A client in the emergency department is bleeding profusely from a gunshot wound to the abdomen. In what position should the nurse immediately place the client to promote maintenance of the client's blood pressure above a systolic pressure of 90 mm Hg?

Correct Answer: C

Rationale: In a client with profuse bleeding from a gunshot wound to the abdomen, maintaining the client in a supine position is essential to manage blood pressure. This position helps in reducing diaphragmatic pressure and allows for proper visualization of the wound, aiding in prompt assessment and intervention to control the bleeding and stabilize the client's condition. Placing the client in a 45-degree Trendelenburg position (Choice A) could worsen the bleeding by increasing intrathoracic pressure and venous return, potentially leading to further hemorrhage. Turning the client prone (Choice B) may not be feasible in this situation and can delay essential interventions. Placing the client on the right side (Choice D) does not address the immediate need to manage the bleeding and stabilize the client's condition.

Correct Answer: A

Rationale: The nurse's priority intervention for a client with coronary artery disease (CAD) experiencing dyspnea at rest is to elevate the head of the bed. Elevating the head of the bed helps improve lung expansion and reduces the workload on the heart, aiding in respiratory effort and cardiac function. This intervention is crucial in enhancing oxygenation and optimizing cardiac output in individuals with CAD presenting with dyspnea. Administering oxygen (Choice B) is important but elevating the head of the bed takes precedence as it directly addresses the client's respiratory distress. Continuous ECG monitoring (Choice C) and applying a nasal cannula (Choice D) are relevant interventions but not the priority when a client with CAD reports dyspnea at rest.

Correct Answer: D

Rationale: Choice D is correct because acetaminophen, aspirin, and ibuprofen are safe OTC options for pain/fever when used per guidelines, with well-established profiles. Choice A is incorrect alone as it's one drug. Choice B is wrong by itself because aspirin is just part. Choice C is incorrect solo since ibuprofen is only one option.

Correct Answer: B

Rationale: The correct technique for using a metered-dose inhaler (MDI) involves exhaling fully before inhaling deeply while pressing the canister to ensure effective delivery of the medication. Choice A is incorrect as exhaling should precede inhaling. Choice C is incorrect as taking two short breaths is not part of the correct technique. Choice D is incorrect as there is no need to hold the breath for a specific time after inhaling the medication.

Correct Answer: A

Rationale: The correct answer is A: Tachycardia. Tachycardia is a common sign of theophylline toxicity. The nurse should monitor the client for an increased heart rate, as it can indicate a dangerous level of theophylline in the body. Prompt medical attention is required if tachycardia is observed to prevent further complications. Choices B, C, and D are incorrect because constipation, drowsiness, and tremors are not typically associated with theophylline toxicity. While theophylline can cause gastrointestinal upset or central nervous system effects, tachycardia is a more specific and serious indicator of toxicity that requires immediate attention.

Correct Answer: B

Rationale: In the scenario described, the client's chest pain persists despite three doses of nitroglycerin, indicating a potentially severe cardiac issue like a myocardial infarction. The priority for the nurse in this situation is to involve the healthcare provider promptly. Calling the healthcare provider immediately is essential to ensure timely evaluation and appropriate intervention for the client. Administering more nitroglycerin without further assessment or instructions may not be safe and could delay necessary treatments. Providing oxygen or changing the client's position may offer some comfort but does not address the underlying potentially life-threatening condition, making these options less appropriate as the immediate next best action.

Correct Answer: A

Rationale: Choice A is correct because phase I metabolism, involving cytochrome P450 enzymes, relies on protein for enzyme synthesis; malnutrition impairs this, reducing metabolism. Choice B is incorrect as iron deficiency affects oxygen transport, not directly phase I processes. Choice C is wrong since only protein malnutrition, not iron deficiency, is directly relevant. Choice D is incorrect because protein malnutrition does impact metabolism.

Correct Answer: D

Rationale: Choice D is correct because PDMPs track prescriptions, education informs risks, and urine screening detects misuse—all key monitoring tools per guidelines. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since screening is only one approach.

Correct Answer: A

Rationale: Choice A is correct because estrogen counteracts testosterone's masculinizing effects in transgender men, conflicting with therapy aims, so it's avoided. Choice B is incorrect as alpha blockers don't interfere with testosterone goals. Choice C is wrong because beta blockers are unrelated to therapy effects. Choice D is incorrect since only estrogen applies.