The LPN is caring for a patient in the preoperative period who, even after verbalizing concerns and having questions answered, states, “I know I am not going to wake up after surgery.” Which of the following actions should the nurse take?

Correct Answer: C

Rationale: The correct answer is C: Inform the registered nurse. This is the best course of action as the LPN should escalate the situation to a higher level of care by involving the registered nurse who can further assess the patient's concerns and provide appropriate interventions. A. Reassuring the patient may not address the underlying fear and may not be sufficient to alleviate their anxiety. B. Providing statistics about surgery death rates may further escalate the patient's fears and anxiety, causing more harm than good. D. Involving the family to comfort the patient may not address the patient's specific concerns and may not be within the family's scope of understanding or expertise to effectively address the situation. Informing the registered nurse allows for a more comprehensive assessment and appropriate intervention to address the patient's fears and concerns in a holistic manner.

Correct Answer: C

Rationale: The correct answer is C because it helps the patient explore her support system. By asking who she usually goes to when facing problems, the nurse encourages the patient to identify her sources of emotional support, which can help her cope with the new diagnosis. This response acknowledges the patient's need for support and fosters a therapeutic relationship. Explanation for incorrect choices: A: "Don't worry. You'll be okay." - This response dismisses the patient's feelings and offers false reassurance, which may not address her emotional needs. B: "The treatments you are receiving will make you feel better very soon." - While this statement provides information about treatment, it does not directly address the patient's difficulty in coping with the diagnosis. D: "Have you made end-of-life decisions?" - This response may be premature and could unnecessarily increase the patient's anxiety about her prognosis.

Correct Answer: A

Rationale: Step 1: Pulmonary edema is caused by fluid accumulation in the lungs due to increased pressure in the pulmonary vasculature. Step 2: Decreased left ventricular pumping leads to congestive heart failure, causing increased pressure in pulmonary circulation. Step 3: This increased pressure forces fluid from the capillaries into the alveoli, causing pulmonary edema. Step 4: Increased left atrial contractility (B) would not directly lead to pulmonary edema. Step 5: Decreased right ventricular elasticity (C) and increased right atrial pressure (D) are not directly related to the pathophysiology of pulmonary edema. Summary: The correct answer is A because decreased left ventricular pumping directly contributes to the increased pressure in the pulmonary circulation that leads to pulmonary edema. Choices B, C, and D do not align with the primary underlying disorder of pulmonary edema.

Correct Answer: A

Rationale: The correct answer is A: Liver. The liver is a common site for metastasis because it receives blood from various organs, making it a prime location for cancer cells to travel and establish secondary tumors. Additionally, the liver has a rich blood supply and provides a favorable environment for cancer cells to thrive. In contrast, B (Reproductive tract) and C (Colon) are not as common sites for metastasis compared to the liver. Choice D (White blood cells) is incorrect as metastasis involves the spread of cancer cells to distant organs, not within the blood cells themselves.

Correct Answer: C

Rationale: The correct answer is C: Confusion. Hypernatremia is an electrolyte imbalance characterized by high sodium levels in the blood. Confusion is a common symptom as high sodium levels can affect brain function. Dry skin (A) is more indicative of dehydration, tachycardia (B) is a symptom of various conditions, and pale coloring (D) is not specific to hypernatremia. Confusion is a key indicator that the nurse should assess for when monitoring for hypernatremia.