A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should:

Correct Answer: A

Rationale: Step 1: Fluid restriction of 1800 mL may not be appropriate for all residents in a skilled nursing facility. Step 2: Excessive fluid restriction can lead to dehydration, especially in elderly residents. Step 3: It is crucial for the nurse to question the fluid restriction to ensure it is safe for the resident. Therefore, the correct answer is A. Summary: - Option A is correct as questioning the fluid restriction is essential for the resident's safety. - Option B is incorrect as restraining a resident should only be used as a last resort and should be questioned if not necessary. - Option C is incorrect as blindly transcribing without assessing appropriateness can be harmful. - Option D is incorrect as assessing bowel elimination is important but addressing the fluid restriction is more urgent in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications. Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects. Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications. Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.

Correct Answer: D

Rationale: The correct answer is D because expressing a wish for getting help sooner implies a sense of responsibility and guilt for not doing so. This indicates unresolved feelings of guilt. Choice A refers to sadness during a specific time of the year, not guilt. Choice B reflects acceptance and closure. Choice C indicates a natural progression of grief, not necessarily guilt.

Correct Answer: A

Rationale: Step 1: Pent-up emotions are emotions that are suppressed or not expressed. Step 2: Unexpressed feelings, especially from past traumatic events, can lead to emotional distress. Step 3: Long-term suppression can manifest as depression or other mental health disorders. Step 4: Therefore, choice A is the most appropriate response as it highlights the potential negative consequences of unexpressed emotions. Summary: - Choice B assumes the father has processed his grief, which may not be the case. - Choice C oversimplifies the complexity of emotional expression and may not address the root issue. - Choice D jumps to an extreme outcome without considering the range of possible consequences.

Correct Answer: C

Rationale: The correct answer is C because intervening immediately after the loss has occurred allows for timely support and processing of emotions. This is crucial for healthy grieving and preventing complications. Choice A is too broad and not specific to the immediate need post-loss. Choice B focuses on pre-loss, which is not the most effective time for intervention. Choice D puts the responsibility on the patient, which may delay necessary support.