Correct Answer: C

Rationale: Opioid medications are considered the first-line pharmacological treatment for dyspnea in palliative care patients with advanced cancer. Opioids help relieve dyspnea by reducing respiratory drive and the sensation of breathlessness, providing effective symptom management. In this case, addressing the patient's dyspnea with opioid medications would likely also help alleviate their anxiety related to breathlessness. Administering oxygen therapy (choice A) may not be effective at relieving dyspnea in this situation, as dyspnea in advanced cancer patients is often not primarily due to low oxygen levels. Teaching pursed-lip breathing techniques (choice B) and referring the patient to a respiratory therapist for breathing exercises (choice D) may be helpful complementary interventions, but opioid medications should be the priority for symptom management.

Correct Answer: B

Rationale: Normal saline is the preferred solution for wound irrigation because it is isotonic and will not damage healthy tissue or delay wound healing. It helps to remove debris and pathogens from the wound, promoting a clean environment for healing. Sterile water can be used if normal saline is not available, but it may cause cellular damage if used in large volumes. Hydrogen peroxide and Betadine solution are not recommended for wound irrigation as they can be cytotoxic to the tissues and interfere with the wound healing process. It's important for the nurse to use evidence-based practice and follow recommended guidelines to promote optimal wound healing outcomes.

Correct Answer: D

Rationale: Taking off the room lights and drawing the window shades would provide a calm and soothing environment for the five-year-old patient admitted due to pneumonia with symptoms of cough, respiratory distress, anxiety, and dehydration. By creating a dim and quiet atmosphere, it can help reduce the child's anxiety levels, promote rest and relaxation, and potentially aid in the management of distress caused by pneumonia. Providing a quiet and dark environment can also support the child's comfort and recovery process during the hospital stay.

Correct Answer: C

Rationale: NSAIDs are commonly known to increase the risk of gastrointestinal adverse effects, including gastritis, ulcers, and gastrointestinal bleeding. This risk is due to the inhibition of prostaglandin synthesis, which plays a protective role in the gastrointestinal mucosa. Gastrointestinal bleeding can manifest as symptoms such as black, tarry stools, vomiting blood, or abdominal pain. Therefore, it is crucial for the nurse to closely monitor the patient for signs and symptoms of gastrointestinal bleeding while taking NSAIDs to prevent potentially serious complications. Hypotension, hyperkalemia, and hyperglycemia are not commonly associated with NSAIDs use, making them less likely adverse effects to monitor for in this scenario.

Correct Answer: A

Rationale: The clinical presentation of gross hematuria, flank pain, palpable abdominal mass, along with imaging findings of a large heterogeneous renal mass with necrosis and calcifications are highly suggestive of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer in adults. The presence of necrosis and calcifications are characteristic features of RCC. Imaging modalities such as CT scans or MRI can confirm the diagnosis by showing the typical features of RCC, including a solid mass with areas of necrosis and calcifications. It is important to further evaluate this patient, likely with a biopsy, to confirm the diagnosis and determine the extent of the disease for appropriate management.