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: C

Rationale: The correct answer is C: Cells die. In Alzheimer's disease, there is a progressive degeneration of brain cells, leading to cell death. This results in a loss of important brain functions such as memory, cognition, and eventually, bodily functions. The atrophy of the brain stem (choice A) is not a characteristic feature of Alzheimer's. Fluid buildup (choice B) is not a primary mechanism of the disease. Tissue swelling (choice D) is not typically associated with the progression of Alzheimer's; rather, there is a gradual loss of brain tissue due to cell death.

Correct Answer: C

Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.

Correct Answer: A

Rationale: The correct answer is A: Salary of nurses. In a study, the researcher is likely to exclude salary as it is not directly related to the quality of patient care. The focus should be on factors like responsiveness, caring attitude, and competence of nurses, which directly impact patient outcomes. Including salary may introduce bias and distract from the main objective of studying patient care quality. Responsiveness, caring attitude, and competence are crucial aspects of nursing care that directly influence patient satisfaction and health outcomes. Salary, on the other hand, is an external factor that may not directly correlate with the quality of care provided.

Correct Answer: A

Rationale: The correct answer is A: Identify and count cases. In the initial stages of an outbreak investigation, it is crucial to identify and count cases to understand the scope and magnitude of the outbreak. By counting cases, Nurse Rona and her team can track the spread of the disease, identify common characteristics among those affected, and determine the extent of the outbreak. This step helps in guiding further investigation and control measures. Summary of other choices: B: Define and identify cases - While defining cases is important, it is not the initial step in outbreak investigation. C: Verify diagnosis - Verifying diagnosis is important but comes after identifying and counting cases. D: Prepare for field work - Field work is important in outbreak investigations, but it typically comes after the initial step of identifying and counting cases.

Correct Answer: C

Rationale: The correct answer is C: Secures clean ties before removing soiled ones. This is the priority action because securing clean ties prevents accidental dislodgement of the tracheostomy tube, ensuring the patient's airway remains patent. Cutting the dressing (A) or cleaning the incisions (B) can be important but not as critical as securing the tube. Using clean technique (D) is essential but not the priority in this situation.

Correct Answer: D

Rationale: The correct answer is D: Tilt the head slightly forward and angle the bottle toward the side of the nostril. This method allows for proper administration of the spray into the nasal passage, ensuring effective delivery of the medication. Tilted head helps direct the spray towards the nasal cavity without causing discomfort or leakage. It also helps prevent the medication from dripping down the back of the throat. Choices A, B, and C are incorrect: A: Finishing instillation in one nostril before moving to the other can lead to uneven distribution of medication and reduced effectiveness. B: Inhaling quickly may cause irritation and discomfort to the mucous membranes due to the forceful intake of the spray. C: Blowing the nose after spraying can expel the medication before it has a chance to be absorbed, decreasing its efficacy.

Correct Answer: A

Rationale: The correct answer is A because zero absenteeism and tardiness of pupils indicate that the school nursing programs are effectively promoting student health and well-being. This outcome shows that students are healthy, engaged, and present in school, which is a key goal of school nursing initiatives. Choice B is incorrect as teachers being observers does not directly measure the effectiveness of the nursing programs. Choice C is incorrect as limited information hinders the success and impact of school health initiatives. Choice D is incorrect as constant visits and phone calls from parents may not necessarily reflect the success of the nursing programs.

Correct Answer: B

Rationale: The correct answer is B: Smoking cessation. Smoking is the leading cause of lung cancer, so quitting smoking is crucial in preventing and improving survival rates. Smoking cessation reduces the risk of developing lung cancer and improves treatment outcomes. High-dose chemotherapy (A) may be part of the treatment plan, but quitting smoking is more impactful. Early bronchoscopy (C) and early detection (D) are important, but without addressing the root cause (smoking), the survival rates will not significantly increase.