A postpartum client reports feeling emotional and tearful despite no apparent physical discomfort. What nursing intervention should be prioritized to address the client's emotional well-being?

Correct Answer: B

Rationale: Educating the client about the "baby blues" phenomenon should be prioritized as it is a common occurrence that happens to many women after giving birth. The "baby blues" refer to feelings of sadness, irritability, and tearfulness that many new mothers experience due to hormonal changes and the stress of adjusting to motherhood. By understanding that these feelings are a normal part of the postpartum period and that they usually resolve on their own within a few weeks, the client may feel reassured and supported. Providing information and support can help the client cope with these emotions and reduce any anxiety or distress they may be feeling. If the client's emotional state does not improve or becomes more severe, further intervention such as referring to a mental health professional may be necessary. But initially, education and reassurance about the "baby blues" can be an effective nursing intervention to address the client's emotional well-being.

Correct Answer: B

Rationale: The palliative nurse should prioritize performing thoracentesis to drain the pleural fluid and relieve dyspnea in a patient with terminal cancer experiencing pleural effusion. Pleural effusion is a common complication in patients with advanced cancer and can cause significant respiratory distress. Drainage of the pleural fluid through thoracentesis can provide immediate relief by easing the pressure on the lungs and improving the patient's ability to breathe. This intervention is essential in managing dyspnea for comfort and quality of life in palliative care settings. Administering bronchodilator medications (option A) or recommending non-invasive positive pressure ventilation (option C) may not directly address the underlying cause of dyspnea in this case. While relaxation techniques (option D) can help with anxiety and overall well-being, they may not be sufficient in managing the physical symptom of dyspnea caused by pleural effusion.

Correct Answer: D

Rationale: Confirming the patient's informed consent before the procedure is the most crucial action for the nurse to prioritize to ensure procedural safety during a thoracentesis. Informed consent is a legal and ethical requirement that ensures the patient understands the purpose of the procedure, its potential risks, benefits, and alternatives. By confirming informed consent, the nurse ensures that the patient has the necessary information and has willingly agreed to undergo the procedure. This process promotes patient autonomy, prevents misunderstandings, and reduces the likelihood of legal issues related to the procedure. Additionally, verifying informed consent helps establish a foundation of trust between the healthcare team and the patient. While other actions like positioning the patient correctly and ensuring pre-procedure antibiotics may also contribute to the safety of the procedure, obtaining informed consent is the foundational step that must be prioritized.

Correct Answer: C

Rationale: The sudden onset of shortness of breath, chest pain, and cyanosis in a postpartum client could be indicative of a pulmonary embolism, a potentially life-threatening condition. Therefore, it is crucial to notify the healthcare provider immediately for further assessment and management. Prompt intervention is essential in this situation to prevent any potential complications and ensure the client receives appropriate care as soon as possible. Placing the client in a semi-Fowler's position or administering supplemental oxygen therapy may provide temporary relief, but the priority is to seek immediate medical attention. Consulting with the healthcare provider ensures that the client receives the necessary interventions promptly.

Correct Answer: A

Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, a protozoan parasite that causes malaria. The patient's symptoms of fever, chills, headache, and myalgia align with the typical presentation of malaria. Additionally, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination is characteristic of Plasmodium species, particularly P. falciparum, which causes the most severe form of malaria.

Correct Answer: A

Rationale: As a nurse manager, the most effective way to let the staff imbibe the culture of quality at the health center is to become a role model. Leading by example is a powerful way to influence behavior and attitudes within a team. By demonstrating a commitment to quality in your own work, behavior, and decision-making, you set a positive example for your staff to follow. This proactive approach creates a culture of quality that is more likely to be embraced by the team as they see it being consistently demonstrated by their leader. This can result in improved staff morale, motivation, and overall performance in delivering quality care to patients. Additionally, being a role model fosters trust and respect among the staff, which is essential for building a strong team dynamic centered around quality healthcare delivery.

Correct Answer: D

Rationale: The lesson that can be gained from this scenario is that every protocol must be followed. In this situation, failure to replace the defective electric fan immediately and having a missing fire extinguisher directly led to the fire escalating and causing significant damage. By ensuring that all safety protocols and procedures are followed promptly and consistently, potential hazards and risks can be mitigated or prevented. It is crucial for employees to understand the importance of adhering to established protocols in order to maintain a safe working environment and prevent accidents or emergencies.

Correct Answer: A

Rationale: When a nurse involves well-being in her definition of health, it indicates a holistic approach that considers not only physical health but also emotional, mental, and social aspects of well-being. In the context of a family confronting the imminent death of a family member, the primary concern of the nurse would be to focus on reinforcing the need for the whole family to adapt to the impending death. This involves providing emotional support, facilitating communication, addressing coping mechanisms, and assisting the family in coming to terms with the situation. By emphasizing the importance of the whole family adapting to the imminent death, the nurse can help promote holistic well-being for the family during this challenging time.

Correct Answer: B

Rationale: Magnesium sulfate is used to prevent eclampsia, but it can lead to toxicity if levels become too high. One common sign of magnesium toxicity is increased deep tendon reflexes, also known as hyperreflexia. This occurs because magnesium is a muscle relaxant, and elevated levels can lead to over-relaxation of muscles, causing an exaggerated reflex response. Other signs of magnesium toxicity include respiratory depression, decreased urine output, and cardiac arrest. Therefore, in a woman receiving intravenous magnesium sulfate during labor, an increase in deep tendon reflexes would indicate potential toxicity and require immediate intervention.