Correct Answer: C

Rationale: The correct answer is C: procrastination. Procrastination is the act of delaying or avoiding a task that needs to be accomplished. In this scenario, the novice nurse is avoiding the task of inserting a nasogastric tube for a patient who needs it due to uncertainty and fear. Waiting for someone else to volunteer or delaying the task until the end of the shift are clear examples of procrastination. Energy management (
A) involves efficiently allocating time and resources, which is not demonstrated here. Priority setting (
B) would involve recognizing the urgency of the situation and taking appropriate action. Introspection (
D) refers to self-reflection and analyzing one's thoughts and feelings, which is not the primary issue at hand in this scenario.

Correct Answer: A

Rationale: The correct answer is A: the federally coordinated National Disaster Medical System (NDMS). This system is specifically designed to provide medical care and support during disasters, including incidents involving mass casualties like the suicide bombing in the question. NDMS can rapidly deploy medical teams, equipment, and supplies to support local medical responses.


Choice B is incorrect because local homeland communities may not have the necessary resources and capabilities to handle a large-scale medical emergency like this.
Choice C is incorrect because while the Medical Reserve Corps can provide additional support, it may not have the same level of coordination and resources as the NDMS.
Choice D is incorrect as the National Incident Management System focuses on overall coordination of all emergency response efforts, not specifically medical care.

Correct Answer: C

Rationale: The correct answer is C: Application. In this scenario, the nurse needs to apply knowledge of arterial blood gas results and assessment findings to determine appropriate actions. With the patient having abnormal ABG results and visible carotid artery pulsation, the nurse must recognize impending respiratory failure and act promptly, such as notifying the healthcare provider or respiratory therapist. This requires applying critical thinking skills to make decisions based on collected data.

Incorrect choices:
A: Knowledge - Choosing this option implies only recalling facts, which is not sufficient in this situation.
B: Comprehension - This choice suggests understanding the information given, but it does not involve applying that understanding to make decisions.
D: Analysis - While analysis involves breaking down information, the immediate action needed in this case is more about applying knowledge to prevent a potential crisis, rather than deeply analyzing the situation.

Correct Answer: C

Rationale: The correct answer is C: Continual supervision is being provided until the RN determines competency.


Rationale:
1. Continual supervision is necessary for the LPN/LVN on the first day to assess their competency.
2. The RN checks frequently throughout the shift to provide support and evaluate the LPN/LVN's performance.
3. Competency must be determined before reducing supervision levels.
4. This level of supervision ensures patient safety and quality care.

Incorrect choices:
A: There is no supervision - Incorrect because supervision is provided by the RN.
B: Periodic inspection - Incorrect as continual supervision is needed for competency assessment.
D: Initial supervision - Incorrect as supervision should continue until competency is established.

In summary, choice C is correct as continual supervision is crucial for the LPN/LVN on their first day to ensure patient safety and quality care.

Correct Answer: C

Rationale: Rationale for Correct Answer C: Irregular heartbeat is a significant symptom of hyperkalemia, which can be life-threatening. The nurse should evaluate capillary refill to assess perfusion. High potassium levels can affect cardiac function, leading to arrhythmias. Monitoring capillary refill provides insight into tissue perfusion, helping to assess the severity of the condition and guide appropriate interventions.

Summary of Incorrect

Choices:
A: Drowsiness is not a typical symptom of hyperkalemia. Stimulating the patient every 30 minutes does not address the underlying issue.
B: Confusion is not a common symptom of hyperkalemia. Asking the patient to state their name and birthdate does not address the cardiac implications of high potassium levels.
D: Muscle cramps may occur with hyperkalemia but are not as critical as irregular heartbeat. Elevating the affected limb is not the priority in this situation.