Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?

Correct Answer: D

Rationale: The most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats is the desire to punish others. Individuals who commit suicide often exhibit behaviors or thought patterns indicating a desire to cause harm or guilt to others. This desire to punish others may drive them to take their own lives as a way to make others feel responsible or suffer the consequences of their actions. On the other hand, individuals who make suicidal attempts or threats may not have the same level of intent to harm others through their actions, and their motivations may stem from different underlying issues such as social isolation, stress, or depression. Therefore, the desire to punish others is a crucial factor that sets those who commit suicide apart from those who make attempts or threats.

Correct Answer: A

Rationale: The most reliable index of cerebral state in a patient diagnosed with a brain tumor and concerning increased intracranial pressure is the level of consciousness. Changes in consciousness, such as alterations in alertness, orientation, and responsiveness, are significant indicators of the brain's functioning and can provide valuable insights into the impact of increased intracranial pressure. Monitoring the level of consciousness helps healthcare providers assess neurological status and make critical decisions regarding the management of intracranial pressure. Unilateral papillary dilatation, increased systolic blood pressure, and decreased pulse pressure may also be important indicators but are not as reliable or direct as changes in the level of consciousness when evaluating cerebral status in this context.

Correct Answer: C

Rationale: Aniridia and hemihypertrophy are features of WAGR syndrome, which increases the risk of Wilms tumor.

Correct Answer: B

Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated infections caused by group A beta-hemolytic streptococci. These bacterial infections are usually in the form of strep throat or scarlet fever. Rheumatic fever typically occurs 2-4 weeks after a streptococcal infection. The body's immune response to the streptococcal infection can lead to an autoimmune reaction, resulting in rheumatic fever. It is important to promptly diagnose and treat streptococcal infections to prevent the development of rheumatic fever.

Correct Answer: D

Rationale: Bell's Palsy is a condition that affects the facial nerve, leading to weakness or paralysis of the facial muscles. One common complication of Bell's Palsy is the inability to fully close the affected eye, which can result in corneal exposure and dryness. Lubricating eye drops help prevent dryness and protect the cornea from damage due to inadequate eye closure. Using lubricating eye drops regularly can help maintain the eye's moisture and prevent potential complications such as corneal abrasions and infections, which are common in patients with Bell's Palsy. Megavitamin therapy, application of ice, and elastic bandages are not typically indicated for preventing complications in patients with Bell's Palsy.

Correct Answer: A

Rationale: Milia are small, whitish, pinpoint spots that commonly occur in newborns due to retained sebaceous secretions in the skin. They are commonly seen on the nose and can also appear on the cheeks and chin. Milia are not indicative of any illness and tend to disappear on their own without any treatment. They are a benign and temporary skin condition in newborns.

Correct Answer: D

Rationale: Thrombocytopenia is a condition characterized by a low platelet count, which can lead to impaired clot formation and increased risk of bleeding. With a low platelet count, there is an increased risk of internal bleeding and hemorrhage, which can affect vital organs such as the brain, heart, and gastrointestinal tract. Therefore, the priority nursing diagnosis for a client with thrombocytopenia receiving chemotherapy would be Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI. Monitoring for signs of internal bleeding, such as changes in mental status, chest pain, and abdominal pain, is crucial to prevent potential life-threatening complications.

Correct Answer: B

Rationale: Lactulose (Duphalac) is a synthetic sugar that is not absorbed in the small intestine but is broken down by bacteria in the colon into short-chain fatty acids and low molecular weight organic acids. The primary action of lactulose is to decrease resident intestinal flora. This reduces the production of ammonia in the colon and leads to acidification of the colonic contents. By doing so, lactulose helps in treating hepatic encephalopathy, a condition associated with hepatic failure where ammonia levels are elevated in the body. It works by promoting the excretion of ammonia through the stool, thereby reducing the toxic effects of ammonia on the brain.

Correct Answer: C

Rationale: Aniridia and hemihypertrophy are features of WAGR syndrome, which increases the risk of Wilms tumor.