Correct Answer: B

Rationale: The responsibility of obtaining informed consent typically falls on the physician or the healthcare provider who is performing the procedure or treatment. Informed consent is a process where the healthcare provider explains the procedure, its risks, benefits, possible alternatives, and potential outcomes to the patient or their legal representative. The patient must have a comprehensive understanding of these aspects before agreeing to the treatment. While nurses, nurse managers, anesthesiologists, midwives, and other healthcare professionals may assist in the consent process by providing information or clarifications, the ultimate responsibility lies with the physician. This is because the physician is usually the one with the expertise and knowledge about the specific procedure or treatment being performed.

Correct Answer: D

Rationale: In end-stage liver disease, pruritus (itching) can be a distressing symptom caused by the accumulation of bile salts in the skin due to impaired liver function. Cholestyramine and other bile acid sequestrants are the primary treatment for managing pruritus in these patients. These medications bind to the bile salts in the intestine, preventing their reabsorption and reducing the itching symptoms. Antihistamines may not be as effective for this type of pruritus since it is not histamine-mediated. Topical corticosteroids are generally not recommended for long-term use in liver disease due to the risk of systemic absorption and adverse effects. Avoiding hot showers or baths may provide some temporary relief but is not a definitive treatment. Therefore, prioritizing the prescription of cholestyramine or bile acid sequestrants would be the most appropriate intervention to address the severe pruritus in a patient with end-stage liver disease

Correct Answer: B

Rationale: The clinical scenario described is consistent with a diagnosis of anterior epistaxis due to a prominent vascular lesion located in Little's area, which is an important site for nosebleeds. Silver nitrate cautery is the most appropriate intervention for managing this condition. Silver nitrate cautery is a commonly used method to chemically cauterize and eliminate the friable blood vessels responsible for recurrent epistaxis. It is a cost-effective and minimally invasive technique that can be easily performed in an outpatient setting. Nasal packing with anterior nasal tampons might be considered in cases of severe or refractory epistaxis, but in this scenario, where the source of bleeding is localized and identifiable, silver nitrate cautery is the treatment of choice. Endoscopic cauterization of the sphenopalatine artery and surgical excision of a nasal polyp are unnecessary and overly invasive for the described scenario.

Correct Answer: B

Rationale: Nurse Chona should explain to Patient Noel that the sign of negative before the word means that he is not drinking alcohol or smoking cigarettes. This is a simple misunderstanding and clarification should help clear up any confusion. It is important to uphold patient confidentiality and respect their autonomy, rather than reprimanding the patient for looking at their own chart. It is also essential to address any discrepancies in the patient's medical record to ensure accurate information is documented for proper treatment and care.

Correct Answer: C

Rationale: The element involved when a nurse initiates interpersonal communication is the sender. In the communication process, the sender is the person who initiates the message or information to be conveyed to the receiver. In this case, the nurse is taking on the role of the sender by initiating the communication with the patient, another healthcare professional, or any other individual. The sender is responsible for encoding the message and selecting the appropriate channel to convey it effectively. Therefore, in this scenario, the nurse is the one initiating communication, making her the sender in the communication process.