The sister of a patient diagnosed with BRCA gene¢â‚¬"related breast cancer asks the nurse, 'Do you think I should be tested for the gene?' Which response by the nurse is most appropriate?

Correct Answer: C

Rationale: Although presymptomatic testing for genetic disorders allows patients to take action (such as mastectomy) to prevent the development of some genetically caused disorders, patients also need to consider that test results in their medical record may affect insurance, employability, etc. Telling a patient that a decision about mastectomy should be made before testing implies that the nurse has made a judgment about what the patient should do if the test is positive. Although most breast cancers are not related to BRCA gene mutations, the patient with a BRCA gene mutation has a markedly increased risk for breast cancer.

Correct Answer: C

Rationale: A low-protein diet is recommended for clients with hepatic encephalopathy to reduce ammonia levels. Ammonia, a byproduct of protein metabolism, can accumulate in the blood due to impaired liver function. Elevated ammonia levels can lead to worsening hepatic encephalopathy, a condition characterized by cognitive and neurological disturbances. Therefore, by limiting protein intake, the production of ammonia is reduced, thereby helping to manage hepatic encephalopathy.

Correct Answer: B

Rationale: Increasing sharp pain related to compartment syndrome necessitates immediate intervention as it may lead to permanent damage to muscles and nerves. Compartment syndrome is a serious condition that requires urgent medical attention to prevent further complications such as tissue necrosis and nerve injury.

Correct Answer: C

Rationale: The primary reason for administering morphine to a patient with a myocardial infarction (MI) is to reduce cardiac workload. Morphine helps in reducing preload and afterload, which ultimately improves oxygenation to the heart muscle. By decreasing the workload on the heart, morphine can alleviate symptoms and decrease the strain on the heart muscle during an MI.

Correct Answer: D

Rationale: Warfarin should be discontinued around one week before elective surgery to decrease the likelihood of excessive bleeding during the procedure. This allows adequate time for the effects of warfarin to diminish and reduces the risk of perioperative bleeding complications.

Correct Answer: A

Rationale: The correct response is A: 'The cancer involves only the cervix.' In staging, 'Tis' indicates cancer in situ, which means it is localized to the cervix and not invasive at this time. The differentiation of cancer cells is not part of clinical staging. Since the cancer is in situ, its origin is the cervix. Further testing is not required as the cancer has not spread beyond the cervix.

Correct Answer: B

Rationale: The primary action of short-acting beta2-agonists (SABAs) is to relieve bronchospasm. These medications are bronchodilators that work by opening the airways, making breathing easier for patients experiencing asthma exacerbations. By relieving bronchospasm, SABAs help improve airflow and alleviate symptoms of asthma such as wheezing and shortness of breath.

Correct Answer: C

Rationale: The correct answer is C. Clients with liver cirrhosis should avoid acetaminophen because it can cause further liver damage. Acetaminophen is metabolized in the liver, and in individuals with liver disease, it can lead to liver toxicity. Therefore, clients with liver cirrhosis should use alternative pain medications that do not affect the liver, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids as prescribed by their healthcare provider.

Correct Answer: B

Rationale: The correct instruction for a patient with hypothyroidism prescribed levothyroxine is to take the medication in the morning on an empty stomach to enhance absorption. Taking it with meals can interfere with absorption. Patients should not discontinue the medication without consulting their healthcare provider as it can lead to adverse effects. Doubling the dose if a dose is missed can increase the risk of side effects and overdosage. It is crucial for patients to follow the prescribed dosing schedule and consult their healthcare provider for any concerns or missed doses.