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: A

Rationale: In a community clinic providing primary care for patients, the most common healthcare professional who manages patient care is a physician. Physicians, also known as doctors, are trained and licensed to diagnose and treat a wide range of medical conditions. They are responsible for conducting exams, prescribing medications, ordering tests, and developing treatment plans for patients. While other healthcare professionals such as nurses, midwives, and barangay health workers also play important roles in providing care, physicians typically lead the team, make critical decisions, and provide overall management of patient care in a primary care setting like a community clinic.

Correct Answer: C

Rationale: In this situation, the most appropriate way for the nurse to handle it would be to encourage the mother to keep calm because the health care team is doing their best to help Ramon recover. This response acknowledges the mother's concerns and reassures her that everything possible is being done for her son's well-being. It also helps to foster trust and rapport between the nurse, mother, and the healthcare team, which is important for effective communication and support during a challenging time. Promoting a sense of calm and trust in the healthcare professionals can help alleviate the mother's anxiety and stress, allowing her to focus on being a supportive presence for her son.

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: C

Rationale: A pituitary adenoma is a type of benign tumor that arises from the pituitary gland, which is located at the base of the brain. When a pituitary adenoma grows large enough, it can compress surrounding structures, including the optic chiasm – the point at which the optic nerves cross over in the brain. Compression of the optic chiasm can lead to symptoms such as vision problems (e.g., visual disturbances), headaches, and nausea/vomiting, which are consistent with the presentation described in the question. Meningiomas, glioblastoma multiforme, and medulloblastomas are less likely to compress the optic chiasm and present with different characteristic symptoms based on their locations and growth patterns.

Correct Answer: C

Rationale: Hypokalemia (low levels of potassium) increases the risk of digoxin toxicity. This is because digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in the cell membrane. When potassium levels are low, there is an increased binding of digoxin to these pumps, leading to enhanced entry of calcium into the cells. This can result in an increased intracellular calcium concentration, leading to digoxin toxicity and potential cardiac arrhythmias. Therefore, monitoring and correcting potassium levels is crucial in patients prescribed digoxin to reduce the risk of toxicity.

Correct Answer: A

Rationale: The correct instruction that the nurse should include in patient education about phosphate binder therapy is to "Take phosphate binders with meals." Phosphate binders are medications given to patients with chronic kidney disease to help control high phosphate levels in the blood. Taking phosphate binders with meals allows them to bind to the phosphorus present in the food, reducing its absorption in the body. This helps to lower blood phosphate levels effectively. Instructing the patient to take phosphate binders with meals ensures optimal binding of phosphorus from the diet, which is crucial for managing phosphate levels in patients with chronic kidney disease.

Correct Answer: D

Rationale: In cases where a patient becomes seriously ill or is harmed due to receiving the wrong medication, both the nurse and the hospital are likely to be held liable. The nurse is responsible for administering the correct medication to the patient, and any error in this process can lead to harm. The hospital may also be held liable for the actions of its employees, including nurses, under the legal principle of vicarious liability. Additionally, the hospital has a duty to ensure that proper protocols are in place to prevent medication errors, and failure to do so can lead to liability. Therefore, in this scenario, both the nurse and the hospital are likely to share liability for the patient's harm.

Correct Answer: D

Rationale: In the situation described, where the client experienced a prolonged labor and instrumental delivery, there may be physical and emotional factors impacting breastfeeding success. A lactation consultant is a specialized healthcare provider who can assess the client's breastfeeding difficulties, offer individualized support, and provide guidance on techniques to overcome challenges such as latch issues, positioning problems, and milk supply concerns. Referring the client to a lactation consultant will help ensure that she receives expert assistance tailored to her specific needs, thereby increasing the likelihood of successful breastfeeding. This proactive approach focuses on addressing the root causes of breastfeeding difficulties and supporting the client in achieving her breastfeeding goals.