Correct Answer: C

Rationale: The correct answer is C: Invasion of the uterine wall by endometrial tissue. Adenomyosis is a condition where endometrial tissue grows into the muscular wall of the uterus, causing symptoms like heavy menstrual bleeding and severe cramping. This process results in inflammation, thickening of the uterine wall, and can lead to enlargement of the uterus. Choice A: Loss of muscle tone in the vaginal wall is incorrect because adenomyosis does not involve the vaginal wall. Choice B: Excessive synthesis and release of unopposed estrogen is incorrect because although estrogen can contribute to the growth of endometrial tissue, it is not the primary pathophysiologic process in adenomyosis. Choice D: Proliferation of tumors in the uterine wall is incorrect because adenomyosis does not involve the growth of tumors, but rather the infiltration of endometrial tissue into the uterine muscle.

Correct Answer: A

Rationale: The correct answer is A because providing instructions in simple, clear terms is crucial when communicating with a blind patient. This method allows the patient to understand information effectively without visual cues. Choice B is incorrect because a firm, loud voice may startle the patient. Choice C is incorrect as touching a patient without consent may be inappropriate. Choice D is incorrect because stating name and role without context may confuse the patient.

Correct Answer: B

Rationale: The correct answer is B: Assisting the patient into a sitting position. The Epley maneuver is used to treat benign paroxysmal positional vertigo by repositioning displaced calcium carbonate crystals in the inner ear. This maneuver involves a series of specific head movements. Starting with the patient in a sitting position allows for proper orientation and positioning for subsequent movements to be effective. Placing the patient in a prone position (A) would not facilitate the correct positioning for the maneuver. Instilling warm saline into the ear (C) is not part of the Epley maneuver. Assessing baseline hearing (D) is unrelated to performing the Epley maneuver.

Correct Answer: D

Rationale: Step 1: Providing encouragement is essential to building trust and rapport with the patient, which is crucial in supporting her emotional needs. Step 2: Empathy helps the patient feel understood and supported, fostering a positive therapeutic relationship. Step 3: Thoughtful encouragement acknowledges the patient's feelings and validates her experiences, empowering her to gradually accept her body changes. Step 4: By offering empathic and thoughtful encouragement, the nurse helps the patient develop a positive body image at her own pace. Choice A focuses on physical appearance, Choice B generalizes experiences, and Choice C overlooks the patient's emotional journey.

Correct Answer: A

Rationale: The correct answer is A: Allowing the patient to express her feelings without judging her. This intervention has the highest priority as it focuses on providing emotional support and creating a safe space for the mother to express her emotions without feeling judged. In this situation, the mother is experiencing intense guilt and grief, and allowing her to talk about her feelings can help her process her emotions and cope with the impending loss. By listening actively and without judgment, the nurse can demonstrate empathy and compassion, which are crucial in supporting the mother through this difficult time. Summary: B: Helping the patient to understand the phases of the grieving process may be helpful, but it is not the highest priority at this moment. C: Reassuring the patient that the child's death is not her fault is important, but the priority is to address the mother's emotional needs first. D: Arranging for genetic counseling is not the highest priority at this time as the immediate focus should be on providing emotional support to the mother