Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. Applying antibiotic ointment and placing the mother in reverse isolation are not appropriate for managing vesicles suspected to be herpes simplex virus (HSV) during labor. 2. HSV can be transmitted to the baby during vaginal delivery, leading to serious consequences. 3. Standard precautions should always be maintained to prevent the spread of infections. 4. Preparing for the possibility of a cesarean section and notifying the obstetrician about the vesicles are important steps to protect the baby and staff from potential harm.

Correct Answer: D

Rationale: The correct answer is D: Eight Cranial Nerve (Vestibulocochlear). Mr. Reyea's complaint of hearing ringing noises indicates a potential issue with his auditory function, which is primarily governed by the Vestibulocochlear nerve. This nerve is responsible for transmitting sound and balance information from the inner ear to the brain. The other choices, A: Frontal lobe, B: Six cranial nerve (abducent), and C: Occipital lobe, are not directly associated with auditory function or the perception of ringing noises in the ear.

Correct Answer: D

Rationale: Step 1: Hypernatremia is defined by elevated serum sodium levels (>145mEq/L). Step 2: Serum osmolality of 245mOsm/kg is high, consistent with hypernatremia. Step 3: Urine specific gravity below 1.003 indicates dilute urine, a common finding in hypernatremia. Step 4: The combination of elevated serum sodium, high serum osmolality, and low urine specific gravity confirms hypernatremia. Summary: A: Incorrect, as high serum osmolality (not 245mOsm/kg) is associated with hypernatremia. B: Incorrect, as low urine specific gravity (not below 1.003) is seen in hypernatremia. C: Incorrect, as serum sodium needs to be >145mEq/L to indicate hypernatremia.

Correct Answer: D

Rationale: The correct answer is D because it involves collaboration with the client to validate the identified health problem. By asking the client directly if they agree that fatigue is a problem for them, it promotes client-centered care and empowers the client in their own care. Choice A is incorrect as it assumes the nurse's assessment is enough to confirm fatigue. Choice B is incorrect as it focuses on the nurse's analysis rather than the client's experience. Choice C is incorrect because it is a closed-ended question that may not encourage open communication or validation from the client.

Correct Answer: B

Rationale: The correct answer is B: obtaining daily weights at the same time. This is crucial in monitoring fluid retention, a common issue in heart failure patients. Daily weights help detect early signs of fluid buildup. Option A is incorrect as physical activity is important for heart failure patients. Option C is incorrect as walking 2 miles daily may be too strenuous for some heart failure patients. Option D is incorrect as a high fiber diet is beneficial, but monitoring fluid retention is more critical in this case.