A nurse is performing change of shift assessments on 4 clients. Which of the following findings should the nurse report to provider first?

Correct Answer: B

Rationale: The correct answer is B because lethargy and confusion in a client with gastroenteritis may indicate dehydration or electrolyte imbalance, which can lead to serious complications. The nurse should report this finding first to prevent deterioration. Choice A is incorrect because thick productive cough and thirst in a client with cystic fibrosis are common symptoms and may not require immediate provider notification. Choice C is incorrect because a morning fasting blood glucose of 185 mg/dL in a client with diabetes mellitus is elevated but not considered a critical finding that requires immediate reporting. Choice D is incorrect because pain 15 minutes after receiving an oral analgesic is a common occurrence and does not indicate an urgent need for provider notification.

Correct Answer: C

Rationale: The correct answer is C: A urinary tract infection. Nancy's mother's symptoms such as nonsensical speech, disheveled appearance, strong urine smell, and stain on dressing gown are indicative of a urinary tract infection. UTIs in the elderly can cause confusion, delirium, and incontinence. By recognizing these symptoms, Nancy can suspect a UTI as the cause and seek medical treatment promptly to address the infection. Incorrect choices: A: Early onset dementia - Symptoms of UTI are acute and temporary, not indicative of a chronic condition like dementia. B: A mild cognitive disorder - UTI symptoms are not typically associated with mild cognitive disorders. D: Skipping breakfast - Skipping breakfast does not explain the range of symptoms observed in Nancy's mother.

Correct Answer: C

Rationale: The nurse would include improved access to less costly services as the main focus as it aligns with the goal of managed care in mental health, which emphasizes providing quality care in a cost-effective manner. By focusing on improving access to less costly services, the nurse can educate the women's club on how managed care models aim to reduce healthcare costs while still ensuring appropriate and timely mental health services for individuals. Choice A (Cost savings) is too broad and doesn't specifically address mental health services. Choice B (Consistent third-party reimbursement) is important but not the main focus of managed care in mental health. Choice D (Individualized care for additional inpatient stays) is not typically a primary focus of managed care which aims to promote outpatient and less costly services.

Correct Answer: B

Rationale: The correct answer is B: Slowed information processing. As individuals age, it is normal for their cognitive processing speed to decrease. This is a common age-related change in cognition due to factors such as decreased brain processing efficiency. Slowed information processing does not necessarily indicate cognitive impairment but is a normal part of aging. A: Disorientation to time is not a normal cognitive change but rather a sign of cognitive impairment or confusion. C: Diminished executive functioning refers to difficulties in tasks such as planning, problem-solving, and decision-making, and is not a normal age-related change. D: Restricted judgment is not a typical age-related cognitive change but may indicate cognitive decline or impairment.

Correct Answer: C

Rationale: The correct answer is C because discussing options and helping the patient weigh consequences promotes autonomy by involving the patient in decision-making. This empowers the patient to make informed choices about their care. A is incorrect as it limits the patient's autonomy. B restricts the patient's support system. D focuses on setting boundaries rather than promoting autonomous decision-making.