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: The clinical manifestations of Aster suggest acromegaly, a condition characterized by the excessive growth of hands and feet due to a tumor in the pituitary gland leading to overproduction of growth hormone. Cyanosis is a bluish discoloration of the skin caused by poor oxygenation, which is not typically associated with acromegaly. The other options do not match the unique clinical manifestation described for Aster. Anemia, weight loss, moon facies, and edema are more commonly associated with other conditions like Cushing's syndrome, anemia, or heart failure.

Correct Answer: C

Rationale: In this scenario, the action that violates a psychiatric patient's rights is option C, where staff members confiscated written letters done by patients addressed to the local newspaper. Patients have the right to communicate freely and express their thoughts and feelings through various means, such as letter-writing. Confiscating these letters is a violation of their rights to free expression and communication. It is essential to respect and uphold the rights of psychiatric patients, including their right to communicate with others.

Correct Answer: A

Rationale: The nurse recommends regular monitoring of the patient's blood cholesterol levels to prevent complications from their heart disease. High levels of cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart problems such as heart attacks and strokes. Monitoring cholesterol levels allows healthcare providers to assess the patient's risk and make appropriate recommendations for managing their heart disease. Regular monitoring can help track the effectiveness of lifestyle changes or medications in lowering cholesterol levels and reducing the risk of complications.

Correct Answer: A

Rationale: Physiologic jaundice in newborns is a common and typically benign condition caused by the immaturity of the newborn's liver. The correct statement about physiologic jaundice is that it occurs due to an imbalance between the production and elimination of bilirubin. In contrast, Option A is the false statement because it incorrectly states that physiologic jaundice is caused by impairment in the removal of bilirubin deficiency in the production of glucuronide transferase. This statement is inaccurate as physiologic jaundice results from the immature liver's reduced ability to conjugate bilirubin.

Correct Answer: D

Rationale: Thyroid nodules are abnormal growths of thyroid cells that form a lump within the thyroid gland. When a thyroid nodule becomes large enough, it can cause compressive symptoms such as difficulty swallowing and breathing. The presence of colloid nodules on fine-needle aspiration biopsy indicates a benign and common type of thyroid nodule. In this case, the symptoms are likely due to the physical pressure exerted by the thyroid nodule, rather than an underlying endocrine disorder like Hashimoto's thyroiditis, Graves' disease, or diabetes mellitus. Therefore, the most likely cause of the patient's symptoms is the thyroid nodule itself.

Correct Answer: D

Rationale: Clubbing of the fingers is a specific term that Nurse Gladys should write in her charting when a patient is suffering from a change in the angle between the nail base greater than 180 degrees due to congenital heart disease. Clubbing of the fingers is a diagnostic sign associated with various medical conditions, including congenital heart disease. It is characterized by changes in the angle and shape of the nails, typically involving softening of the nail bed, enlargement of the fingertips, and a loss of the normal angle between the nail and the nail bed. Peripheral neuropathy, inflammation of the fingers, and peripheral cyanosis are different conditions and do not specifically describe the nail changes seen in clubbing.

Correct Answer: B

Rationale: Quality Improvement is a systematic approach that aims to continually enhance the quality of services or products within an organization. The statement that is true of Quality Improvement is that it focuses on continually improving every process in the organization (Option B). This includes processes related to patient care, organizational structure, and all aspects of operations. Quality Improvement involves identifying areas for improvement, implementing changes, monitoring the effectiveness of those changes, and then making further refinements. By focusing on every process within the organization, Quality Improvement helps drive positive outcomes and ensures sustainable improvements in quality and performance.

Correct Answer: D

Rationale: Referring the client to a lactation consultant for specialized support should be prioritized to support successful breastfeeding in this situation. Breast augmentation surgery may impact milk production, let-down reflex, and proper latch due to alterations in breast tissue and nerve pathways. A lactation consultant can provide individualized guidance and support to address these specific challenges. Additionally, the consultant can assist in establishing a breastfeeding plan tailored to the client's unique needs, helping to optimize the breastfeeding experience for both the mother and the baby. It is crucial to seek expert assistance in navigating any potential difficulties that may arise from breastfeeding after breast augmentation to promote successful breastfeeding outcomes.