During the first contact of the patient with the nurse, the latter should demonstrate the following behavior, which the EXCEPTION of _______.

Correct Answer: D

Rationale: During the first contact with a patient, a nurse should demonstrate caring, encouraging, and comforting behaviors. These qualities help create a positive and supportive environment for the patient. However, compelling behavior, which implies forcing or pressuring someone to do something, is not appropriate during the initial interaction with a patient. It is essential for the nurse to build trust and rapport with the patient, and compelling behavior can be counterproductive to establishing a nurturing relationship. Thus, compelling is the exception among the given choices for the nurse's behavior during the first contact with a patient.

Correct Answer: C

Rationale: The appropriate initial management for a conscious patient experiencing a syncopal episode (fainting) is to provide reassurance and assist the patient to a lying position. This is important to ensure adequate blood flow to the brain and to prevent further injury in case the patient faints again. Elevating the legs above the level of the heart is not recommended as a routine intervention for syncope. Administering intravenous fluids rapidly is not usually needed in the initial management of syncope without signs of dehydration or significant bleeding. Administering oxygen via nasal cannula is not necessary for most cases of syncope unless there are specific indications such as signs of respiratory distress.

Correct Answer: D

Rationale: Continuing Professional Development (CPD) programs are essential for the professional growth and development of nurses. CPD programs provide opportunities for nurses to enhance their knowledge, skills, and competencies, keeping them up-to-date with the latest advancements in healthcare. These programs may include workshops, conferences, seminars, online courses, and certifications that contribute to a nurse's professional development. By engaging in CPD programs, nurses can improve their clinical practice, critical thinking skills, and patient care, ultimately benefiting both the nurse and the patients they serve.

Correct Answer: B

Rationale: In this scenario, the palliative nurse should prioritize encouraging the patient to conserve energy and avoid unnecessary activities (Option B). End-stage heart failure can lead to severe fatigue and limited mobility, making it essential for the patient to conserve energy to prevent exacerbating symptoms and improve quality of life. Engaging in physical therapy (Option A) may not be suitable for a patient experiencing severe fatigue, as it can further drain energy reserves. Prescribing stimulant medications (Option C) may have limited effectiveness and potential side effects. Referring the patient to a nutritionist for dietary modifications (Option D) is important for overall health but may not directly address the immediate comfort and quality of life concerns related to fatigue and limited mobility. Helping the patient prioritize energy conservation will allow them to use their limited energy for essential activities, leading to a more comfortable and fulfilling experience while receiving palliative care for end-stage heart failure.

Correct Answer: C

Rationale: The core public health function of assessment involves systematic data collection on the population's health status, monitoring changes in health, and making information available to the public. In this context, collecting data and monitoring the health status of the population directly aligns with the assessment function of public health. Quality assurance focuses on ensuring that health services meet established standards, policy development involves creating policies to address public health issues, and health promotion involves empowering individuals to improve their health. While these functions are also essential in public health, the act of collecting data and monitoring health status specifically falls under the assessment core function.

Correct Answer: A

Rationale: The symptoms of irritability, muscle weakness, tremors, weight loss despite increased appetite, along with elevated serum thyroid hormone levels and suppressed TSH levels, are indicative of hyperthyroidism. In hyperthyroidism, the thyroid gland produces an excess amount of thyroid hormone, leading to an overactive metabolism. This results in symptoms such as weight loss, tremors, irritability, and muscle weakness. The elevated levels of thyroid hormone are detected in the laboratory tests, along with low TSH levels due to negative feedback regulation. Therefore, the most likely endocrine disorder responsible for these symptoms is hyperthyroidism.

Correct Answer: C

Rationale: The most effective plan would be for the nurse to educate the entire family at the same time about the disease and medications to treat it (Option C). This approach ensures that each family member receives the same information and understanding about obsessive compulsive disorder (OCD) and its treatment. By educating the entire family simultaneously, it creates a supportive environment where everyone is on the same page and can provide understanding and assistance to the individual with OCD, in this case, Mrs. Juan. It also allows for open communication and collaboration within the family unit, leading to better management and support for Mrs. Juan in dealing with her illness.

Correct Answer: B

Rationale: Meconium-stained amniotic fluid indicates that the fetus may have passed stool in utero, which can lead to potential respiratory problems once born due to meconium aspiration. The priority action for the nurse in this situation is to prepare for immediate delivery to expedite the removal of the fetus from the contaminated environment and provide necessary interventions such as suctioning of the airway to prevent aspiration of meconium. Prompt delivery is crucial to minimize the risk of complications related to meconium aspiration syndrome. Administering oxygen, inserting a urinary catheter, and notifying the neonatal resuscitation team can be important subsequent actions, but the immediate focus should be on delivering the baby.

Correct Answer: B

Rationale: Autonomy is the ethical principle that respects an individual's right to make their own decisions about their medical treatment, even if it goes against medical advice or the preferences of others. In this case, the 70-year-old patient has voluntarily decided not to have the pacemaker inserted despite the physician's recommendation. The fact that the patient's decision is respected by the family reflects the importance of honoring the patient's autonomy and right to make decisions about their own healthcare.