A patient receiving palliative care for end-stage amyotrophic lateral sclerosis (ALS) experiences difficulty swallowing and expresses concerns about choking. What intervention should the palliative nurse prioritize to address the patient's concerns?

Correct Answer: B

Rationale: The most appropriate intervention for a patient with difficulty swallowing due to end-stage ALS and concerns about choking is to refer the patient to a speech therapist for swallowing exercises and techniques (Choice B). Speech therapists are trained to assess and manage swallowing difficulties in patients, especially those with neurodegenerative diseases like ALS. They can provide specific exercises and strategies to help the patient swallow safely and reduce the risk of choking. This intervention focuses on addressing the underlying issue causing the difficulty swallowing and aims to improve the patient's quality of life by enhancing their ability to eat and drink. The other options are not as effective or appropriate in addressing the patient's concerns.

Correct Answer: A

Rationale: Albuterol (salbutamol) is a short-acting beta agonist bronchodilator commonly used for quick relief of bronchoconstriction in patients with COPD. It works by relaxing the smooth muscles in the airways, allowing for easier breathing and improved airflow. The patient's increased dyspnea, wheezing, and productive cough are indicative of bronchoconstriction, and albuterol is the most appropriate medication to provide rapid bronchodilation and symptom relief in this situation. Diphenhydramine (Benadryl) is an antihistamine and not typically used for bronchodilation in COPD. Montelukast (Singulair) is a leukotriene receptor antagonist that may be used in the maintenance treatment of COPD but is not the initial choice for acute symptom relief. Prednisone is a cortic

Correct Answer: A

Rationale: The patient's presentation of fatigue, weakness, jaundice, elevated indirect bilirubin levels, reticulocytosis, and positive Coombs test is consistent with hemolytic anemia. Among the options provided, hereditary spherocytosis is the most likely condition to cause these findings.

Correct Answer: A

Rationale: Natural killer (NK) cells play a vital role in the innate immune response by identifying and eliminating virus-infected cells, as well as tumor cells, without the need for prior exposure or activation. NK cells are able to detect abnormal cells by recognizing changes in the cell surface molecules, such as downregulation of MHC class I molecules. Once activated, NK cells release cytotoxic granules containing perforin and granzyme, leading to the destruction of the target cell. This direct killing mechanism is crucial for controlling viral infections and preventing the development of tumors. NK cells do not produce antibodies (option B), present antigens to T cells (option C), or release cytokines to recruit other immune cells (option D) as their primary function in the immune response.

Correct Answer: B

Rationale: Pelvic inflammatory disease (PID) is the most likely cause of the symptoms described in the pregnant woman. PID is an infection of the female reproductive organs, typically caused by sexually transmitted bacteria like Chlamydia or Gonorrhea. The classic presentation includes lower abdominal pain, fever, vaginal discharge, cervical motion tenderness, and bilateral adnexal tenderness on examination. This condition can lead to serious complications if not promptly treated, including infertility, ectopic pregnancy, and chronic pelvic pain. Therefore, it is crucial to diagnose and manage PID promptly, especially in pregnant women, to prevent adverse outcomes.

Correct Answer: A

Rationale: Prior to a gastric lavage procedure, it is essential for the nurse to ensure the correct size of the nasogastric tube is selected. The appropriate size of the tube will allow for effective removal of the ingested poisonous substance during the procedure. Proper sizing also helps in preventing complications such as injury to the gastrointestinal tract or inadequate removal of the substance. This step is crucial for the safe and successful completion of gastric lavage. Reminding parents to be careful, obtaining informed consent immediately, or accusing them of negligence are not immediate responsibilities of the nurse in this context.

Correct Answer: C

Rationale: In a primiparous patient who complains of unrelieved perineal pain on the first postpartum day, Nurse Kayla should assess for a perineal hematoma. A perineal hematoma is a collection of blood in the perineal tissues and can cause significant pain and discomfort. It can be a result of trauma during delivery or due to a blood vessel rupture. This condition requires prompt assessment and intervention to prevent complications such as infection or excessive bleeding. Vaginal laceration would typically be identified during the delivery process and would have been repaired by the healthcare provider. History of drug abuse, while important to know for overall patient care, is not as relevant in this immediate postpartum pain assessment. Puerperal infection usually presents with other signs such as fever, foul-smelling discharge, and uterine tenderness, which are not mentioned in this scenario.

Correct Answer: C

Rationale: The appropriate management for a conscious patient experiencing a seizure is to follow these steps:

Correct Answer: B

Rationale: The nurse should provide accurate information about the medication, including potential side effects, to address the patient's concerns. It is important for the nurse to listen to the patient's worries and provide them with the knowledge they need to make an informed decision about their treatment. By educating the patient about the medication and its potential side effects, the nurse empowers the patient to be actively involved in their care and promotes shared decision-making. Disregarding the patient's concerns, encouraging them to stop taking the medication, or minimizing the importance of their worries are not appropriate responses and may negatively impact the patient-nurse relationship and the patient's adherence to the prescribed treatment.