Lillian asks the nurse the cause of this ailment. Which of the following would the nurse explain as predisposing factors of mastitis? (Select all that apply) I. Milk stasis II. Nipple trauma III. Using alcohol in cleaning nipples IV. Baby 's sitting position

Correct Answer: B

Rationale: Mastitis is typically caused by bacterial infection, with predisposing factors including milk stasis (I) and nipple trauma (II). Milk stasis occurs when milk is not effectively removed from the breast, leading to a build-up that can block ducts and predispose to infection. Nipple trauma, such as cracks or damage, can provide entry points for bacteria to infect the breast tissue. Factors like using alcohol in cleaning nipples (III) and the baby's sitting position (IV) are not directly associated with the development of mastitis.

Correct Answer: B

Rationale: Option B is the most appropriate response when addressing a postpartum client's concerns about resuming sexual activity after a vaginal delivery. Educating the client about the normal changes in sexual desire and response following childbirth can help alleviate anxiety and provide reassurance. It is crucial for the nurse to explain that it is common for women to experience changes in libido, physical discomfort, and emotional adjustments after giving birth. By discussing these normal postpartum changes, the nurse can support the client in understanding that her feelings are valid and that it may take time for her to feel ready to engage in sexual activity again. Furthermore, the nurse can provide information on ways to enhance comfort and intimacy when resuming sexual activity, such as communication with partners, using lubricants, and gradually easing back into sexual activity as desired.

Correct Answer: C

Rationale: Mastitis is an infection of the breast tissue that may occur in postpartum clients. When a postpartum client exhibits signs of mastitis, including breast tenderness, erythema, and warmth, it is crucial to notify the healthcare provider immediately. Prompt medical evaluation is necessary to determine the appropriate treatment plan, which may include antibiotics. Delay in treatment can lead to complications, such as abscess formation. Encouraging the client to continue breastfeeding and applying warm compresses may provide some relief but do not address the underlying infection. Administering oral antibiotics would require a prescription from the healthcare provider, hence notifying the provider is the most appropriate initial nursing action in this situation.

Correct Answer: A

Rationale: Rhinitis is inflammation of the nasal mucosa, and common clinical manifestations include nasal congestion (blockage or stuffiness), rhinorrhea (runny nose), and sneezing. These symptoms are often present in both allergic and non-allergic rhinitis. While headaches, sore throat, and fever can occur in some cases, they are not as specific to rhinitis as nasal congestion, rhinorrhea, and sneezing.

Correct Answer: D

Rationale: In the scenario described, with the patient having an acute exacerbation of chronic kidney disease (CKD) leading to hyperkalemia and metabolic acidosis, the priority intervention to manage the metabolic derangements is to perform emergent hemodialysis for potassium removal. Hemodialysis is the most effective and rapid method to lower dangerously high potassium levels in the blood. It is crucial in cases of severe hyperkalemia where other measures such as medications or dietary modifications may not be sufficient or fast enough to correct the elevated potassium levels. Additionally, hemodialysis can also help in improving metabolic acidosis by removing waste products and excess electrolytes from the blood. Overall, emergent hemodialysis is the most appropriate intervention for managing the acute metabolic abnormalities in this critically ill patient.

Correct Answer: A

Rationale: ** In a patient with ARDS, the priority intervention to manage respiratory failure is to initiate lung-protective mechanical ventilation with low tidal volume. ARDS is characterized by widespread inflammation and injury to the alveoli, leading to impaired gas exchange and severe hypoxemia. Lung-protective ventilation strategies aim to minimize ventilator-induced lung injury by using lower tidal volumes (around 6 mL/kg of predicted body weight) to reduce barotrauma and volutrauma.

Correct Answer: C

Rationale: Severe nausea and vomiting with a large volume of vomitus can indicate a serious underlying issue such as gastrointestinal obstruction or other medical emergencies. In this situation, it is crucial for the nurse to notify the physician immediately so that further assessment and appropriate management can be initiated promptly. Delay in seeking medical help can lead to complications and worsen the patient's condition. It is important to act quickly and involve the physician in situations where the patient's health may be at risk.

Correct Answer: B

Rationale: Acetaminophen (Tylenol) is given pre-operatively to decrease intra-operative anesthetic requirements and post-operative pain. It is a common analgesic that can help reduce the amount of intra-operative anesthesia needed and provide some pain relief during the surgery. Unlike drugs like Celebrex, Ibuprofen, and Demerol, Acetaminophen does not have anti-inflammatory properties, but it is effective in managing pain and can contribute to overall pain control before, during, and after surgery. This makes it a preferred choice for pre-operative medication in order to decrease the need for higher doses of anesthetics and reduce post-operative pain levels.

Correct Answer: D

Rationale: The presentation described is characteristic of a parathyroid adenoma. Parathyroid adenomas are benign neoplasms that can present as painless, well-defined nodules usually located in the lower pole of the thyroid gland or in close proximity, such as the lateral aspect of the neck above the clavicle. Fine-needle aspiration cytology of a parathyroid adenoma typically reveals polygonal cells with abundant granular cytoplasm, often referred to as chief cells. This is key in differentiating it from other conditions mentioned in the question.