A patient with suspected tuberculosis (TB) presents with cough, weight loss, night sweats, and hemoptysis. Chest X-ray reveals upper lobe infiltrates and cavitation. Which of the following diagnostic tests is most appropriate for confirming the diagnosis of pulmonary TB?

Correct Answer: A

Rationale: In a patient with suspected pulmonary TB, the most appropriate diagnostic test for confirming the diagnosis is the sputum acid-fast bacilli (AFB) smear and culture. This test involves examining sputum samples under the microscope for the presence of acid-fast bacilli, which are characteristic of Mycobacterium tuberculosis, the bacteria that causes TB. Additionally, culturing the sputum allows for the bacteria to grow in a controlled environment, further confirming the diagnosis. In the given scenario, the patient's symptoms (cough, weight loss, night sweats, hemoptysis), along with chest X-ray findings of upper lobe infiltrates and cavitation, are highly suggestive of pulmonary TB. Therefore, performing a sputum AFB smear and culture is crucial for definitive diagnosis and initiation of appropriate treatment. The other options (Tuberculin skin test, Interferon

Correct Answer: C

Rationale: Whole health education in public health aims to provide individuals and communities with opportunities to improve their overall health and well-being by promoting healthy behaviors, creating supportive environments, and offering resources for prevention and early intervention. This approach focuses on empowering people to make informed choices that lead to better health outcomes and reduce the risk of developing diseases such as hypertension. By increasing access to healthcare services, promoting healthy lifestyles, and addressing underlying social determinants of health, public health education seeks to create better health opportunities for everyone in the community.

Correct Answer: B

Rationale: The nurse's best approach to address non-compliance with prescribed medications and treatment plans is to actively listen to the patient's reasons for non-compliance. By acknowledging and addressing any barriers or concerns the patient may have, the nurse can work collaboratively with the patient to find effective solutions. This approach promotes open communication, trust, and a patient-centered care plan that takes into consideration the patient's individual needs and circumstances. Dismissing the patient's reasons (choice A), ignoring the non-compliance (choice C), or resorting to a confrontational approach (choice D) are less effective strategies that may lead to further resistance and hinder the patient's willingness to engage in their treatment.

Correct Answer: D

Rationale: It is important for the nurse to explore Ella's feelings further when she expresses thoughts of wishing to be dead and struggling with not having someone around. These statements indicate that Ella may be experiencing emotional distress or depression, which require immediate attention. By exploring Ella's feelings, the nurse can assess the severity of her emotional state, provide appropriate support, and potentially prevent any harm or self-harm. It is crucial to address and validate her emotions, as well as to initiate necessary interventions to ensure her safety and well-being.

Correct Answer: A

Rationale: Clients who are taught skills such as measuring blood glucose, taking blood pressure, changing dressings, and bathing infants are learning skills that involve physical movement and coordination. These activities require the integration of mental and physical skills, and they fall under the psychomotor domain of learning. In this domain, individuals develop physical skills and coordination through practice and repetition. The psychomotor domain is one of the three domains of learning, along with the cognitive domain (which involves knowledge and intellectual skills) and the affective domain (which involves emotions, values, and attitudes).

Correct Answer: B

Rationale: During the acute phase response, C-reactive protein (CRP) primarily serves to activate the complement system. CRP binds to phosphocholine on the surface of pathogens, allowing for the activation of the classical pathway of the complement system. This leads to the recruitment of immune cells, opsonization of pathogens, and enhancement of phagocytosis. The activation of the complement system by CRP plays a crucial role in the host defense against infections, aiding in the elimination of pathogens and the resolution of inflammation.

Correct Answer: A

Rationale: Assisting the mother into a hands-and-knees position should be prioritized to facilitate fetal rotation and optimize labor progress in the case of persistent occiput posterior fetal position. This position helps in promoting fetal rotation to a more favorable position for delivery by allowing the baby's head to move into the anterior position. It can help alleviate back pain and may help reduce the duration of labor. This simple maneuver can sometimes correct the malposition without the need for interventions like instrumental delivery. It is a non-invasive and effective technique that can be easily implemented by healthcare providers to support the progression of labor.

Correct Answer: D

Rationale: The patient is presenting with symptoms and laboratory findings consistent with a paraneoplastic syndrome related to Hodgkin lymphoma. In this case, the fever, chills, generalized malaise, pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement are all indicative of a paraneoplastic syndrome associated with Hodgkin lymphoma. Paraneoplastic syndromes are a group of disorders that are triggered by an abnormal immune response to a neoplasm, such as Hodgkin lymphoma, leading to various systemic manifestations.

Correct Answer: B

Rationale: When a woman in active labor is receiving intravenous oxytocin for labor augmentation, it is essential to increase the oxytocin infusion rate gradually to prevent oxytocin-induced uterine hyperstimulation. Uterine hyperstimulation can lead to complications such as fetal distress, uterine rupture, and postpartum hemorrhage. By increasing the oxytocin infusion rate gradually, the uterus has more time to adapt to the medication and reduces the risk of hyperstimulation. It is crucial for the healthcare provider to carefully monitor the woman's response to oxytocin and adjust the infusion rate as needed to ensure safe and effective labor augmentation. Monitoring for signs of uterine hyperstimulation, such as persistent contractions close together or excessive uterine activity, is crucial in preventing complications and ensuring the well-being of both the mother and baby.