One morning during rounds, Nurse Myra noticed that Marlene was unduly sad. The nurse 's BEST way of communicating her concern is _______.

Correct Answer: D

Rationale: Placing her hand over Marlene's shoulder and asking why the sad face is the best way for Nurse Myra to communicate her concern. This approach shows empathy and creates a safe space for Marlene to open up about her feelings. By using physical touch and showing genuine interest in Marlene's well-being, Nurse Myra can effectively address the situation and provide appropriate support or guidance as needed. Simply dismissing Marlene's feelings (option B and C) or resorting to religious advice (option A) may not effectively address the underlying cause of Marlene's sadness. It is important in situations like this to show empathy, compassion, and a willingness to listen in order to provide the best support for the individual in distress.

Correct Answer: D

Rationale: Patient Sonia, who has hypothyroidism, would benefit from treatment with levothyroxine. Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4) and is commonly prescribed to replace the deficient thyroid hormone in patients with hypothyroidism. It helps restore the thyroid hormone levels in the body, relieving symptoms such as fatigue, weight gain, and cold intolerance that are characteristic of hypothyroidism. Propranolol is a beta-blocker used for conditions like hypertension, anxiety, and migraines; iron pills are used to treat iron deficiency anemia; and iodine supplementation is not typically used in the treatment of hypothyroidism unless it is due to iodine deficiency.

Correct Answer: A

Rationale: The death of Lory is the precipitating factor for Ella's feeling of wanting to die. Losing someone close to us can lead to feelings of profound sadness, grief, and hopelessness, which may trigger thoughts of wanting to die. The impact of losing a loved one can be devastating and overwhelming, often leading individuals to question the meaning of life and their own mortality. In Ella's case, the death of Lory has likely caused a significant emotional upheaval, contributing to her desire to end her own life. It is essential to address these feelings of loss and provide support and intervention to help Ella cope with her grief and prevent any self-harm.

Correct Answer: B

Rationale: Refeeding syndrome is a potentially dangerous condition that can occur in malnourished individuals when nutrition is reintroduced too quickly. It is characterized by shifts in electrolytes, fluid imbalance, and metabolic abnormalities. Monitoring for decreased bowel sounds, nausea, bloating, and abdominal distention is the priority action to prevent complications associated with refeeding syndrome. These symptoms can indicate gastrointestinal issues such as ileus or overfeeding, which can lead to further complications. Early recognition and intervention can help prevent serious consequences of refeeding syndrome.

Correct Answer: C

Rationale: When documenting pitting edema in a patient's notes, it is important to include details such as the degree of edema (A), duration of indentation (B), and depth of edema (D) as these parameters are relevant in assessing the severity of the condition and monitoring changes over time. However, mentioning the degree of temperature (C) is not directly related to assessing pitting edema. Temperature is typically assessed as part of a general physical assessment for signs of infection or inflammation and is not specifically needed when documenting pitting edema.