Which of the following interventions is most appropriate for managing a patient with acute respiratory failure and hypercapnia due to chronic obstructive pulmonary disease (COPD) exacerbation?

Correct Answer: B

Rationale: In a patient with acute respiratory failure and hypercapnia due to a COPD exacerbation, the most appropriate intervention is the initiation of non-invasive positive pressure ventilation (NIPPV). NIPPV helps improve ventilation and oxygenation by providing mechanical support to the patient's breathing without the need for endotracheal intubation. It can reduce the work of breathing, decrease carbon dioxide retention, and improve respiratory muscle function. This intervention is particularly beneficial for COPD exacerbations as it can help alleviate hypercapnia and hypoxemia, leading to improved outcomes and potentially reducing the need for invasive ventilation methods. Therefore, NIPPV is the recommended management strategy in this scenario.

Correct Answer: C

Rationale: In ALS (Amyotrophic Lateral Sclerosis), communication difficulties may occur as the disease progresses and affects the muscles responsible for speech. It is crucial to initiate early measures to assist the patient in communicating effectively. Using pre-signals before the loss of speech can be helpful in maintaining communication with the patient. These pre-signals can include gestures, writing tools, communication boards, or technology-assisted communication devices. By introducing and practicing these pre-signals early on, the patient can adapt and utilize alternative communication methods before the loss of speech becomes more challenging. This proactive approach can significantly improve the patient's ability to communicate and maintain a sense of connection with others.

Correct Answer: C

Rationale: The presence of ecchymosis (bruising) and significant swelling in the perineum despite analgesic medication suggests a potential complication such as a hematoma. A hematoma is a collection of blood that can occur due to trauma or during childbirth. It is important to notify the healthcare provider immediately so that further assessment and interventions, such as drainage of the hematoma, can be initiated promptly to prevent complications and alleviate the client's pain. Applying ice packs or encouraging the client to sit on a donut cushion may provide temporary relief but will not address the underlying issue of a potentially serious hematoma. Administering additional analgesic medication may not be effective in this case if the pain is primarily due to the hematoma. Prompt notification of the healthcare provider is crucial for proper management of this situation.

Correct Answer: B

Rationale: A "full understanding" in research should be understood by the nurse researcher as explaining the study including risks and ben . When conducting research involving participants, it is crucial for nurse researchers to provide all necessary information about the study, including potential risks and benefits, in a clear and understandable manner. This ensures that participants are well-informed and can make informed decisions about their participation. By explaining the study thoroughly, nurse researchers uphold ethical principles such as informed consent and respect for participants' autonomy. It also helps in building trust between the researcher and participants, ultimately leading to more reliable and ethical research outcomes.

Correct Answer: C

Rationale: The best way for Myra to collect data from these participants is through a survey or questionnaire. Surveys and questionnaires are structured instruments that allow for the systematic collection of data from a large number of participants efficiently. They can be easily distributed and completed by participants, making them a convenient method for gathering information. Surveys and questionnaires also provide a standardized approach to data collection, ensuring consistency in the responses obtained. Additionally, they can be designed to include both closed-ended and open-ended questions, allowing for a comprehensive understanding of the participants' perspectives and experiences. Overall, using a survey or questionnaire would enable Myra to collect data from the participants in a systematic and efficient manner.

Correct Answer: A

Rationale: The patient in this scenario presents with normocytic normochromic anemia, normal iron studies, and elevated serum erythropoietin levels. These findings are characteristic of anemia of chronic disease, which is commonly seen in patients with chronic kidney disease (CKD). In CKD, there is a decrease in renal production of erythropoietin, leading to reduced stimulation of erythropoiesis and subsequent anemia. The normocytic normochromic anemia pattern is typical in anemia of chronic disease, as opposed to microcytic hypochromic anemia seen in iron deficiency anemia and thalassemia. Aplastic anemia is characterized by pancytopenia, which is not described in the scenario. Therefore, the most likely cause of the patient's presentation is chronic kidney disease.

Correct Answer: A

Rationale: Long-term corticosteroid use in patients with rheumatoid arthritis can lead to osteoporosis, which is a common complication. Osteoporosis causes weakening of the bones, increasing the risk of fractures, particularly in weight-bearing bones such as the hip, spine, and wrist. Osteoporotic fractures are a significant concern in patients on long-term corticosteroid therapy, highlighting the importance of monitoring bone health and considering preventive measures such as calcium, Vitamin D supplementation, and regular bone density testing. While osteonecrosis of the femoral head and avascular necrosis of the talus can also occur as complications of corticosteroid use, osteoporotic fractures are more commonly associated with this type of therapy in patients with rheumatoid arthritis. Septic arthritis, on the other hand, is not directly related to corticosteroid use but can occur due to other factors such as joint infections.

Correct Answer: A

Rationale: Benign prostatic hyperplasia (BPH) can lead to urinary retention, which is a common complication associated with this condition. As the prostate gland enlarges, it can obstruct the flow of urine from the bladder through the urethra. This obstruction can result in difficulty starting to urinate, weak urine flow, frequent urination, incomplete bladder emptying, and eventually urinary retention. If left untreated, urinary retention can lead to serious complications such as urinary tract infections, bladder damage, kidney damage, and even kidney stones. Therefore, urinary retention is an important complication to be aware of in patients with BPH.

Correct Answer: C

Rationale: Prioritizing the application of a topical anesthetic cream to the biopsy site is essential to ensure patient comfort during the bone marrow biopsy procedure. This will help numb the area where the biopsy needle will be inserted, reducing the pain and discomfort experienced by the patient. Administering intravenous sedation may not always be needed for a bone marrow biopsy and should be decided by the healthcare provider based on the patient's individual needs. Providing distraction techniques such as music or relaxation exercises can be helpful, but they may not be as effective at reducing the physical discomfort caused by the procedure. Allowing the patient to eat or drink up to one hour before the procedure is important for other reasons, such as preventing potential complications during sedation or anesthesia, but it is not directly related to ensuring comfort during the biopsy itself.