A nurse is assessing a client diagnosed with paranoid schizophrenia. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" Which potential symptom of this disorder is the nurse assessing?

Correct Answer: D

Rationale: The correct answer is D: Delusions of reference. The nurse is assessing the client's belief that external messages are specifically meant for them, a common symptom of paranoid schizophrenia. Thought insertion (A) refers to the belief that one's thoughts are not their own. Paranoid delusions (B) involve beliefs of harm or persecution. Magical thinking (C) is a belief in the power of unrelated actions to influence events. Delusions of reference (D) are the belief that neutral stimuli have personal significance. In this scenario, the nurse is specifically assessing the client's perception of external messages from the TV or radio, indicating delusions of reference.

Correct Answer: B

Rationale: The correct answer is B: an increased heart rate. When an individual is injured, their sympathetic nervous system is activated, causing an increase in heart rate to supply more oxygen and nutrients to the injured area. This response helps the body prepare for fight or flight. A: an increased appetite is incorrect because injury typically suppresses appetite due to stress and pain. C: a decrease in perspiration is incorrect because the body often responds to stress or injury by increasing perspiration to help regulate body temperature. D: a decrease in respiratory rate is incorrect because injury or stress typically leads to an increase in respiratory rate to meet the body's increased oxygen demand.

Correct Answer: B

Rationale: The correct answer is B: ANA Code of Ethics for Nurses. This code provides guidance on ethical considerations for nurses, including the duty to respect human dignity and promote patients' autonomy. It specifically addresses end-of-life decisions and emphasizes the nurse's role in supporting the client's wishes while upholding ethical standards. Choices A, C, and D are incorrect because the Medical Code of Ethics, state boards of nursing, and facility protocols may not specifically address the ethical considerations surrounding end-of-life care for terminally ill clients. Nurses should adhere to the ANA Code of Ethics to ensure they are making ethical, moral, and professional decisions in such sensitive situations.

Correct Answer: A

Rationale: The correct action is to press gently on the inner canthus area immediately after instilling eyedrops. This helps prevent systemic absorption of the medication and reduces the risk of side effects. Pressing on the inner canthus area also prevents drainage of the medication into the nasolacrimal duct, ensuring maximum efficacy. Choice B is incorrect as wiping the eyelid toward the inner canthus can cause the medication to be wiped away before it has a chance to be absorbed. Choice C is incorrect as applying a sterile eye patch is unnecessary and can lead to ocular irritation. Choice D is incorrect as maintaining light pressure on the lower eyelid can cause the medication to be squeezed out of the eye prematurely.

Correct Answer: D

Rationale: The correct answer is D: Quantitative research. Quantitative research emphasizes the collection of numerical data and statistical analysis to draw conclusions. It focuses on quantifying the data and measuring relationships between variables. This method is commonly used in scientific studies to analyze cause and effect relationships. In contrast, basic research (A) aims to expand knowledge without any immediate practical application, while applied research (B) focuses on solving practical problems. Qualitative research (C) involves collecting non-numerical data such as opinions and experiences. Thus, D is the correct choice as it aligns with the emphasis on numerical data collection and analysis.