Correct Answer: B

Rationale: The correct instruction for a client with myasthenia gravis prescribed pyridostigmine (Mestinon) is to take the medication 30 minutes before meals. This timing is crucial as it helps improve muscle strength for eating and swallowing. By taking the medication before meals, the client can experience enhanced muscle function during mealtime, which is especially important for managing the symptoms of myasthenia gravis.

Correct Answer: A

Rationale: The correct answer is A: Liver function tests. Patients on atorvastatin should have their liver function tests monitored periodically to detect any potential liver damage. Atorvastatin, a statin medication used to lower cholesterol levels, can rarely cause liver enzyme abnormalities, so regular monitoring is essential to identify any adverse effects early on.

Correct Answer: C

Rationale: The rapid, deep (Kussmaul) respirations in a patient with diabetic ketoacidosis indicate a metabolic acidosis, necessitating correction with a saline bolus to prevent hypovolemia, followed by insulin administration to facilitate glucose re-entry into cells. Oxygen therapy is not warranted as the increased respiratory rate is not due to hypoxemia but is compensatory in response to acidosis. Encouraging slow breathing or administering lorazepam would be inappropriate as they can worsen the acidosis by suppressing the compensatory respiratory effort.

Correct Answer: B

Rationale: In this scenario, the immediate need is to provide passive immunity to the adolescent patient. Gamma globulin contains antibodies against hepatitis B, which can offer immediate protection. The hepatitis B vaccine provides active immunity over time but is not immediate. Fresh frozen plasma and corticosteroids are not indicated for immediate protection against hepatitis B infection.

Correct Answer: C

Rationale: The correct answer is C: Deep, rapid respirations (Kussmaul breathing). This is a sign of severe acidosis commonly seen in diabetic ketoacidosis (DKA) and requires immediate intervention. Kussmaul breathing helps to compensate for the metabolic acidosis by blowing off carbon dioxide. Prompt intervention is necessary to prevent further deterioration and potential respiratory failure.