A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: C

Rationale: The correct answer is C: Hyponatremia. SSRI medications can lead to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), causing hyponatremia. This occurs due to increased levels of serotonin affecting the hypothalamus, leading to excessive ADH release. Hyponatremia can result in neurological symptoms and must be closely monitored. A: Bradycardia is not a common adverse effect of SSRIs. B: Hyperkalemia is not typically associated with SSRIs. D: Hypertension is not a common adverse effect of SSRIs; they may actually lower blood pressure.

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: C

Rationale: The correct action in this scenario is to choose option C: put a line across the sentence, make the correction over it, and sign. This method is recommended because it maintains the integrity of the original record by showing what was initially written and clearly indicating the correction. By crossing out the error, making the correction, and signing the entry, the nurse acknowledges and takes responsibility for the mistake while ensuring the accuracy and transparency of the documentation. Option A is incorrect as crossing the error many times can make the note illegible and may not clearly indicate the correction. Option B is incorrect because using correction fluid can make the note messy and may raise suspicions of tampering with the record. Option D is incorrect as erasing with a rubber eraser can damage the document and also raise concerns about the validity of the information. In summary, option C is the best choice as it allows for a clear and professional correction without compromising the integrity of the progress notes.

Correct Answer: B

Rationale: One potential maternal condition that may contribute to abnormal labor progression with slow cervical dilation despite regular contractions is pelvic outlet obstruction. This can occur if the maternal pelvis is too small, misshapen, or has an obstruction such as a fibroid tumor. The inadequate space in the pelvis can prevent the fetus from descending properly and can result in a prolonged or difficult labor. If suspected, interventions such as a cesarean delivery may be necessary to prevent complications for both the mother and baby. It is essential for the nurse to assess for signs of pelvic outlet obstruction and work with the healthcare team to address any issues promptly to ensure a safe delivery.

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: B

Rationale: The correct answer is B: establish a credit body of evidence to support and improve the delivery of care. Conducting research in nursing aims to generate a robust evidence base to inform and enhance the quality of care provided to patients. This evidence helps in identifying best practices, improving patient outcomes, and advancing the nursing profession as a whole. Choice A is incorrect because the main goal of research is not to solely justify the role of nurses, but rather to improve care delivery. Choice C is incorrect as the goal is not to justify an oversupply of nurses, but to address healthcare needs effectively. Choice D is incorrect because the focus of nursing research is on nursing-related issues, not non-nursing problems.

Correct Answer: C

Rationale: The correct answer is C: Durable power of attorney. This legal document allows Mr. M to appoint his daughter as his healthcare proxy, granting her the authority to make medical decisions on his behalf if he becomes incapacitated. A: Expressed contract involves clear terms agreed upon by both parties, not relevant here. B: Implied contract arises from actions rather than explicit agreement, not applicable in this situation. D: A living will outlines an individual's medical treatment preferences, but does not grant decision-making authority to another person.

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: B

Rationale: The correct initial step before starting TPN is to evaluate the patient's tolerance to glucose. This is crucial to ensure the patient can metabolize the glucose effectively and avoid complications such as hyperglycemia. Assessing affordability (A) is important but not the immediate concern. Identifying allergies (C) should be done but is not the first step. Assessing the patient's understanding (D) is important but not as critical as evaluating glucose tolerance before starting TPN.