During a physical examination, a patient presents with swollen lymph nodes. How should you adjust your palpation technique based on the findings?

Correct Answer: A

Rationale: In pharmacology, understanding how to adjust palpation techniques during a physical examination is crucial for accurate assessment. In this scenario, when a patient presents with swollen lymph nodes, the correct adjustment is to increase the pressure to assess for tenderness (Option A) because swollen lymph nodes can indicate inflammation or infection, and applying increased pressure can help determine if tenderness is present, providing valuable diagnostic information. Option B, using a firmer grip to ensure feeling the nodes, is incorrect because the focus should be on assessing tenderness rather than just feeling the nodes. Option C, continuing to use soft finger pads but applying a more vigorous motion, is incorrect as increased vigor can potentially cause discomfort to the patient and may not necessarily provide more accurate information. Option D, maintaining a light circular motion but focusing on the areas of swelling, is incorrect as it does not address the need to assess for tenderness which is crucial in this context. Educationally, it is important to understand that adjusting palpation techniques based on specific findings during a physical examination is a skill that requires both knowledge of anatomy and pathophysiology. By choosing the correct technique of increasing pressure to assess for tenderness in the presence of swollen lymph nodes, healthcare providers can better evaluate the patient's condition and provide appropriate care.

Correct Answer: C

Rationale: In the context of treating a patient with acute asthma exacerbation, the most appropriate first step is to administer a short-acting beta-agonist (SABA), which is reflected in option C. This is because SABAs, such as albuterol, work quickly to dilate the airways and provide rapid relief of bronchoconstriction, helping to alleviate acute symptoms like shortness of breath and wheezing. Providing oxygen therapy (option B) is important in managing asthma exacerbation, but it typically follows the administration of a bronchodilator like a SABA. Oxygen therapy helps to ensure adequate oxygenation in cases where the patient may be hypoxic due to respiratory distress. Administering oral corticosteroids (option A) is also an essential component of asthma management, especially in preventing future exacerbations and reducing airway inflammation. However, in the acute setting, bronchodilators like SABAs take precedence due to their immediate bronchodilatory effects. Giving intravenous fluids (option D) is not typically indicated as a first-line treatment for acute asthma exacerbation. Fluids may be needed if the patient is dehydrated or in shock, but addressing the airway obstruction and bronchoconstriction with a bronchodilator is the primary focus in the initial management of asthma exacerbation. In an educational context, understanding the stepwise approach to managing acute asthma exacerbation is crucial for healthcare providers involved in the care of patients with asthma. Recognizing the importance of prompt administration of bronchodilators like SABAs can help improve patient outcomes and reduce the risk of complications associated with uncontrolled asthma exacerbations.

Correct Answer: B

Rationale: The most appropriate intervention for an older adult at risk for malnutrition is to encourage intake of a variety of foods rich in vitamins and minerals (Option B). This is because malnutrition in older adults is often multifactorial and can be due to deficiencies in various nutrients. Encouraging a diverse diet helps ensure the individual receives a wide range of essential nutrients necessary for overall health and well-being. Administering high-calorie supplements (Option A) may not address the specific nutrient deficiencies contributing to malnutrition and could potentially lead to weight gain without addressing the underlying nutritional needs. Restricting caloric intake (Option C) is counterproductive in this situation as it could exacerbate malnutrition and lead to further health complications. Focusing on protein supplements exclusively (Option D) neglects the importance of other essential nutrients needed for overall health and may not adequately address the individual's nutritional needs. In an educational context, it is important for nurses to understand the complexities of nutritional needs in older adults and the importance of promoting a balanced and varied diet to prevent malnutrition. By choosing Option B, the nurse can help ensure the older adult receives a comprehensive array of nutrients to support their health and well-being.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to take next is to check the client's blood glucose level (Option A). The strong odor of acetone on the client's breath is indicative of diabetic ketoacidosis (DKA), a serious complication of diabetes characterized by high blood glucose levels and the presence of ketones in the blood and urine. Checking the blood glucose level will help confirm if the client is experiencing hyperglycemia and DKA. Option B, offering the client a glass of water, is not the priority in this situation. While hydration is important in managing diabetes, addressing the underlying cause of the acetone breath is crucial. Option C, assessing the client's urine for signs of infection, is not the immediate action needed when acetone breath is present. The priority is to assess and address the client's glucose and ketone levels. Option D, administering insulin immediately, is not recommended without first assessing the client's blood glucose level. Administering insulin without knowing the current glucose level can lead to further complications. Educationally, this question highlights the importance of recognizing clinical manifestations of DKA in clients with diabetes and the significance of prompt assessment and intervention to prevent serious complications. Nurses need to be vigilant in assessing for signs of DKA and reacting quickly to provide appropriate care.