Correct Answer: A

Rationale: The correct answer is A: Heart rate 56/min. Metoprolol, a beta blocker, should be withheld if the client's heart rate is below 60/min to prevent further bradycardia.

Choices B, C, and D are within normal ranges and do not indicate a need to withhold metoprolol.

Correct Answer: B

Rationale: Performing a wound culture before administering antibiotics is crucial when managing a client with a wound infection. This step helps identify the specific pathogens causing the infection, allowing for the prescription of the most effective antibiotics. Changing the wound dressing every 24 hours (
Choice
A) is important for wound care but not the priority when an infection is present. Cleansing the wound with alcohol-based solutions (
Choice
C) can be too harsh and may delay wound healing. Applying a wet-to-dry dressing (
Choice
D) is not recommended for infected wounds as it can cause trauma to the wound bed during dressing changes.

Correct Answer: D

Rationale: The most relevant suggestion for minimizing stress in individuals with Alzheimer's disease is to maintain consistency in the environment, routine, and caregivers. This approach helps create a sense of familiarity and security for the individual, reducing stress and anxiety.
Choice A is incorrect as it suggests allowing the client to go to bed multiple times during the day, which may disrupt their routine and lead to confusion.
Choice B is incorrect as continuously testing cognitive functioning can be overwhelming and stressful for the individual.
Choice C is also incorrect as providing reality orientation in cases of severe memory loss can cause frustration and confusion, ultimately increasing stress levels.

Correct Answer: A

Rationale: The correct answer is A: Inspection, Palpation, Percussion, Auscultation. A focused respiratory assessment involves inspecting the chest for symmetry and signs of distress, palpating for tenderness or abnormal masses, performing percussion to assess underlying tissues, and auscultating lung sounds.
Choice B is incorrect as observation is a broad term that can encompass both inspection and palpation.
Choice C is incorrect as auscultation is usually performed after inspection and palpation.
Choice D is incorrect as observation should be more specific, and auscultation is a key component that is typically done last in a respiratory assessment.

Correct Answer: D

Rationale: In the management of sepsis, prompt intervention is crucial. Administering IV antibiotics is essential to target the underlying infection. Monitoring blood pressure helps assess the patient's hemodynamic status. Administering fluids is vital to maintain adequate perfusion.
Therefore, all the options are integral components of the initial management of sepsis, making 'All of the above' the correct answer. Choosing any single intervention over the others may delay optimal care and compromise patient outcomes.