Foundations and Adult Health Nursing Study Guide Answers

Correct Answer: C

Rationale: The correct action for the nurse to take when observing signs of distress and discomfort in a patient during assessment is to offer emotional support and actively listen to the patient's concerns. Ignoring the patient's distress may lead to worsening of the patient's condition and can be detrimental to the patient's well-being. Documenting the findings and informing the healthcare provider later is important but should not be the immediate response when a patient is in distress. Administering pain medication without further assessment is also not appropriate as the nurse needs to understand the underlying cause of the distress before providing appropriate interventions. Offering emotional support and actively listening to the patient's concerns can help the nurse understand the patient's needs, provide comfort, and potentially address the root cause of the distress.

Correct Answer: A

Rationale: Option A, "Can we talk about Mrs. Santos?" is indicative of a collaborative relationship between the nurse and the attending physician. It shows open communication and a willingness to discuss the patient's case together, which is essential for optimal patient care. This statement implies teamwork and a shared responsibility for the patient's well-being. The other options either lack a collaborative tone, show concern without inviting discussion, or suggest a dismissive attitude towards addressing the patient's needs.

Correct Answer: B

Rationale: The nurse's best response in this situation is to listen actively to the patient's concerns, acknowledge the inconvenience they are experiencing, and offer support. It is essential to validate the patient's feelings and show empathy towards their frustration. By actively listening and addressing the patient's concerns, the nurse can help alleviate some of their frustration and build a positive rapport with the patient. This approach demonstrates respect for the patient's feelings and promotes effective communication in the healthcare setting. Dismissing or ignoring the patient's frustration can lead to further dissatisfaction and impact the quality of care provided.

Correct Answer: C

Rationale: Intracerebral hemorrhage occurs when there is bleeding directly into the brain tissue, often due to conditions such as hypertension or vascular malformations. The sudden-onset severe headache, altered mental status, and focal neurological deficits described in the patient are typical symptoms of an intracerebral hemorrhage. The location of the hemorrhagic lesion within the right basal ganglia corresponds to the clinical presentation. Ischemic stroke, subarachnoid hemorrhage, and transient ischemic attack (TIA) typically have different presentations and imaging findings compared to an intracerebral hemorrhage. Therefore, in this scenario, intracerebral hemorrhage is the most likely cause of the patient's symptoms.

Correct Answer: A

Rationale: The correct practice in this situation would be to have a dedicated fire extinguisher in every strategic location throughout the hospital. Having fire extinguishers readily available in key areas ensures that they can be accessed quickly in case of a fire emergency. Placing one fire extinguisher between two units may not be sufficient as it may not be easily accessible in the event of a fire. Fire extinguishers should not be replaced with fire sensors as these serve different functions. Additionally, borrowing fire extinguishers may not be a safe or reliable practice, as they should be properly maintained and placed according to safety standards. Therefore, having dedicated fire extinguishers in every strategic location is the best practice to ensure the safety and well-being of individuals in the hospital.