As the nurse enters a patient's room, the nurse finds her crying. The patient states that she has just found out that the lump in her breast is cancer and says, 'I'm so afraid of, um, you know.' The nurse's most therapeutic response would be to say in a gentle manner:

Correct Answer: A

Rationale: The correct response, option A, "You're afraid you might lose your breast?" is the most therapeutic because it demonstrates active listening and empathy towards the patient's emotional state. By reflecting the patient's feelings back to her, the nurse shows understanding and opens up a supportive dialogue, allowing the patient to express her fears and concerns. Option B, "No, I'm not sure what you are talking about," is dismissive and invalidating of the patient's emotions, which can worsen the patient's distress. This response lacks empathy and fails to address the patient's immediate emotional needs. Option C, "I'll wait here until you get yourself under control, and then we can talk," is insensitive and implies impatience. It disregards the patient's current emotional state and fails to offer immediate support or comfort. Option D, "I can see that you are very upset. Perhaps we should discuss this later," is also not as therapeutic as option A. It postpones the conversation and does not actively engage with the patient's feelings in the moment, missing an opportunity to provide immediate emotional support and connection. In an educational context, this scenario highlights the importance of therapeutic communication skills in nursing practice. Active listening, empathy, and validation of patient emotions are crucial in establishing trust and rapport with patients, especially in sensitive situations like delivering a cancer diagnosis. Nurses must prioritize patient-centered care and emotional support to effectively meet the holistic needs of patients.

Correct Answer: B

Rationale: In this scenario, option B, "Consider these findings normal for a 1-month-old infant," is the correct choice. During infancy, it is typical for an infant's head circumference to be larger than their chest circumference. These measurements fall within the expected range for a 1-month-old infant and do not raise any immediate concerns regarding growth or development. Option A, "Refer the infant to a physician for further evaluation," is incorrect as there are no alarming signs in the provided measurements that would warrant an immediate referral to a physician. Option C, "Expect the chest circumference to be greater than the head circumference," is incorrect as it goes against typical infant growth patterns where the head circumference is usually larger in proportion to the chest circumference. Option D, "Ask the parent to return in 2 weeks to re-evaluate the head and chest circumferences," is unnecessary in this case as the measurements are within the normal range for a 1-month-old infant and do not require immediate reassessment. Educationally, understanding normal variations in infant growth parameters is crucial for healthcare providers to appropriately assess and monitor infant development. It is essential to recognize what is considered normal versus abnormal to provide appropriate care and avoid unnecessary referrals or interventions.

Correct Answer: D

Rationale: In the context of measuring blood pressure, the correct answer is D) Peripheral vascular resistance. This is because blood pressure is determined by the resistance the blood encounters as it flows through the blood vessels. Peripheral vascular resistance refers to the resistance offered by the small arteries throughout the body. When these arteries constrict, the resistance increases, leading to higher blood pressure. Option A) Pulse rate is incorrect because while pulse rate is related to cardiovascular health, it specifically refers to the number of times the heart beats per minute and not directly to blood pressure. Option B) Pulse pressure is the difference between the systolic and diastolic blood pressure readings. While pulse pressure is an important indicator of cardiovascular health, it is not a factor that directly determines blood pressure. Option C) Vascular output is not a direct factor in determining blood pressure. Vascular output refers to the amount of blood pumped by the heart in a minute and is more related to cardiac output than blood pressure. Understanding the factors that influence blood pressure is crucial for healthcare professionals to accurately assess a patient's cardiovascular health. Knowledge of peripheral vascular resistance helps nurses and other healthcare providers in interpreting blood pressure readings, identifying abnormalities, and making informed decisions regarding patient care and interventions.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Hypopituitary dwarfism. This condition is characterized by a deficiency in growth hormone production, leading to stunted growth and delayed development. The child's appearance of being significantly younger than his age, chubby with infantile facial features, and measuring below the third percentile for growth rate aligns with the characteristic features of hypopituitary dwarfism. Option B) Achondroplastic dwarfism is characterized by short stature with disproportionately short arms and legs, not chubby or with infantile facial features. Option C) Marfan syndrome presents with tall stature, long limbs, and other distinct features like arachnodactyly and joint hypermobility, which do not match the child's description. Option D) Acromegaly is a condition of excessive growth hormone production, leading to enlarged bones and tissues, not characteristic of the child's appearance. Educationally, understanding the physical manifestations of different growth disorders is crucial in pediatric health assessment. Recognizing these features aids in early identification, appropriate referrals, and timely interventions to support the child's growth and development. It also highlights the importance of comprehensive health assessments and the role of healthcare providers in promoting optimal growth and well-being in children.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Jaundice. Jaundice is a condition characterized by a yellowish discoloration of the skin, sclera, and mucous membranes due to an excess of bilirubin in the blood. The nurse can rule out other options based on the findings described. A) Pallor refers to a pale or whitish appearance of the skin, which is not consistent with the yellowish-brown skin observed in this patient. C) Cyanosis is characterized by a bluish discoloration of the skin and mucous membranes due to decreased oxygen levels in the blood. Since the patient's skin is not bluish, cyanosis can be ruled out. D) Iron deficiency does not typically manifest as yellowish-brown skin discoloration but may present with other symptoms such as fatigue, weakness, and pale skin. Educationally, understanding the variations in skin color and their clinical significance is crucial for accurate health assessments. This case highlights the importance of recognizing jaundice based on specific skin manifestations and differentiating it from other conditions that present with varying skin discolorations. Nurses must be adept at interpreting these findings to provide appropriate care and make informed clinical decisions.