Correct Answer: D

Rationale: The patient in this scenario exhibits signs of chronic hypertension, particularly due to the history of heart disease in her family, the postpartum persistence of elevated blood pressure, and the diagnosis of hypertension at the 6-week checkup. While pregnancy-induced hypertension (PIH), gestational hypertension, and preeclampsia can occur during pregnancy, they typically resolve within a few weeks after delivery. The fact that the patient's hypertension persists beyond the postpartum period suggests that she likely had preexisting, undiagnosed chronic hypertension. Therefore, option D is the most appropriate choice in this case.

Correct Answer: B

Rationale: The primary aim when transitioning a patient with rapid cancer metastases from active treatment to palliative care is to prevent and relieve suffering. Palliative care focuses on enhancing quality of life, managing symptoms, and addressing physical, emotional, and spiritual needs. By prioritizing the prevention and relief of suffering, healthcare providers can work towards improving the patient's comfort and overall well-being during this difficult time. This approach aligns with the goals of palliative care, which aim to provide holistic support and care for patients facing serious illnesses like cancer.

Correct Answer: C

Rationale: Distorted lines on an Amsler grid can be an indication of changes in central vision, which is commonly seen in macular degeneration. Therefore, it is crucial for the nurse to arrange for the patient to visit his ophthalmologist promptly for further evaluation and management. The ophthalmologist will be able to determine the severity of the visual changes, provide appropriate treatment options, and closely monitor the progression of macular degeneration. This proactive approach ensures that the patient receives timely and specialized care for his condition. Options A, B, and D do not directly address the urgency of the situation and the need for specialized ophthalmologic evaluation in cases of macular degeneration.

Correct Answer: B

Rationale: Smoking cessation most directly addresses the leading cause of cancer deaths in North America, which is lung cancer. Tobacco use, particularly cigarette smoking, is the primary cause of lung cancer. By helping individuals quit smoking, the public health nurse is targeting the main risk factor for lung cancer and therefore addressing the root cause of the issue. This intervention has the potential to have a significant impact on reducing cancer-related deaths in the community. Monthly self-breast exams, annual colonoscopies, and monthly testicular exams are important for detecting breast, colon, and testicular cancers respectively, but they do not directly address the leading cause of cancer deaths in North America.

Correct Answer: A

Rationale: Vaginal examination of the cervix may result in perforation of the placenta and subsequent hemorrhage in a patient admitted with suspected placenta previa. It is important to avoid any unnecessary manipulation of the cervix to prevent complications. Assessing cervical dilation and effacement should be avoided until placenta previa is ruled out to prevent harm to the patient.