Nurse Harper provides health instruction to the patient experiencing heartburn, which statement by the patient indicates a NEED or further Instructions? I have to drink milk between meals it

Correct Answer: A

Rationale: This statement indicates a need for further instructions because drinking milk between meals may worsen heartburn for some individuals. Milk can temporarily neutralize stomach acid, but it can also stimulate acid production in the stomach leading to increased heartburn symptoms. Therefore, Nurse Harper should provide more guidance on appropriate dietary choices for managing heartburn, such as avoiding trigger foods like fatty or spicy foods, eating small, frequent meals, and not lying down immediately after eating.

Correct Answer: D

Rationale: Thyroid nodules are abnormal growths of thyroid cells that form a lump within the thyroid gland. When a thyroid nodule becomes large enough, it can cause compressive symptoms such as difficulty swallowing and breathing. The presence of colloid nodules on fine-needle aspiration biopsy indicates a benign and common type of thyroid nodule. In this case, the symptoms are likely due to the physical pressure exerted by the thyroid nodule, rather than an underlying endocrine disorder like Hashimoto's thyroiditis, Graves' disease, or diabetes mellitus. Therefore, the most likely cause of the patient's symptoms is the thyroid nodule itself.

Correct Answer: C

Rationale: It is crucial to have a complete set of surgical instruments for any surgical procedure to ensure patient safety and the success of the surgery. If the nurse notices that the surgical instrument tray is incomplete, the best course of action is to inform the sterile processing department immediately. By doing so, the missing instruments can be promptly provided, ensuring that the surgical team has all the necessary tools for the procedure. Proceeding with the procedure using incomplete instruments can compromise patient safety and the quality of care provided. Documenting the missing instruments in the surgical count log is important for record-keeping purposes but should not delay the immediate action of requesting additional instruments. Borrowing instruments from another OR is not recommended as it can create confusion, potential cross-contamination, and disrupt the workflow of another surgical team.

Correct Answer: C

Rationale: The nurse should instruct the patient to hold their breath for at least 10 seconds after inhaling the medication from the ipratropium bromide inhaler. This allows the medication to reach deep into the lungs and be more effective. Holding the breath also helps reduce the risk of side effects such as throat irritation. It is essential for optimal drug delivery and therapeutic effect.

Correct Answer: B

Rationale: The nurse's best response when a patient asks about alternative treatment options is to provide the patient with information about those options, including their benefits and risks. It is important for the nurse to support the patient in their exploration of different treatment approaches and empower them to make informed decisions about their care. Dismissing the question, ignoring it, or discouraging alternative treatments are not appropriate responses and may hinder the patient's ability to make choices that align with their values and preferences. Therefore, providing information and facilitating an open discussion about alternative treatments is the most appropriate approach for the patient's best interest.

Correct Answer: A

Rationale: Having a tracheostomy means that a patient has an artificial opening in their neck to help them breathe. Therefore, any issues related to breathing, such as blockages in the tracheostomy tube or difficulty in clearing secretions, can pose a major problem for a patient with a tracheostomy. It is crucial to monitor the patient's respiratory status closely and intervene promptly if any breathing difficulties arise to prevent potential respiratory distress or complications.

Correct Answer: D

Rationale: Patients prescribed proton pump inhibitors (PPIs) for the treatment of GERD should be closely monitored for the development of osteoporosis. PPIs have been associated with an increased risk of developing osteoporotic fractures, particularly in long-term users. This risk is thought to be due to decreased calcium absorption as stomach acidity is reduced by PPIs, leading to potential alterations in bone metabolism and density. Therefore, it is important for healthcare providers to assess bone health, educate patients on calcium and vitamin D supplementation, and consider other risk factors for osteoporosis in individuals taking PPIs long-term. While hypoglycemia, hyperkalemia, and Clostridium difficile infection may be seen as adverse effects with other medications or conditions, osteoporosis is the adverse effect most closely monitored in patients taking PPIs for GERD.

Correct Answer: A

Rationale: The patient's presentation of fatigue, weakness, jaundice, elevated indirect bilirubin levels, reticulocytosis, and positive Coombs test is consistent with hemolytic anemia. Among the options provided, hereditary spherocytosis is the most likely condition to cause these findings.

Correct Answer: B

Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It typically presents as multiple dome-shaped, translucent papules with central umbilication on the face and trunk. The lesions are usually asymptomatic but can be itchy. Molluscum contagiosum is a common infection in children but can also occur in adults, especially those who are immunocompromised. The lesions can gradually increase in number over time. Basal cell carcinoma, sebaceous hyperplasia, and keratoacanthoma do not typically present with the characteristic features of molluscum contagiosum.