A patient with a history of haemophilia A arrives in the emergency department complaining of a "funny feeling" in his elbow. The patient states that he thinks he is bleeding into the joint. Which response by the nurse is correct?

Correct Answer: B

Rationale: For a patient with a history of hemophilia A complaining of a "funny feeling" in the elbow, suspecting bleeding into the joint, the correct response by the nurse is to notify the physician immediately and expect an order for factor VIII. Hemophilia A is a genetic disorder characterized by a deficiency in clotting factor VIII, leading to prolonged bleeding. In this case, immediate medical intervention in the form of factor VIII replacement therapy is crucial to control and manage the bleeding episode. Urgent treatment aims to prevent complications such as joint damage and to promote hemostasis in patients with hemophilia. Palpating the elbow, preparing for an x-ray, or applying heat are not the appropriate initial actions when managing a suspected bleeding episode in a patient with hemophilia.

Correct Answer: C

Rationale: Corticosteroid therapy is commonly used in the treatment of multiple myeloma. It is often part of the initial treatment plan for this disease and is used to help control the cancer cells by reducing inflammation and immune responses. Corticosteroids can help manage symptoms such as pain and complications related to the disease. Bed rest, fluid restriction, and calcium replacement therapy may not be directly indicated for multiple myeloma treatment.

Correct Answer: C

Rationale: Confronting the denial is the best response in this situation. Denial is a common defense mechanism that individuals may use when faced with overwhelming emotions or situations, such as in the case of a post-mastectomy client. By confronting the denial in a supportive and empathetic manner, the nurse can help the client acknowledge and accept their feelings, which is an important step in the healing and coping process. Ignoring or supporting the denial may hinder the client's ability to address their emotions and work through them effectively. Confronting the denial allows for open communication and helps the client move towards acceptance and adjustment.

Correct Answer: D

Rationale: Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. It indicates abnormal changes in the cells that can be a precursor to cancer. In the context of a Papanicolaou test, the presence of dysplasia may suggest abnormal cell growth in the cervix, which can potentially develop into cervical cancer if left untreated. It is important for the client to follow up with healthcare providers for further evaluation and management if dysplasia is detected.

Correct Answer: D

Rationale: Sigmoidoscopy is a diagnostic study that allows direct visualization of the lower part of the colon and rectum using a flexible tube with a camera at its end, called a sigmoidoscope. This procedure enables the healthcare provider to visually inspect the lining of the colon and rectum, identify any abnormal growths, such as tumors or polyps, and obtain tissue samples for biopsy if necessary. In the case of suspected colorectal cancer, sigmoidoscopy is crucial for confirming the diagnosis by directly visualizing any cancerous lesions or abnormal tissue changes in the colon and rectum. Other diagnostic tests, such as stool hematest, abdominal CT, and CEA scan, may aid in the evaluation and staging of colorectal cancer but are not as effective in confirming the diagnosis as sigmoidoscopy. Thus, sigmoidoscopy is the preferred diagnostic study for definitively diagnosing colorectal cancer in a client suspected of having the disease.