A patient receiving palliative care for end-stage lung disease experiences dyspnea and anxiety. What intervention should the palliative nurse prioritize to address the patient's symptoms?

Correct Answer: B

Rationale: Teaching the patient diaphragmatic breathing exercises for respiratory support would be the most appropriate intervention to address the symptoms of dyspnea and anxiety in this scenario. Diaphragmatic breathing, also known as belly breathing, focuses on engaging the diaphragm for deep, slow breaths, which can help improve lung expansion and ventilation. This technique can help the patient manage their breathing difficulty and reduce anxiety by promoting relaxation and improving oxygen exchange in the lungs. It empowers the patient with a coping strategy they can use independently to alleviate distressing symptoms at any time. Administering oxygen therapy may be beneficial, but the priority is to teach the patient a technique they can use proactively and routinely. Prescribing benzodiazepines should be considered as an adjunct if non-pharmacological interventions are ineffective in managing anxiety. Referring to a pulmonologist may be necessary for comprehensive evaluation and treatment but may not directly address the immediate symptoms of dyspnea and anxiety.

Correct Answer: B

Rationale: The patient who had a left total hip replacement surgery due to osteoarthritis needs to strictly follow the postoperative teaching of being shown how to gently irrigate the external auditory canal because this instruction is unrelated to a hip replacement surgery. The other options are not relevant to the surgery and patient's condition. Option A about airplane travel, Option C about dizziness, and Option D about hair washing are not appropriate instructions for a patient who had a hip replacement. It is important for healthcare providers to give accurate and relevant postoperative instructions to help the patient recover successfully.

Correct Answer: C

Rationale: The pancreas is the structure responsible for producing digestive enzymes and bicarbonate-rich pancreatic juice. These enzymes aid in the breakdown of carbohydrates, fats, and proteins in the small intestine to facilitate the absorption of nutrients. The pancreas plays a crucial role in the process of digestion, making it an essential organ in the digestive system. The liver is primarily involved in producing bile to aid in the digestion of fats, the gallbladder stores bile produced by the liver, and the spleen is involved in filtering the blood and storing blood cells.

Correct Answer: C

Rationale: Conducting a staff meeting is the best strategy for Nurse Nena to give feedback on patients' evaluation of health services. This option allows for direct communication and interaction with the team, ensuring that feedback is effectively conveyed, discussed, and understood by all members. Staff meetings provide a platform for open dialogue, clarification of any concerns, and collaborative problem-solving. It also promotes team cohesion and shared accountability in improving health services based on patients' feedback. This approach encourages active participation and engagement from all team members, fostering a more effective and comprehensive response to the evaluations received.

Correct Answer: B

Rationale: Record-keeping is not an optional task; it is a critical aspect of professional nursing practice. As a nurse, maintaining accurate and timely records is essential for providing quality care, ensuring legal and ethical standards are met, and promoting patient safety. Failure to keep thorough records can lead to serious consequences such as compromising patient care, violating regulations, and even facing legal consequences. Thus, record-keeping should be seen as a mandatory part of the professional duty of nurses rather than an optional task that can be done when circumstances allow.

Correct Answer: A

Rationale: The clinical presentation of fever, chills, headache, and myalgia following a trip to sub-Saharan Africa is highly suggestive of malaria, which is caused by the Plasmodium species. Specifically, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination points towards Plasmodium falciparum as the most likely causative agent.

Correct Answer: D

Rationale: When determining the existence of malpractice, intent is not considered as a factor. Malpractice typically involves unintentional actions or negligence rather than a deliberate intent to cause harm. The key factors that are usually considered in a malpractice case include duty (a legal obligation to provide a certain standard of care), causation (the link between the provider's actions and the patient's injury), and the existence of an injury resulting from the provider's actions or omissions. Intent does not play a direct role in malpractice cases, as they are focused on the standard of care provided by the healthcare professional and the harm caused as a result.

Correct Answer: D

Rationale: The patient is presenting with symptoms and laboratory findings consistent with a paraneoplastic syndrome related to Hodgkin lymphoma. In this case, the fever, chills, generalized malaise, pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement are all indicative of a paraneoplastic syndrome associated with Hodgkin lymphoma. Paraneoplastic syndromes are a group of disorders that are triggered by an abnormal immune response to a neoplasm, such as Hodgkin lymphoma, leading to various systemic manifestations.

Correct Answer: C

Rationale: Bronchoscopy is a procedure that allows direct visualization of the inside of the airways in the lungs. It is considered the most definitive method to establish a diagnosis of lung cancer as it can directly visualize any abnormal growths or tumors in the bronchial tubes. During bronchoscopy, tissue samples can be collected for biopsy to confirm the presence of cancer cells. This procedure is more accurate compared to other diagnostic methods such as chest x-ray, CT scan, cytological study of sputum, or magnetic resonance imaging in confirming a diagnosis of lung cancer.