An 85-year-old woman with congestive heart failure and frailty asks about hastening her death. Which of the following is legal throughout the United States?

Correct Answer: C

Rationale: The correct answer is C: Voluntary stopping of eating and drinking. This is legal throughout the United States because it is considered a patient's right to refuse food and water, even if it may lead to death. This decision is based on the principle of patient autonomy and respects the patient's wishes. Euthanasia (A) involves actively causing death, which is illegal in the United States. Palliative sedation (B) is providing medication to relieve suffering, but not with the intention of hastening death. Physician-assisted death (D) involves a physician providing medication for a patient to self-administer to end their life, which is not legal in all states.

Correct Answer: C

Rationale: The correct answer is C because Certified Nursing Assistants (CNAs) typically provide the majority of direct patient care in nursing homes. CNAs assist with activities of daily living, monitoring patients' health, and providing emotional support. This is true in most nursing homes as they play a crucial role in patient care. Rationale: - A: Most nurses in nursing homes are not necessarily Registered Nurses (RNs), as there are also Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs) who provide care. - B: LPNs or LVNs may assist with the patient care plan under the supervision of an RN, but they do not typically develop the plan themselves. - D: Staff turnover is a major issue in nursing homes due to various factors such as workload, stress, and burnout among healthcare workers.

Correct Answer: A

Rationale: The correct answer is A because dopamine, serotonin, and norepinephrine are neurotransmitters commonly associated with mood regulation. Medications that affect these neurotransmitters can lead to symptoms of depression as a side effect. B: Gabapentin is not primarily associated with mood regulation. C: Milnacipran is an SNRI used to treat depression, not cause it. D: Cortisol is a stress hormone, not a neurotransmitter directly linked to depression symptoms.

Correct Answer: C

Rationale: The correct answer is C. The patient's age (36 years) and chronic smoking are the main reasons why a combined hormonal contraceptive would be contraindicated. Age over 35 and tobacco use increase the risk of cardiovascular complications with hormonal contraceptives. Obesity (choice A), type 2 diabetes (choice B), and a sedentary lifestyle (choice D) are also risk factors, but they are not the primary reasons for contraindicating combined hormonal contraceptives in this case.

Correct Answer: B

Rationale: The correct answer is B: A dull pain or cramp. In peripheral artery disease, calf pain is typically described as a dull ache or cramp due to inadequate blood flow to the muscles during exercise. This pain is known as claudication. Choice A is incorrect as sharp, stabbing pain is not typically associated with peripheral artery disease. Choice C, an electric shock, is more indicative of nerve-related conditions. Choice D, a pulsating pain, is more characteristic of an aneurysm rather than peripheral artery disease.