A nurse is preparing to perform a chest tube insertion for a patient with a pneumothorax. What action should the nurse prioritize to ensure proper placement of the chest tube?

Correct Answer: D

Rationale: The correct answer is D because confirming the insertion site and direction using imaging guidance ensures precise placement of the chest tube, minimizing the risk of complications. Imaging guidance allows the nurse to visualize the exact location of the pneumothorax and guide the tube insertion accurately. A: Positioning the patient in a semi-Fowler's position with arms elevated may be beneficial for comfort but does not directly ensure proper chest tube placement. B: Marking the insertion site with a pen may help as a reference point but does not guarantee accurate placement. C: Administering analgesia is important for the patient's comfort but does not impact the placement of the chest tube. In summary, choice D is the most critical step to ensure the chest tube is correctly placed and effectively treats the pneumothorax.

Correct Answer: A

Rationale: Rationale: A is the correct answer as it demonstrates therapeutic communication by encouraging Annie to express her feelings and fears. It shows empathy and understanding, allowing Annie to elaborate on her concerns. B is incorrect as it dismisses Annie's fears and implies blame on her parenting. C is incorrect as it focuses on the behavior of the children rather than addressing Annie's emotions. D is incorrect as it places the responsibility on the children to make Annie feel comfortable, rather than addressing her concerns directly.

Correct Answer: A

Rationale: The correct answer is A: Anterior uveitis. This condition presents with redness, pain, and photophobia due to inflammation of the uveal tract. Ciliary injection, corneal edema, and mid-dilated pupil with fixed reaction to light are classic signs of anterior uveitis. The other choices can be ruled out based on specific findings: B: Acute angle-closure glaucoma would present with a high intraocular pressure, not fixed dilated pupil. C: Endophthalmitis typically presents with severe pain, hypopyon, and vitreous inflammation. D: Corneal abrasion would not cause ciliary injection or fixed dilated pupil.

Correct Answer: A

Rationale: The correct answer is A: Bleeding. Chemotherapy can lead to low platelet counts (thrombocytopenia), increasing the risk of bleeding. The priority goal of the nurse is to prevent bleeding by taking precautions such as avoiding invasive procedures, using soft toothbrushes, and monitoring for signs of bleeding. Infection (B) is important but not the priority as bleeding can be life-threatening. Hypotension (C) is not directly related to thrombocytopenia. Diarrhea (D) is a potential side effect of chemotherapy but is not the priority when considering thrombocytopenia.

Correct Answer: A

Rationale: The correct answer is A: Plasmodium falciparum. Plasmodium falciparum is the most likely causative agent because the patient's symptoms of fever, chills, headache, and myalgia, along with the presence of intraerythrocytic ring forms and trophozoites on blood smear, are characteristic of malaria, particularly caused by P. falciparum in sub-Saharan Africa. Summary of other choices: B: Trypanosoma cruzi causes Chagas disease, which presents with symptoms like fever, rash, and swelling at the site of entry, not consistent with the patient's presentation. C: Borrelia burgdorferi causes Lyme disease, which typically presents with a characteristic rash (erythema migrans) and arthritis, not matching the patient's symptoms. D: Leishmania donovani causes visceral leishmaniasis, which presents with symptoms like weight loss, hepatosplen

Correct Answer: B

Rationale: The correct answer is B: Psoriasis. Psoriasis is characterized by pruritic, erythematous patches with silvery scales, commonly found on the elbows, knees, and scalp. This presentation matches the patient's symptoms. Eczema (choice A) typically presents with red, inflamed, and itchy skin patches. Pityriasis rosea (choice C) manifests as a herald patch followed by smaller scaly patches in a "Christmas tree" distribution. Seborrheic dermatitis (choice D) involves oily, yellowish, scaly patches mainly on the scalp, face, and ears, and does not typically present with silvery scales.

Correct Answer: A

Rationale: The correct answer is A: Initiate non-invasive positive pressure ventilation (NIPPV). This intervention is prioritized as it helps improve oxygenation and ventilation in COPD exacerbation without the need for invasive mechanical ventilation, reducing the risk of ventilator-associated complications. NIPPV also decreases the work of breathing and can prevent the need for intubation. Administering bronchodilator medications (B) is important in COPD exacerbation but may not address the immediate need for ventilatory support. Endotracheal intubation (C) should be reserved for cases of respiratory failure not responding to NIPPV. Chest physiotherapy (D) may be beneficial in some cases but is not the first-line intervention for managing acute COPD exacerbation.

Correct Answer: B

Rationale: The correct answer is B: Lie on the affected area. This position would hinder drainage and increase pressure on the affected area. A: Tilt head to the side if sitting up, is correct as it promotes drainage. C: Putting pillows behind the head can also aid drainage. D: Lying on the non-affected ear can help reduce pressure on the affected side.

Correct Answer: D

Rationale: The correct immediate action for the nurse is to notify the anesthesia provider immediately (Option D). This is crucial because a sudden change in the patient's level of consciousness during surgery could indicate a serious issue related to anesthesia administration. Notifying the anesthesia provider promptly allows for quick assessment and intervention to address the underlying cause, potentially preventing complications or even saving the patient's life. Administering a reversal agent (Option A) without proper evaluation by the anesthesia provider could be dangerous. Documenting the change in the patient's chart (Option B) is important but not the most immediate action. Checking the patient's vital signs (Option C) is also important but may not provide immediate insight into the cause of the change in consciousness.