A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this?

Correct Answer: D

Rationale: The correct answer is D: Spontaneous pneumothorax. In this scenario, the decreased to absent breath sounds on the right side indicate a possible lung collapse, which is characteristic of a spontaneous pneumothorax. This condition occurs when air enters the pleural space, causing the lung to collapse. The absence of breath sounds is due to the lack of air movement in the affected lung. Acute asthma (choice A) typically presents with wheezing and prolonged expiration. Chronic bronchitis (choice B) is characterized by productive cough and wheezing. Pneumonia (choice C) would present with crackles and increased breath sounds in the affected area.

Correct Answer: D

Rationale: Rationale: - Option D is correct because it acknowledges the mother's concern, provides reassurance, and educates about the temporary nature of the hair loss due to the treatment. - It shows empathy, offers hope, and addresses the mother's emotional distress in a supportive and informative manner. Summary: - Option A ignores the mother's feelings and does not address the underlying concern. - Option B is dismissive and invalidates the mother's emotions, lacking empathy. - Option C suggests suppressing emotions, which can be harmful and does not address the mother's concern.

Correct Answer: A

Rationale: The correct answer is A: Impaired clotting mechanism. Cirrhosis can lead to decreased production of clotting factors by the liver, resulting in impaired blood clotting ability. This puts Mr. Gonzales at a higher risk of excessive bleeding. Varix formation (B) can cause bleeding but is not the primary reason in this case. Inadequate nutrition (C) may contribute to overall health but is not directly linked to bleeding risk. Trauma of invasive procedure (D) is a potential risk but not the primary concern in cirrhosis.

Correct Answer: B

Rationale: The correct answer is B because it accurately defines mental health as a state of overall well-being where an individual can recognize their abilities, manage normal life stressors, and function effectively. This definition takes into account the holistic nature of mental health, emphasizing not just the absence of illness but also the presence of positive qualities. Option A is incorrect as it specifically refers to the symptom of psychosis, not mental health as a whole. Option C is incorrect as it focuses on different aspects of mental health care rather than the definition of mental health itself. Option D is incorrect as it only defines mental health in terms of the absence of illness, which is an oversimplified and incomplete understanding.

Correct Answer: C

Rationale: The correct answer is C: Ensure the safety of the victim. This is the primary nursing intervention for a victim of child abuse because ensuring the safety of the child is the most urgent and critical priority. By ensuring the safety of the victim, the nurse can prevent further harm and protect the child from ongoing abuse. Assessing the scope of the problem (choice A) and analyzing family dynamics (choice B) are important but secondary to ensuring the immediate safety of the child. Teaching coping skills (choice D) can be beneficial, but it is not the primary intervention needed to address the immediate safety concerns of a child abuse victim.