The nurse anticipates that which one is prescribed to prevent a common bacterial complication from the dog bite?

Correct Answer: C

Rationale: Ciprofloxacin is an antibiotic commonly prescribed for the prevention of bacterial infections that can result from animal bites, such as dog bites. Dog bites are often contaminated with bacteria and can lead to infections, particularly from organisms such as Pasteurella multocida. Ciprofloxacin is effective against a broad range of bacteria, including those commonly found in animal bites, making it a suitable choice for infection prophylaxis in this scenario. Ibuprofen is a pain reliever and anti-inflammatory medication, tetanus toxoid is given to prevent tetanus infection, and meperidine is a narcotic analgesic used for pain relief, but none of these options specifically target bacterial prevention in the case of a dog bite.

Correct Answer: A

Rationale: Acute respiratory distress syndrome (ARDS) is a serious and life-threatening condition characterized by rapid onset of respiratory failure, severe hypoxemia (low oxygen levels in the blood), and non-cardiogenic pulmonary edema. The hallmark of ARDS is severe hypoxemia that is difficult to correct even with high levels of supplemental oxygen. Patients with ARDS often require mechanical ventilation to maintain adequate oxygen levels. Severe cough with purulent sputum production, chest pain exacerbated by deep breathing, and productive cough with hemoptysis are not typical features of ARDS.

Correct Answer: B

Rationale: The nurse's best response when a patient expresses frustration with the healthcare system's inefficiencies is to listen actively to the patient's concerns, acknowledge the challenges they are facing, and offer support. It is important for the nurse to validate the patient's feelings and demonstrate empathy, rather than dismissing or ignoring their frustrations. By offering support and showing understanding, the nurse can help the patient feel heard and valued, which is an essential aspect of providing patient-centered care. This approach can also help to strengthen the nurse-patient relationship and build trust, ultimately leading to better outcomes for the patient's overall healthcare experience.

Correct Answer: A

Rationale: The most significant contributory factor to the development of lung cancer is being a cigarette smoker. Cigarette smoking is directly linked to approximately 85% of lung cancer cases. The harmful substances in tobacco smoke, such as carcinogens, damage the cells in the lungs, leading to the development of cancer over time. Smokers are at a significantly higher risk of developing lung cancer compared to non-smokers. Therefore, being a cigarette smoker is the primary and most influential risk factor for developing lung cancer.

Correct Answer: B

Rationale: When a patient receiving palliative care for end-stage COPD expresses a desire to discuss advance care planning, the palliative nurse should initiate a conversation about advance directives and future care preferences. Advance care planning involves discussing and documenting a patient's preferences regarding future medical care, particularly in situations where the patient may no longer be able to make decisions. This discussion helps ensure that the patient's wishes are respected and followed in the event they are unable to communicate their preferences. By engaging in advance care planning discussions, the nurse can help the patient feel empowered, supported, and in control of their medical care decisions. It also allows healthcare providers to align care with the patient's values and goals, ultimately improving quality of life and ensuring dignity at the end of life.

Correct Answer: D

Rationale: Prinzmetal's angina, also known as variant angina, is characterized by episodes of chest pain that occur at rest and are relieved by nitroglycerin. Patients with Prinzmetal's angina may also have transient ST-segment elevation on an electrocardiogram (ECG) during episodes of chest pain. This is due to coronary artery vasospasm, which causes temporary obstruction of blood flow to the heart muscle. Stable angina typically presents with chest pain on exertion that resolves with rest, while unstable angina and acute myocardial infarction present with chest pain that is not relieved with nitroglycerin and are associated with more severe coronary artery disease.

Correct Answer: A

Rationale: The bioethical issue described in option A revolves around the concept of advance directives. Advance directives are legal documents that outline a person's wishes regarding medical treatment in the event that they are unable to communicate those wishes themselves. In this scenario, the issue pertains to the withholding of food and treatment based on a written advance directive that was made before the patient suffered permanent brain damage. This raises important ethical considerations about respecting a patient's autonomy and adhering to their previously expressed wishes, even in difficult circumstances. The decision to withhold treatment in such a situation is a complex bioethical issue that needs to be handled carefully while balancing the principles of autonomy and beneficence.

Correct Answer: D

Rationale: Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. Patients with thrombocytopenia are at risk for injury due to potential bleeding complications. Therefore, the appropriate nursing diagnosis to protect the patient from further injury in this case would be "Risk for injury related to thrombocytopenia." This nursing diagnosis allows the nurse to assess for signs of bleeding, implement interventions to prevent injury, and closely monitor the patient's platelet levels to prevent complications.

Correct Answer: C

Rationale: Opioid medications are considered the first-line pharmacological treatment for dyspnea in palliative care patients with advanced cancer. Opioids help relieve dyspnea by reducing respiratory drive and the sensation of breathlessness, providing effective symptom management. In this case, addressing the patient's dyspnea with opioid medications would likely also help alleviate their anxiety related to breathlessness. Administering oxygen therapy (choice A) may not be effective at relieving dyspnea in this situation, as dyspnea in advanced cancer patients is often not primarily due to low oxygen levels. Teaching pursed-lip breathing techniques (choice B) and referring the patient to a respiratory therapist for breathing exercises (choice D) may be helpful complementary interventions, but opioid medications should be the priority for symptom management.