A patient who had a total gastrectomy one year ago reports a sore mouth, indigestion, and tingling in the lower extremities. Which test does the family nurse practitioner order?

Correct Answer: B

Rationale: The correct answer to this question is option B, a Complete Blood Count (CBC). In a patient who had a total gastrectomy one year ago and presents with symptoms like a sore mouth, indigestion, and tingling in the lower extremities, one of the common complications is vitamin B12 deficiency. A CBC can detect anemia related to this deficiency, providing valuable information about the patient's red blood cell count, hemoglobin levels, and mean corpuscular volume. Option A, a Blood Urea Nitrogen (BUN) level, is not indicated in this case as the symptoms described are more suggestive of a nutritional deficiency rather than a renal issue. Option C, a Liver Function Study, is also not the most appropriate test as the symptoms do not directly point to liver dysfunction. Option D, a Thyroid Function Study, is not relevant in this scenario as the symptoms are not indicative of thyroid problems. In an educational context, it is crucial for family nurse practitioners to understand the potential complications of specific surgical procedures, such as a total gastrectomy, and to be able to recognize common postoperative complications like vitamin deficiencies. Ordering the right tests based on a patient's symptoms is essential in providing timely and accurate care, ultimately leading to better patient outcomes. This case highlights the importance of clinical reasoning and diagnostic skills in the context of client-centered care.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates cultural sensitivity by acknowledging the importance of family involvement in many Asian cultures. In Chinese culture, family plays a significant role in healthcare decision-making and support for the patient. By providing the patient's father with an informational packet to read during the examination, the family nurse practitioner respects the cultural norms of involving family members in the patient's care while still maintaining the focus on the patient. Option A is incorrect because it assumes the father has questions and may not be the most appropriate way to involve him in the care process. Option B is incorrect as asking the father to leave the room disregards the cultural value of family involvement and may disrupt the patient's comfort and trust. Option C is wrong as it neglects the opportunity to engage the father in the care process, missing a chance to provide holistic care. Educationally, this scenario highlights the importance of cultural competence in healthcare. Understanding and respecting cultural practices and beliefs are crucial for providing patient-centered care. Healthcare providers need to be aware of how cultural factors influence patients' healthcare decisions and preferences, and adapt their care approaches accordingly to ensure effective communication and positive health outcomes.

Correct Answer: C

Rationale: In the context of client-centered care, the correct answer, option C, is the most appropriate choice because it showcases professional leadership qualities in a family nurse practitioner. Creating a task force to address scope-of-practice concerns demonstrates proactive collaboration, critical thinking, and initiative. This action involves gathering stakeholders, fostering teamwork, and addressing complex practice issues collectively, all of which are essential aspects of professional leadership in healthcare. Option A, adding clinical protocols to the nurse practitioner's scope of practice, while important for enhancing clinical skills, does not directly reflect professional leadership qualities. It is more about expanding individual competencies rather than leading and influencing others within the healthcare team. Option B, comparing the workplace roles of the registered nurse and the nurse practitioner, is more focused on understanding different roles within the healthcare system rather than actively demonstrating leadership qualities. While understanding roles is important, it does not necessarily equate to exhibiting professional leadership. Option D, lobbying to eliminate continuing education requirements, is not aligned with professional leadership in the context of client-centered care. Professional leadership involves advocating for best practices, continuous learning, and quality improvement, rather than seeking to eliminate educational requirements that are essential for maintaining competence and providing high-quality care to clients. In an educational context, understanding the nuances of professional leadership in nursing practice is crucial for nurse practitioners. It involves not only clinical expertise but also the ability to collaborate effectively, advocate for clients, engage in critical decision-making, and drive positive change within the healthcare system. By choosing option C as the correct answer, learners can grasp the importance of proactive leadership in addressing complex practice issues and enhancing client-centered care delivery.

Correct Answer: B

Rationale: In the context of adolescent obesity, the most appropriate health promotion strategy is motivational interviewing (Option B). Motivational interviewing is a patient-centered counseling approach that helps individuals explore and resolve ambivalence about behavior change. It is particularly effective in engaging adolescents in discussions about their health behaviors and motivating them to make positive changes. Option A, individual-based behavior modification, may be too prescriptive and may not take into account the unique needs and motivations of each adolescent. Adolescents are in a stage of development where autonomy and self-determination are crucial, making motivational interviewing a more suitable approach. Option C, parental regulation of meals, may not address the underlying issues related to adolescent obesity. While parental involvement is important in supporting healthy behaviors, adolescents also need to develop their own intrinsic motivation for behavior change. Option D, presentation of video case studies, may not actively engage adolescents in the process of behavior change. While educational materials like case studies can be helpful, they may not be as effective as a personalized, interactive approach like motivational interviewing. In an educational context, it is important to teach healthcare professionals the importance of using patient-centered approaches like motivational interviewing when working with adolescents. By understanding the unique needs and developmental stage of adolescents, healthcare providers can better support them in making sustainable behavior changes for their health and well-being.

Correct Answer: D

Rationale: Client-centered goals should meet immediate client needs, as this ensures that the client's immediate concerns and issues are addressed. Including preventative health care in client-centered goals is important because it focuses on preventing future health problems and promoting overall well-being. Additionally, rehabilitation needs should be included in client-centered goals to support clients in recovering and regaining their functional abilities. Therefore, all of the above options are correct in terms of what client-centered goals should include.