The nurse is planning the care of a patient who is adapting to the use of a hearing aid for the first time. What is the most significant challenge experienced by a patient with hearing loss who is adapting to using a hearing aid for the first time?

Correct Answer: B

Rationale: One of the most significant challenges experienced by patients with hearing loss who are adapting to using a hearing aid for the first time is learning to cope with the amplification of background noise. When a person starts using a hearing aid after experiencing hearing loss, they may find that the device picks up not only the sounds they want to hear but also surrounding noises, such as background chatter, traffic noise, or ambient sounds. This sudden increase in volume and clarity of background noise can be overwhelming and challenging for the individual to adjust to. It can affect their ability to focus on conversations or specific sounds they are trying to hear, leading to frustration and potentially causing them to avoid using the hearing aid altogether. Supporting the patient in gradually acclimating to these new sounds and providing strategies for managing background noise can help improve their overall experience with the hearing aid.

Correct Answer: A

Rationale: Assessing own biases and attitudes is the first step a nurse should take when beginning to use patient-centered care and cultural competence to improve nursing care. By becoming more aware of one's biases and attitudes about human behavior, the nurse can enhance self-awareness and self-reflection. This self-awareness is vital in understanding one's own perspectives, beliefs, and values that may influence interactions with patients from different cultural backgrounds. It also allows the nurse to identify areas that may require improvement or further education. Understanding and addressing personal biases is fundamental to providing patient-centered care and avoiding potential cultural misunderstandings that may arise in the healthcare setting.

Correct Answer: C

Rationale: The nurse's best response is option C - "AIDS isn't transmitted by casual contact." This response is accurate and provides the necessary information to address the friend's concern. It is important to educate the friend that HIV/AIDS is not transmitted through casual contact such as visiting a patient in the hospital. By stating this fact clearly, the nurse can help alleviate any unfounded fears or misconceptions the friend may have about contracting HIV while visiting the patient. This response promotes understanding and helps reduce stigma associated with HIV/AIDS, while also emphasizing the importance of accurate information in preventing the spread of the virus.

Correct Answer: D

Rationale: Recurrent episodes of acute otitis media (AOM) can cause fluid accumulation in the middle ear, leading to hearing loss and increased risk of further infections. Insertion of a ventilation tube, also known as a tympanostomy tube, is a common intervention for children with recurrent AOM. This procedure involves placing a tiny tube through the eardrum to allow ventilation and drainage of fluid from the middle ear. Ventilation tubes help equalize pressure, prevent fluid buildup, and reduce the frequency of ear infections. It can improve hearing and decrease the likelihood of future episodes of AOM. Ossiculoplasty, insertion of a cochlear implant, and stapedectomy are not indicated for recurrent AOM.

Correct Answer: A

Rationale: The most appropriate information for the nurse to tell the patient is option A, which states that this condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. Condylomata acuminata, or genital warts, is caused by the human papillomavirus (HPV). Certain strains of HPV, specifically types 16 and 18, are considered high-risk strains that can lead to cervical cancer in women. Therefore, regular Pap tests are crucial for early detection of any cervical changes that could indicate pre-cancerous or cancerous lesions. It is important for the patient to be informed about this risk and the importance of regular screening to monitor her cervical health.

Correct Answer: D

Rationale: When caring for a patient receiving total parenteral nutrition (TPN), it is crucial to maintain strict aseptic technique to prevent infection. Wearing a sterile mask when changing the central venous catheter dressing helps to reduce the risk of introducing pathogens into the catheter site, which can lead to serious bloodstream infections. It is essential to use sterile gloves, a sterile mask, and to assess the insertion site for any signs or symptoms of infection during central venous catheter dressing changes. Additionally, to prevent infection, TPN infusion tubing should be changed every 24 hours, and no single container of TPN should be hung for longer than 24 hours, with lipids not running for longer than 12 hours.

Correct Answer: C

Rationale: Distorted lines on an Amsler grid can be an indication of changes in central vision, which is commonly seen in macular degeneration. Therefore, it is crucial for the nurse to arrange for the patient to visit his ophthalmologist promptly for further evaluation and management. The ophthalmologist will be able to determine the severity of the visual changes, provide appropriate treatment options, and closely monitor the progression of macular degeneration. This proactive approach ensures that the patient receives timely and specialized care for his condition. Options A, B, and D do not directly address the urgency of the situation and the need for specialized ophthalmologic evaluation in cases of macular degeneration.

Correct Answer: A

Rationale: Vaginal examination of the cervix may result in perforation of the placenta and subsequent hemorrhage in a patient admitted with suspected placenta previa. It is important to avoid any unnecessary manipulation of the cervix to prevent complications. Assessing cervical dilation and effacement should be avoided until placenta previa is ruled out to prevent harm to the patient.

Correct Answer: A

Rationale: In the assessment of a patient with potential placenta previa or abruptio placentae, the nurse should pay close attention to the amount and characteristics of vaginal bleeding. Placenta previa typically presents with painless vaginal bleeding, which can be sudden and significant. Therefore, a saturated perineal pad within a short period of time (1 hour) is more indicative of placenta previa, as opposed to abruptio placentae which usually presents with painful vaginal bleeding and may not necessarily saturate a perineal pad quickly. Monitoring the amount of bleeding and keeping track of pad saturation over time can provide valuable information to differentiate between these two conditions.