A patient with chronic obstructive pulmonary disease (COPD) is experiencing severe dyspnea. What position should the nurse encourage the patient to assume?

Correct Answer: C

Rationale: The correct answer is C: High Fowler's. This position helps improve lung expansion and breathing efficiency by maximizing chest expansion. Sitting upright reduces pressure on the diaphragm, allowing for better ventilation. Supine (A) position can worsen dyspnea by restricting lung expansion. Prone (B) position is not ideal for COPD patients as it can hinder breathing. Trendelenburg (D) position, where the patient's feet are elevated above the head, can increase pressure on the diaphragm and impair breathing, making it inappropriate for a patient experiencing severe dyspnea.

Correct Answer: B

Rationale: The correct answer is B: Binds with phosphorus in foods and prevents absorption. Sevelamer (RenaGel) is a phosphate binder used in ESRD to reduce phosphorus levels. Taking it with meals allows it to bind with phosphorus in food, preventing its absorption in the gastrointestinal tract. This helps in controlling hyperphosphatemia, a common complication in ESRD. Choices A, C, and D are incorrect as RenaGel does not prevent indigestion, promote stomach emptying, or buffer hydrochloric acid.

Correct Answer: A

Rationale: The correct answer is A: Right upper quadrant pain. Cholecystitis is inflammation of the gallbladder, typically caused by gallstones. The gallbladder is located in the right upper quadrant of the abdomen, so pain in this area is a common symptom. The pain may also radiate to the back or right shoulder. Choices B, C, and D are incorrect because they do not typically align with the specific location of the gallbladder or the characteristic pain associated with cholecystitis.

Correct Answer: C

Rationale: The correct answer is C because genetic testing for the BRCA gene involves complex considerations beyond just the test results. By stating that there are many things to consider before deciding to have genetic testing, the nurse acknowledges the importance of discussing the potential implications of the test result, such as emotional, social, and medical factors. This response promotes informed decision-making and empowers the patient to make a well-considered choice. Choices A, B, and D are incorrect: A: This statement is inaccurate as a significant proportion of breast cancers are indeed linked to the BRCA gene mutations. B: This response oversimplifies the decision-making process by focusing solely on emotional aspects, neglecting other critical factors that should be considered before genetic testing. D: This option is not appropriate as it suggests a specific treatment option (bilateral mastectomy) without addressing the broader aspects of genetic testing and decision-making.

Correct Answer: B

Rationale: The correct answer is B: Muscle weakness. Myasthenia gravis is characterized by muscle weakness due to an autoimmune attack on acetylcholine receptors at the neuromuscular junction. This leads to impaired muscle contraction and weakness, especially in the face, neck, and extremities. Joint pain (A) is not a typical symptom of myasthenia gravis. Loss of sensation (C) is more indicative of a sensory nerve disorder rather than a motor disorder like myasthenia gravis. Severe headache (D) is not a common symptom of myasthenia gravis; it is more likely to be associated with other conditions such as migraines or intracranial pathology.

Correct Answer: A

Rationale: The correct answer is A: Report any vision changes immediately. This is crucial because hydroxychloroquine can cause retinal toxicity, which may lead to irreversible vision loss. Monitoring for vision changes allows for early detection and intervention. Choice B is incorrect as hydroxychloroquine is typically taken with food or milk to reduce gastrointestinal side effects. Choice C is irrelevant as there is no specific dietary restriction for hydroxychloroquine. Choice D is also incorrect as there is no evidence to support increasing green leafy vegetable intake in relation to hydroxychloroquine therapy.

Correct Answer: B

Rationale: The correct answer is B: Limit foods high in protein. Levodopa competes with amino acids for absorption in the small intestine, so consuming high-protein foods can reduce its effectiveness. Limiting protein intake can help maximize the absorption and efficacy of levodopa. Increasing vitamin C (option A) is not directly related to levodopa metabolism. Avoiding fiber (option C) is not necessary for levodopa therapy. Increasing sodium intake (option D) is not indicated for levodopa treatment in Parkinson's disease.

Correct Answer: C

Rationale: The correct answer is C. The patient with a sibling having newly diagnosed polycystic kidney disease may need a referral for genetic testing. Polycystic kidney disease has a genetic component, so there is a higher likelihood of the patient also having the condition. Referral for genetic testing can help in early diagnosis, management, and counseling for the patient and their family members. Choice A is incorrect because strokes in maternal grandparents at advanced ages are not typically indicative of a need for genetic testing. Choice B is incorrect as cerebral palsy is not typically a genetic condition related to the patient's pregnancy test result. Choice D is incorrect as dyspnea in a smoking patient is more likely related to respiratory issues such as chronic obstructive pulmonary disease rather than a genetic condition.

Correct Answer: A

Rationale: The correct answer is A: Take the medication with food. Allopurinol can cause stomach upset, so taking it with food can help minimize gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or stomach pain. Choice B is incorrect because increasing high-purine foods can exacerbate gout symptoms. Choice C is incorrect because limiting fluid intake can lead to dehydration, which is not recommended for gout patients. Choice D is incorrect because allopurinol does not provide immediate pain relief; it works to lower uric acid levels over time to prevent gout attacks.