Correct Answer: A

Rationale: The nurse should prioritize ensuring proper zeroing and calibration of the ICP monitoring system to ensure procedural accuracy and reliability of the measurements obtained. Proper zeroing involves setting the transducer at the level of the patient's external auditory meatus (ear), which serves as a reference point for accurate ICP readings. Calibration is necessary to establish accurate pressure measurements. Incorrect zeroing or calibration can lead to inaccurate ICP readings, which can impact clinical decision-making for patients with traumatic brain injury. Positioning the patient in a high-Fowler's position, administering prophylactic antibiotics, or placing the ICP monitor in the subarachnoid space via lumbar puncture are not directly related to ensuring the accuracy of the ICP monitoring procedure.

Correct Answer: B

Rationale: When a patient receiving palliative care for end-stage cancer experiences severe nausea and vomiting despite current antiemetic therapy, the palliative nurse should consider switching to a different antiemetic medication with a different mechanism of action. This approach is based on the concept of individual variability in response to medications, as well as the potential development of tolerance to a particular drug. Switching to a different antiemetic with a new mechanism of action can provide the patient with a fresh chance at better symptom control by targeting different receptors or pathways involved in nausea and vomiting. It is important to consult the healthcare team and consider the patient's overall condition and medication history before making any changes in the treatment plan.

Correct Answer: D

Rationale: The presentation described, including a well-demarcated, hyperpigmented patch with irregular borders, asymmetric color distribution, and increase in size over a short period, is concerning for melanoma. Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment in the skin. The irregular borders, color variation, and growth over time are classic signs of melanoma. Melanomas are potentially dangerous and should be evaluated promptly by a healthcare provider for proper diagnosis and treatment. It is important to distinguish melanoma from other benign lesions like melanocytic nevus (mole), lentigo simplex, and seborrheic keratosis, as early detection and treatment of melanoma can significantly impact patient outcomes.

Correct Answer: D

Rationale: The correct answer is D, issuing a permit for the opening of nursing programs in the country. The PRC-Board of Nursing (PR-BON) in the Philippines primarily focuses on regulating nursing practice and ensuring the quality and standards of nursing care provided in the country. While they have the authority to oversee aspects such as certification of registered nurses, enforcing quality standards, and monitoring proper conduct of nurses, the responsibility of issuing permits for the opening of nursing programs typically falls under the jurisdiction of other relevant educational or accrediting bodies.

Correct Answer: C

Rationale: The indicators listed indicate measures that Nurse Cirila can take to maintain a safe environment for her pediatric patients. However, assessing the competencies of staff before delegating a task is more related to ensuring effective delegation and appropriate task assignment rather than directly ensuring a safe environment for patients. While it is important to delegate tasks to qualified staff, this specific action does not directly contribute to maintaining a safe environment in the same manner as the other indicators listed (proper waste disposal, infection control, emergency protocols).