During a patient consultation, the nurse notices the patient seems anxious and is avoiding eye contact. What is the most appropriate action for the nurse to take?

Correct Answer: B

Rationale: The most appropriate action for the nurse to take when noticing that the patient seems anxious and is avoiding eye contact is to ask the patient if they are feeling anxious and if they would like to talk about it. This approach shows empathy, concern, and openness to addressing the patient's emotional state. By directly acknowledging the patient's behavior and giving them the opportunity to express their feelings, the nurse can create a supportive and caring environment that promotes effective communication and trust between the patient and healthcare provider. It is important to consider the patient's emotional well-being alongside their physical health during consultations.

Correct Answer: B

Rationale: Hodgkin's disease commonly affects young adults between the ages of 15 to 35 and older adults over the age of 50. It is not a disease that occurs most often in older adults. In fact, Hodgkin's disease has a bimodal distribution, meaning it peaks in young adults and again in older adults. It is important to consider the age distribution when suspecting Hodgkin's disease and not exclusively associate it with older adults.

Correct Answer: C

Rationale: Autonomy is the ethical principle that upholds an individual's right to make decisions about their own medical treatment, free from coercion or undue influence. In this scenario, the 70-year-old patient has voluntarily decided not to have the pacemaker inserted despite the physician's recommendation. The fact that the decision is respected by the family further highlights the importance of autonomy in this situation. Respecting the patient's right to make choices regarding their own healthcare, even if it goes against medical advice, demonstrates a commitment to autonomy as an ethical principle.

Correct Answer: C

Rationale: In a critically ill patient admitted to the ICU with acute renal failure requiring renal replacement therapy (RRT), the healthcare team should prioritize the initiation of continuous renal replacement therapy (CRRT). CRRT is preferred in critically ill patients with hemodynamic instability as it allows for slow and continuous removal of solutes and fluids, making it a safer option compared to intermittent hemodialysis. CRRT can also provide better control of volume status and electrolyte imbalances over a longer period, which is beneficial in critically ill patients who are hemodynamically unstable. Peritoneal dialysis is not commonly used in the ICU setting for acute renal failure requiring RRT, and loop diuretics are not effective in treating acute renal failure. Temporary hemodialysis catheters may also be used, but CRRT is generally preferred in critically ill patients for better hemodynamic tolerance and control of solute and fluid removal.

Correct Answer: C

Rationale: Clients undergoing nasogastric suctioning are at highest risk for developing metabolic imbalances, specifically metabolic acidosis. Nasogastric suctioning can lead to the loss of gastric acid, which in turn can cause metabolic acidosis due to a decrease in bicarbonate levels in the body. This disruption in the acid-base balance can result in symptoms such as confusion, headache, and overall malaise. It is crucial for the nurse to monitor the client's acid-base status closely and provide appropriate interventions to prevent or correct metabolic acidosis.

Correct Answer: B

Rationale: The type of pregnancy test is not a factor that should be considered by the nurse or the pregnant woman in interpreting the results of a pregnancy test. Factors such as the last menstrual period, previous pregnancy history, and menstrual cycle length play a crucial role in determining the reliability and accuracy of the pregnancy test results.

Correct Answer: B

Rationale: Becoming emotional is an example of a barrier to successful negotiation because emotions can cloud judgment, lead to irrational decision-making, and hinder effective communication. When negotiating, it is important to remain calm, composed, and rational to navigate the discussion effectively. Emotions can derail the negotiation process, making it challenging to find common ground and reach a mutually beneficial agreement.

Correct Answer: D

Rationale: The best course of action in this scenario is to place a warm wet washcloth over Claudia's eyes for at least three minutes. This will help soften and loosen the dried crust, making it easier to gently clean her eyes and open them. Applying eye drops or ointment may not be effective if the crust is blocking her eyes completely. By using a warm wet washcloth, you can improve the ability to clean her eyes effectively and without causing discomfort.

Correct Answer: C

Rationale: Reflecting the patient's feelings and expressions is a therapeutic communication technique that involves mirroring back the patient's emotions and thoughts. By doing this, the nurse validates the patient's experiences and helps them explore their feelings further. This technique can enhance the patient's self-awareness and promote emotional expression, leading to a deeper understanding of their conflicting emotions. Offering advice (Option A) may not be as effective because the focus should be on helping the patient process their own emotions. Providing reassurance and false hope (Option B) can hinder the patient's emotional exploration and may lead to trust issues if the reality does not align with the false reassurance. Redirecting the conversation to a different topic (Option D) avoids addressing the patient's conflicting emotions, which is crucial for therapeutic communication and support.