A nurse is reinforcing teaching with a client has reports constipation. Which of the following should the nurse discuss as causes of constipation? ((Select ONE that does not apply.)

Correct Answer: B

Rationale: Ignoring the urge to defecate (A) allows stool to harden, excessive laxative use (C) can lead to dependence and reduced motility, and inadequate fluid intake (E) causes harder stools, all contributing to constipation. Increased activity (B) promotes motility and prevents constipation, while increased fiber (D) typically alleviates it unless fluid intake is insufficient. Correct answers are A, C, and E, though E was not listed as an option but is implied in the explanation.

Correct Answer: C

Rationale: Blood pressure and pulse indicate hemodynamic status, critical for an arterial laceration with life-threatening potential, making it the priority. Next of kin (A), medications (B), and respirations (D) are less urgent in this emergency.

Correct Answer: C

Rationale: Case management targets clients with complex, high-cost conditions like chronic heart failure and diabetes. Cystitis (A), hypertension (B), and a fracture (D) typically involve less complexity and cost.

Correct Answer: A

Rationale: The Rapid Response Team (RRT) intervenes for deteriorating clients to prevent arrest, making it the best action for a significant blood pressure drop. Documentation (B) is necessary but insufficient alone, notifying the provider (C) is secondary to RRT, and repeating in 15 minutes (D) delays critical care.

Correct Answer: B

Rationale: B' (Background) provides relevant history (allergies), fitting SBAR. 'A' (Assessment) suggests action, 'R' (Recommendation) notes preferences, and 'S' (Situation) describes the current state, but only B aligns with the background component.