A clinic nurse is teaching a client prior to surgery. The client does not seem to comprehend the teaching, forgets a lot of what is said, and asks the same questions again and again. What action by the nurse is best?

Correct Answer: A

Rationale: Step 1: Assess for anxiety - The client's lack of comprehension, forgetfulness, and repetitive questions indicate potential anxiety affecting their ability to process information. Step 2: Identify potential anxiety cues - Look for signs such as restlessness, increased heart rate, or verbal expressions of worry. Step 3: Address anxiety first - Once anxiety is identified, the nurse can provide appropriate interventions to help the client better understand and retain the information. Step 4: Provide supportive measures - After addressing anxiety, breaking information into smaller bits, giving written information, and reviewing the information can be helpful, but addressing anxiety is key to enhancing the client's ability to comprehend and retain information.

Correct Answer: A

Rationale: The correct answer is A: Increased rate and depth of respirations. In this case, the client has metabolic acidosis indicated by a low pH and low HCO3 levels. The PaCO2 is low, which is not expected in metabolic acidosis. Therefore, the respiratory system is compensating by decreasing PaCO2 through increased rate and depth of respirations to help normalize the pH. Increased urinary output (choice B) and increased thirst and hunger (choice C) are not directly related to compensatory mechanisms for acid-base imbalances. Increased release of acids from the kidneys (choice D) would exacerbate the acidosis rather than compensate for it.

Correct Answer: C

Rationale: The correct answer is C: Natural active immunity. This type of immunity is the longest acting because it results from the body's exposure to a pathogen, leading to the production of memory cells that provide long-lasting protection. Natural active immunity involves the immune system responding to an actual infection or exposure to a pathogen, which triggers the production of antibodies and memory cells for future protection. In contrast, artificial active immunity (choice A) involves vaccines, which may require booster shots for long-lasting protection. Inflammatory response (choice B) is not a type of immunity but rather a non-specific defense mechanism against pathogens. Natural passive immunity (choice D) is short-lived and acquired from maternal antibodies, providing temporary protection.

Correct Answer: B

Rationale: The correct answer is B: speech therapist. Speech therapists specialize in evaluating and treating swallowing difficulties (dysphagia) after a stroke. They can provide techniques and exercises to improve swallowing function. Physical therapists focus on mobility and strength, social workers address psychosocial needs, and respiratory therapists manage breathing-related issues. However, in this case, the primary concern is swallowing dysfunction, making the speech therapist the most appropriate referral.

Correct Answer: A

Rationale: The correct answer is A because the patient's medical record should accompany them to the long-term care facility to ensure continuity of care. This is essential for healthcare providers at the new facility to have access to the patient's medical history, diagnoses, treatments, and medications. Choice B is incorrect because leaving the record in the hospital could lead to delays in treatment and jeopardize patient safety. Choice C is incorrect as shredding the record would violate patient privacy laws and hinder the patient's care continuity. Choice D is incorrect because only the original record should go with the patient to ensure accuracy and completeness.