During a support group meeting, Nurse Donato, in a teasing manner, has made several provocative remarks about your appearance and behavior as a group leader. Select your MOST appropriate response.

Correct Answer: D

Rationale: Choosing option D, "Donato, what you are saying is inappropriate," is the most appropriate response in this situation. It directly addresses Nurse Donato's behavior without escalating the situation or being overly confrontational. By calmly pointing out that the remarks are inappropriate, you are setting a boundary and letting Nurse Donato know that such behavior is not acceptable in a professional setting. This response also signals to the rest of the group that you are aware of the inappropriate comments and are taking action to address them. It is important to address such behavior professionally and assertively to maintain a respectful and supportive environment during the support group meeting.

Correct Answer: B

Rationale: When a patient describes their pain as a 5 on the pain assessment scale, it indicates severe pain and the need for a strong pain medication. Morphine Sulphate is a potent opioid analgesic that is commonly used to manage severe pain, such as in cases where the pain is rated as 5. Meperidine HCl (Demerol) is another opioid analgesic, but it is not as commonly used due to its side effect profile and potential for toxicity. Fentanyl (Duragesic) is also a potent opioid analgesic that can be used for severe pain, but morphine is often preferred in this situation. Acetaminophen (Tylenol) is a milder pain reliever and is not typically sufficient for pain described at a level of 5 on the pain scale.

Correct Answer: B

Rationale: When a patient receiving palliative care for end-stage COPD expresses a desire to discuss advance care planning, the palliative nurse should initiate a conversation about advance directives and future care preferences. Advance care planning involves discussing and documenting a patient's preferences regarding future medical care, particularly in situations where the patient may no longer be able to make decisions. This discussion helps ensure that the patient's wishes are respected and followed in the event they are unable to communicate their preferences. By engaging in advance care planning discussions, the nurse can help the patient feel empowered, supported, and in control of their medical care decisions. It also allows healthcare providers to align care with the patient's values and goals, ultimately improving quality of life and ensuring dignity at the end of life.

Correct Answer: B

Rationale: Ectopic pregnancy is a common complication of untreated gonorrhea or chlamydia infection in women. This occurs when a fertilized egg implants and grows outside the uterus, typically in one of the fallopian tubes. Both gonorrhea and chlamydia can lead to scarring of the fallopian tubes due to untreated inflammation and infection. This scarring may obstruct the fallopian tubes, making it difficult for the fertilized egg to travel to the uterus for implantation. As a result, the egg may implant and grow in the fallopian tube, leading to an ectopic pregnancy. Ectopic pregnancies are dangerous and can result in serious complications for the woman, including rupture of the fallopian tube, internal bleeding, and potentially life-threatening situations. It is crucial to seek prompt treatment for gonorrhea and chlamydia to prevent such severe outcomes.

Correct Answer: B

Rationale: Negligence refers to the failure to act or perform duties according to the standard of care expected from a reasonable person in similar circumstances. In this case, Nurse Lina administering a penicillin injection that was ordered for another patient is a clear instance of negligence. It involves a breach of duty by not verifying the correct patient and medication before administration. While malpractice can also encompass negligence, it typically involves a broader scope of professional misconduct or harm caused by a healthcare provider. Assault and battery involve intentional harmful acts, which are not applicable in this situation.

Correct Answer: A

Rationale: Myxedema is a severe form of hypothyroidism that is characterized by the accumulation of mucopolysaccharides in subcutaneous and other interstitial tissues. This condition leads to puffiness, swelling, and thickening of the skin, giving it a waxy appearance. Other symptoms of myxedema include fatigue, weight gain, cold intolerance, and hair loss. It is important to recognize and treat myxedema promptly as it can lead to serious complications such as myxedema coma, which is a life-threatening condition requiring immediate medical attention.

Correct Answer: D

Rationale: Erosion is the dental condition characterized by the destruction of tooth structure due to exposure to acidic substances, such as gastric acid from conditions like gastroesophageal reflux disease (GERD) or acidic beverages like sodas and citrus fruits. This acidic attack softens and wears away the enamel, leading to the erosion of tooth structure. Unlike dental caries, which is caused by bacteria producing acid from sugars in the mouth, erosion is primarily a result of external acidic sources. Attrition refers to the wear of tooth structure from tooth-to-tooth contact, and abrasion refers to the wear of tooth structure due to forces like brushing too hard or using abrasive toothpaste.

Correct Answer: C

Rationale: Tetanus toxoid provides long-lasting active immunity. When a person is vaccinated with tetanus toxoid, their immune system is stimulated to produce antibodies against the tetanus toxin. These antibodies provide protection against tetanus infection by recognizing and neutralizing the toxin if the person is exposed to the bacteria that causes tetanus in the future. This active immune response can last for many years, providing ongoing protection against tetanus. However, booster doses are recommended every 10 years to maintain adequate levels of protection.

Correct Answer: D

Rationale: The prioritized nursing intervention in this situation should be assessing for the risk of harm to self or infant. It is crucial to ensure the safety of the postpartum client and her infant as depression can increase the risk of self-harm or harm to the newborn. By assessing for any potential risks, the nurse can take appropriate actions to prevent any harm and ensure the well-being of both the client and the infant. Once the assessment is completed, further interventions like encouraging participation in support groups, referring to a mental health professional, or administering medications can be considered based on the assessment findings.