A patient with advanced dementia is bedbound and at risk of developing pressure ulcers. What intervention should the palliative nurse prioritize to prevent pressure ulcer formation?

Correct Answer: C

Rationale: The most effective intervention to prevent pressure ulcers in bedbound patients at risk, such as those with advanced dementia, is to use pressure-relieving support surfaces like specialized mattresses or cushions. These surfaces help distribute the pressure evenly, reducing the risk of pressure ulcer formation on bony prominences. Turning the patient every 2 hours (choice A) can also help relieve pressure, but it may not be sufficient to prevent pressure ulcers in high-risk individuals. Applying barrier creams or moisture barriers (choice B) can help protect the skin but may not address the underlying issue of pressure on vulnerable areas. Administering prophylactic antibiotics (choice D) is not recommended for preventing pressure ulcers as it does not address the root cause of the problem and can lead to antibiotic resistance. Therefore, the priority intervention should be to use pressure-relieving support surfaces to minimize the risk of pressure ulcers in

Correct Answer: C

Rationale: The patient's symptoms of watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip suggest an infection caused by Cryptosporidium parvum. Cryptosporidium is a protozoan parasite that is commonly transmitted through contaminated water sources. Laboratory tests detecting oocysts in the stool sample are characteristic of Cryptosporidium infection.

Correct Answer: B

Rationale: The past medical history section typically includes information about a person's medical background before the current point in time. This would involve details such as prenatal history, birth history, childhood illnesses, surgeries, and medical conditions that have occurred in the past. "Current history" would be more appropriate for the present medical status and ongoing health issues, hence it does not belong in the past medical history section.

Correct Answer: A

Rationale: The nurse recommends regular monitoring of the patient's blood cholesterol levels to prevent complications from their heart disease. High levels of cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart problems such as heart attacks and strokes. Monitoring cholesterol levels allows healthcare providers to assess the patient's risk and make appropriate recommendations for managing their heart disease. Regular monitoring can help track the effectiveness of lifestyle changes or medications in lowering cholesterol levels and reducing the risk of complications.

Correct Answer: D

Rationale: The clinical presentation of chest pain, dyspnea, and a friction rub heard on auscultation is suggestive of pericarditis. The diffuse ST-segment elevation seen on the electrocardiogram (ECG) is a classic finding in pericarditis, known as the "universal sign." In contrast, stable angina typically presents with chest pain on exertion that is relieved by rest or nitroglycerin, while unstable angina presents with chest pain at rest or with minimal exertion. Acute myocardial infarction would typically present with ST-segment elevation in specific leads correlating with the area of myocardial ischemia/infarction. However, in the context of diffuse ST-segment elevation and symptoms suggestive of inflammation (friction rub), the most likely diagnosis is pericarditis.

Correct Answer: A

Rationale: Continuing Professional Development such as post-graduate study is the best strategy among the options provided for addressing short staffing in the hospital. By encouraging nurses to pursue post-graduate studies, Chief Nurse Cirila is investing in the long-term growth and development of her nursing workforce. Post-graduate studies can enhance the knowledge, skills, and expertise of nurses, making them more competent in their roles. This can lead to improved patient care outcomes, increased job satisfaction among nurses, and ultimately help in retaining and attracting talent in the hospital. Additionally, supporting nurses in their professional development can boost morale and motivation, which are crucial factors in addressing short staffing issues.

Correct Answer: A

Rationale: The patient's presentation of recurrent episodes of postnasal drip, chronic cough, halitosis, and foul-smelling, yellowish discharge from the middle meatus is highly suggestive of chronic rhinosinusitis. The presence of nasal polyps further supports this diagnosis. Chronic rhinosinusitis with nasal polyps is characterized by inflammation of the paranasal sinuses, leading to symptoms such as nasal congestion, postnasal drip, cough, and a reduced sense of smell. The yellowish discharge and foul odor are typical findings in cases of chronic rhinosinusitis with secondary bacterial infection. Nasal endoscopy may reveal edematous nasal mucosa and polyps obstructing the middle meatus, contributing to the symptoms described by the patient. Management typically involves a combination of medical therapies such as intranasal corticosteroids, saline irrigation, and antibiotics, and in some cases, surgical intervention

Correct Answer: B

Rationale: The most appropriate intervention for a patient with difficulty swallowing due to end-stage ALS and concerns about choking is to refer the patient to a speech therapist for swallowing exercises and techniques (Choice B). Speech therapists are trained to assess and manage swallowing difficulties in patients, especially those with neurodegenerative diseases like ALS. They can provide specific exercises and strategies to help the patient swallow safely and reduce the risk of choking. This intervention focuses on addressing the underlying issue causing the difficulty swallowing and aims to improve the patient's quality of life by enhancing their ability to eat and drink. The other options are not as effective or appropriate in addressing the patient's concerns.

Correct Answer: A

Rationale: The patient's presentation of fatigue, weakness, jaundice, elevated indirect bilirubin levels, reticulocytosis, and positive Coombs test is consistent with hemolytic anemia. Among the options provided, hereditary spherocytosis is the most likely condition to cause these findings.