereditary bleeding disorder that results from a deficiency or dysfunction of von Willebrand factor (vWF), a protein that plays a key role in platelet adhesion and the initiation of primary hemostasis. The clinical manifestations of von Willebrand disease include recurrent mucocutaneous bleeding, such as nosebleeds, easy bruising, and gum bleeding. Laboratory findings typically show a prolonged bleeding time due to impaired platelet function, while platelet count, PT (prothrombin time), and aPTT (activated partial thromboplastin time) are usually normal. This distinguishes von Willebrand disease from other bleeding disorders such as hemophilia A (Factor VIII deficiency), which would show abnormal PT and aPTT due to deficiencies in specific clotting factors. Thrombocytopenia, on the other hand, would be characterized by a low platelet count