A patient with advanced cancer experiences dyspnea and anxiety during episodes of breathlessness. Which intervention should the palliative nurse prioritize to address the patient's symptoms?

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: C

Rationale: The primary purpose of conducting an audit in a health facility is to ensure that standards are met. Audits are conducted to review and evaluate the documentation and practices within a healthcare facility to ensure compliance with established standards, protocols, procedures, and regulations. By conducting audits, the facility can identify any discrepancies, non-compliance with standards, or areas for improvement to maintain high-quality care and patient safety. This process helps in maintaining a high standard of care, reducing errors, promoting quality improvement initiatives, and ensuring the overall efficiency and effectiveness of healthcare services provided in the facility.

Correct Answer: D

Rationale: The "Rights of Medication Administration" include the following fundamental principles to ensure safe medication administration: right patient, right medication, right dosage, right route, right time, and right documentation. The price of the medication is not a part of these essential rights. These rights help to prevent medication errors and ensure that patients receive the correct medication in the correct way.

Correct Answer: D

Rationale: A trimalleolar fracture is characterized by fractures involving the lateral malleolus (distal fibula), medial malleolus (distal tibia), and the posterior tubercle of the distal tibia. This fracture pattern results in instability of the ankle joint and is often associated with widening of the ankle mortise on X-ray. The deformity and swelling seen in this patient are indicative of a trimalleolar fracture and are typically caused by a high-energy injury, such as a forceful twisting motion. Treatment for trimalleolar fractures often involves surgical intervention to stabilize the ankle joint and restore normal function.

Correct Answer: B

Rationale: The pharynx is the structure responsible for transporting food from the oral cavity to the esophagus during swallowing. When food is chewed and mixed with saliva in the oral cavity, it forms a bolus that is propelled to the pharynx by the tongue. The pharynx serves as a common passageway for both air and food, allowing the bolus to pass into the esophagus while preventing it from entering the trachea. The epiglottis, although important in preventing food from entering the airway, is not directly involved in the transportation of food from the oral cavity to the esophagus.

Correct Answer: B

Rationale: It is crucial for patients with COPD who are prescribed prednisone to be educated about the importance of not abruptly stopping the medication. Prednisone is a type of corticosteroid that should be tapered off gradually under the guidance of a healthcare provider to prevent potential withdrawal symptoms and adrenal insufficiency. Suddenly stopping prednisone can lead to serious adverse effects, including fatigue, weakness, joint pain, fever, dizziness, and potentially life-threatening complications. Therefore, adherence to the prescribed tapering schedule is essential to ensure the safe and effective management of COPD exacerbations with prednisone therapy.

Correct Answer: C

Rationale: Naloxone, also known by the brand name Narcan, is used to reverse the effects of opioid overdose. Opioids can cause respiratory depression, sedation, and other signs of toxicity. Administering naloxone can quickly reverse these effects, restoring the patient's breathing and consciousness. This makes it the appropriate choice for reversing all signs of toxicity related to opioids. Digibind (Digoxin) is used to reverse toxicity from digoxin specifically. Atropine sulfate is used for bradycardia. Diazepam (Valium) is a benzodiazepine used for anxiety, seizures, and muscle relaxation, not for reversing toxicity.

Correct Answer: C

Rationale: The symptoms described in the scenario - chest pain, dyspnea, and cyanosis - are indicative of a potential air embolism. Air embolism occurs when air enters the bloodstream, leading to blockages in blood vessels and impeding oxygen delivery to tissues. In patients receiving Total Parenteral Nutrition (TPN) through intravenous lines, the risk of air embolism exists during line manipulations, disconnections, or improper priming of the tubing. The sudden onset of symptoms like chest pain and cyanosis in a patient on TPN should raise suspicion for an air embolism, as it requires immediate intervention to prevent further complications such as cardiac arrest or stroke.

Correct Answer: A

Rationale: Urinary tract infections are strongly associated with the occurrence of preterm labor. It is important to screen for and address any urinary tract infections during pregnancy to reduce the risk of complications like preterm labor. Diagnostic procedures, such as obtaining a urine sample for testing, help healthcare providers identify and treat any infections promptly to promote a healthy pregnancy. Therefore, the nurse can explain to Patient Presley that the diagnostic procedure is necessary to detect and address any potential urinary tract infections that could impact her pregnancy.