A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which medication for immediate administration?

Correct Answer: C

Rationale: In the management of anaphylaxis, the immediate medication of choice for administration is epinephrine. Epinephrine is a potent vasoconstrictor and bronchodilator which helps restore blood pressure and open up the airways during an anaphylactic reaction. It is the first-line treatment to reverse the potentially life-threatening effects of an allergic reaction. Other medications, like diphenhydramine or dobutamine, may be used as adjuncts later in the treatment, but epinephrine is crucial for immediate administration to stabilize the child's condition.

Correct Answer: A

Rationale: Given that the 16-year-old girl has been diagnosed with genital herpes and is concerned about preventing complications of the disease, the most appropriate nursing diagnosis would be "Risk for transmission of infection." Genital herpes is a highly contagious sexually transmitted infection, and individuals with the infection can transmit it to their partners through sexual contact. Therefore, it is crucial to educate the girl on ways to prevent the transmission of the infection to others. By addressing this nursing diagnosis, the healthcare team can provide guidance on safer sexual practices, including the use of condoms, abstinence during outbreaks, and communication with partners to prevent the spread of the infection. This nursing diagnosis focuses on promoting the girl's health and preventing further complications related to the transmission of genital herpes.

Correct Answer: C

Rationale: Normal serum osmolality typically ranges between 280 to 295mOsm/kg. Serum osmolality reflects the concentration of solute particles in the blood, including sodium, glucose, and blood urea nitrogen. Sodium is a major determinant of serum osmolality, but it is not the only factor. In this case, since the patient's serum sodium is within the normal range, the nurse can reasonably estimate that the serum osmolality would fall within the normal range of 280 to 295mOsm/kg. Options A, B, and D are outside the typical range for serum osmolality in a healthy individual.

Correct Answer: C

Rationale: Nursing assessment for a patient with metabolic alkalosis includes evaluation of laboratory data for hypocalcemia, hypokalemia, and hypoxemia as these are commonly associated with this acid-base imbalance. Hypoglycemia, on the other hand, is not typically linked with metabolic alkalosis and is not commonly assessed in this context. Therefore, hypoglycemia would not be a key focus of nursing assessment in a patient with metabolic alkalosis.

Correct Answer: A

Rationale: Suctioning a tracheostomy tube is a procedure that requires proper technique to prevent complications. Hyperventilating James with 100% oxygen before and after suctioning indicates that Wilma is committing an error. The correct approach is to provide pre-oxygenation with 100% oxygen for at least two minutes before suctioning to prevent hypoxemia. However, hyperventilation with 100% oxygen can lead to oxygen toxicity, which can be harmful to the patient. The other options, instilling normal saline to loosen secretions, applying suction during catheter withdrawal, and suctioning the client every hour are appropriate techniques when performing tracheostomy tube suctioning.