The healthcare provider in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing?

Correct Answer: C

Rationale: The correct answer is C. The patient with a sibling having newly diagnosed polycystic kidney disease may need a referral for genetic testing. Polycystic kidney disease has a genetic component, so there is a higher likelihood of the patient also having the condition. Referral for genetic testing can help in early diagnosis, management, and counseling for the patient and their family members. Choice A is incorrect because strokes in maternal grandparents at advanced ages are not typically indicative of a need for genetic testing. Choice B is incorrect as cerebral palsy is not typically a genetic condition related to the patient's pregnancy test result. Choice D is incorrect as dyspnea in a smoking patient is more likely related to respiratory issues such as chronic obstructive pulmonary disease rather than a genetic condition.

Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct: 1. Tis refers to carcinoma in situ, meaning the cancer is limited to the surface layer of cells in the cervix. 2. N0 indicates no regional lymph node involvement. 3. M0 indicates no distant metastasis. 4. Therefore, the cancer is localized only to the cervix, making answer A correct. Summary: B: Incorrect - Does not address the staging information provided in Tis, N0, M0. C: Incorrect - The staging information is already provided, and further testing may not be necessary at this stage. D: Incorrect - Staging information does not indicate difficulty in determining the original site of the cancer.

Correct Answer: C

Rationale: The correct answer is C: Clean the perianal area carefully after every bowel movement. This is important to prevent skin breakdown and infection due to the potential side effect of radiation-induced diarrhea. By maintaining good hygiene in the perianal area, the patient can reduce the risk of complications such as skin irritation and infection. Choice A is incorrect because testing stools for the presence of blood is not directly related to preventing complications from external-beam radiation. Choice B is incorrect because while a high-residue, high-fiber diet may be beneficial for some cancer patients, it is not specifically recommended to prevent complications from radiation therapy in this case. Choice D is incorrect because inspecting the mouth and throat daily for thrush is more relevant for patients receiving chemotherapy or immunosuppressive therapy, not specifically for those undergoing external-beam radiation.

Correct Answer: C

Rationale: The correct answer is C, administer the prescribed normal saline bolus and insulin. In diabetic ketoacidosis, rapid, deep respirations, known as Kussmaul breathing, occur due to compensatory mechanisms to lower blood pH. Normal saline bolus helps correct dehydration and insulin therapy helps lower blood sugar levels, leading to improved acidosis. Option A is incorrect as lorazepam does not address the underlying cause of the rapid respirations. Option B is incorrect as oxygen is not the priority in this situation. Option D is incorrect as guided imagery does not address the physiological needs of the patient in this critical condition.

Correct Answer: D

Rationale: The correct answer is D: Encourage fluid intake up to 4000 mL every day. High calcium levels can lead to dehydration, so encouraging fluid intake helps prevent this complication. Increased fluid intake also promotes calcium excretion through urine. Bed rest (A) is not directly related to managing high calcium levels. Auscultating lung sounds (B) every 4 hours is more relevant for respiratory issues. Monitoring for Trousseau's and Chvostek's signs (C) is associated with low calcium levels, not high levels.