A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

Correct Answer: A

Rationale: The correct answer is A. Asking the client to consider a direct donation respects their religious beliefs while also addressing the partner's concerns. This option promotes patient autonomy and involves the client in decision-making. B: Withholding the blood transfusion disregards the client's autonomy and may lead to ethical issues. C: This is a repeated option and does not provide a different course of action. D: Requesting a consultation with the ethics committee may delay necessary treatment and should be considered only when there is a significant ethical dilemma beyond this situation.

Correct Answer: B

Rationale: The primary goal of a root cause analysis (RCA) in healthcare is to prevent future errors by identifying underlying causes. This is because RCA focuses on understanding the fundamental reasons behind incidents to implement effective preventive measures. By identifying root causes, healthcare providers can implement strategies to mitigate risks and enhance patient safety. The other choices are incorrect because RCA is not about assigning blame (A), improving patient satisfaction (C), or analyzing financial impact (D), but rather about understanding and addressing the core issues to prevent recurrence.

Correct Answer: C

Rationale: The primary focus of a patient safety program is to enhance patient satisfaction. This is because the ultimate goal of patient safety initiatives is to ensure that patients receive safe and high-quality care, leading to improved patient experience and satisfaction. By prioritizing patient safety, healthcare providers can build trust with patients, reduce medical errors, and prevent harm. Why other choices are incorrect: A: While reducing healthcare costs may be a positive outcome of a patient safety program, it is not the primary focus. B: Improving clinical outcomes is an important goal of patient safety programs, but it is not the primary focus as patient satisfaction encompasses a broader aspect of care. D: Compliance with regulatory standards is essential, but it is a means to achieve patient safety rather than the primary focus.

Correct Answer: A

Rationale: The correct answer is A. The elevated blood pressure of 144/82 mm Hg indicates dehydration due to vomiting and diarrhea, leading to hypovolemia. This is a compensatory mechanism by the body to maintain perfusion. Option B, urine specific gravity of 1.03, indicates concentrated urine and dehydration, but not as specific as elevated blood pressure. Option C, neck vein distention, is more indicative of heart failure or fluid overload rather than dehydration. Option D, urine specific gravity of 1.01, indicates diluted urine and is not consistent with dehydration. Therefore, based on the symptoms and the compensatory mechanism of the body, an elevated blood pressure is the most likely finding in a client with vomiting and diarrhea.

Correct Answer: B

Rationale: The correct answer is B: Noon blood glucose of 52 mg/dL. This value indicates hypoglycemia, which can lead to serious complications like confusion, seizures, or coma. Immediate assessment and intervention are crucial. A: Bedtime glucose of 140 mg/dL is within the normal range. C: Fasting blood glucose of 130 mg/dL is slightly elevated but doesn't require urgent assessment. D: 2-hr postprandial glucose of 220 mg/dL is elevated but not as critical as hypoglycemia.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Understanding why a decision is needed is crucial in this situation to prioritize the client's well-being. 2. The nurse needs to assess the reasons behind the client's refusal to be repositioned, considering factors such as pain level and potential harm. 3. By determining the underlying cause, the nurse can make an informed decision on the best course of action to address the client's needs promptly. 4. Considering the alternatives (choice C) is important but secondary to understanding the urgency and necessity of the decision (choice A). 5. Who makes the decision (choice B) and when it is needed (choice D) are not as critical as the rationale behind the decision-making process. Summary: Choice A is correct because understanding the reason for the decision is essential for prioritizing the client's well-being. Choices B, C, and D are incorrect as they do not directly address the immediate need to assess the situation and make an informed decision based on the client's condition

Correct Answer: C

Rationale: The correct answer is C. This question is most appropriate as unintentional weight loss is a common symptom of type 1 diabetes due to the body's inability to properly use glucose for energy. The nurse should ask about weight loss to assess the patient's overall health status. Explanation: A: Asking about anorexia assumes a specific eating disorder, which may not be relevant to the patient's symptoms of diabetes. B: Dark colored urine may indicate dehydration, but it is not specific to type 1 diabetes symptoms. D: Craving sugary drinks may suggest a preference for sweet beverages but does not directly relate to the onset of type 1 diabetes symptoms.

Correct Answer: C

Rationale: The correct order is C. First, rotate the NPH vial to mix the insulin. Then, inject 20 units of air into the NPH vial to prevent a vacuum. Next, inject 2 units of air into the regular insulin vial to maintain pressure. After that, withdraw the regular insulin to avoid contamination. Finally, withdraw 20 units of NPH, ensuring the correct dosage. This order ensures proper mixing, prevents contamination, and maintains accurate dosing. Other choices have incorrect sequences that may result in inaccurate dosing or contamination.

Correct Answer: C

Rationale: Step 1: Low wages may lead to job dissatisfaction, prompting employees to seek unionization for better pay. Step 2: A direct correlation exists between low wages and union activity due to dissatisfaction. Step 3: This belief can motivate employees to band together for collective bargaining. Step 4: Effective communication or listening by managers does not directly facilitate union activity. Step 5: The perception of supervisors' understanding is secondary to the root cause of dissatisfaction.