A patient with chronic kidney disease presents with periorbital edema, hypertension, and proteinuria. Laboratory findings reveal elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis. What is the most likely diagnosis?

Correct Answer: D

Rationale: The constellation of symptoms presented (periorbital edema, hypertension, proteinuria) along with the laboratory findings (elevated creatinine and urea levels, hyperkalemia, metabolic acidosis) are classical signs of chronic kidney disease (CKD). In CKD, the kidneys gradually lose their function over time, leading to impaired filtration of waste products and electrolyte imbalance. The presence of hypertension and proteinuria are common in CKD due to the compromised renal function. Additionally, elevated serum creatinine and urea levels, hyperkalemia, and metabolic acidosis are indicative of kidney dysfunction.

Correct Answer: B

Rationale: Records are IMPORTANT in health care as they serve as evidence of the health care services that have been provided to a patient. These records contain vital information such as the patient's medical history, diagnoses, treatments, medications, and test results. Keeping accurate and detailed records is crucial for monitoring a patient's progress, ensuring appropriate care is being provided, and serving as a reference point for healthcare providers involved in the patient's treatment. Additionally, health care records are essential for legal and insurance purposes, quality assessment, research, and continuity of care.

Correct Answer: A

Rationale: The presentation of a palpable, non-tender mass in the right neck, just below the angle of the mandible, along with ultrasound imaging findings of a well-defined, hypoechoic lesion with cystic components, is classic for a branchial cleft cyst. Branchial cleft cysts are congenital anomalies that arise from remnants of the branchial clefts or pouches during embryonic development. They are typically located along the anterior border of the sternocleidomastoid muscle, just below the mandible. Ultrasound imaging often shows a cystic lesion with well-defined borders and hypoechoic content, which is consistent with the described findings. Thyroglossal duct cysts usually present as midline neck masses that move with swallowing or tongue protrusion, not in the location described in the scenario. Lymphadenopathy would present as enlarged lymph nodes that may be tender and associated with systemic symptoms.

Correct Answer: C

Rationale: In cases of persistent fetal malpresentation, such as a transverse lie position, a cesarean section is often the safest and most effective intervention to address the abnormal labor presentation. Delivering a baby in a transverse lie position vaginally is associated with high risks, including fetal complications such as umbilical cord prolapse and head entrapment. Therefore, to ensure the safety of both the mother and the baby, a cesarean section is usually the most appropriate and timely intervention to address this situation. It is crucial to prioritize the immediate preparation and facilitation of a cesarean section in cases of persistent fetal malpresentation to prevent potential complications and ensure the best outcome for the mother and the baby.

Correct Answer: D

Rationale: The nurse should prioritize positioning the patient in a left lateral decubitus position during gastric lavage to ensure procedural effectiveness. This position helps to promote optimal drainage of fluid and gastric contents. Placing the patient in a left lateral position allows gravity to assist in the passage of fluid and prevents the risk of aspiration. It also helps to minimize the risk of complications such as reflux of lavage fluid into the respiratory tract. Proper positioning is essential in enhancing the success of the gastric lavage procedure and promoting patient safety.

Correct Answer: C

Rationale: Incident reports are a crucial tool for capturing data on adverse events, near misses, and other incidents within a healthcare institution. These reports help in analyzing patterns, identifying areas for improvement, and implementing quality and safety measures. Therefore, incident reports themselves are not something that needs to be prevented; instead, they are a critical part of the risk management process to enhance patient safety and quality of care.

Correct Answer: C

Rationale: The most appropriate nursing action in this scenario is to notify the healthcare provider immediately. The client's presentation of calf pain, swelling, and warmth could be indicative of a deep vein thrombosis (DVT), which is a serious condition that requires prompt evaluation and intervention by the healthcare provider. DVT is a blood clot that forms in a deep vein, often in the leg, and if left untreated, it can lead to life-threatening complications such as pulmonary embolism. Therefore, timely communication with the healthcare provider is critical to ensure that the client receives the appropriate diagnostic testing and treatment to address the potential DVT. Applying warm compresses, encouraging ambulation, or administering NSAIDs would not be the first-line interventions for a suspected DVT and may even worsen the condition.

Correct Answer: C

Rationale: The correct action for the nurse to take when observing signs of distress and discomfort in a patient during assessment is to offer emotional support and actively listen to the patient's concerns. Ignoring the patient's distress may lead to worsening of the patient's condition and can be detrimental to the patient's well-being. Documenting the findings and informing the healthcare provider later is important but should not be the immediate response when a patient is in distress. Administering pain medication without further assessment is also not appropriate as the nurse needs to understand the underlying cause of the distress before providing appropriate interventions. Offering emotional support and actively listening to the patient's concerns can help the nurse understand the patient's needs, provide comfort, and potentially address the root cause of the distress.

Correct Answer: C

Rationale: Bone pain in the back of the ribs is a classic manifestation of multiple myeloma. Multiple myeloma is a type of cancer that primarily affects plasma cells in the bone marrow, leading to weakened bones and bone pain. Patients with multiple myeloma often experience bone pain in areas such as the ribs, spine, and pelvis. The bone pain is typically persistent and worsens with movement or pressure. Additionally, other common symptoms of multiple myeloma include anemia, kidney damage, recurrent infections, and elevated calcium levels in the blood.