A patient presents with acute onset of shoulder pain and limited range of motion after a fall onto an outstretched hand. Physical examination reveals tenderness over the greater tuberosity of the humerus and pain with passive abduction and external rotation of the shoulder. Which of the following conditions is most likely?

Correct Answer: A

Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition. B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour. C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder. D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.

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: Periodically lie in prone position without a neck pillow. This position helps to prevent spinal flexion by promoting extension of the spine and stretching of the hip flexors. Prone positioning also helps maintain alignment of the spine and prevents contractures. Resting in supine position (choice A) with the head elevated does not promote spinal extension. Sleeping only in dorsal recumbent position (choice B) may lead to spinal flexion. Sleeping on either side (choice D) does not specifically address spinal flexion prevention.

Correct Answer: C

Rationale: The correct answer is C: cope with anxiety. The nurse's goal is to address Belle's difficulty tolerating frustration, which likely leads to anxiety. By helping Belle develop coping strategies for managing her anxiety, the nurse can assist her in handling frustration more effectively. Options A, B, and D are incorrect because increasing self-esteem, recognizing needs, and mobilizing resources may be important aspects of Belle's overall care but are not directly related to addressing her difficulty with frustration and anxiety. Focusing on coping with anxiety directly targets the root issue and is the most appropriate goal in this context.

Correct Answer: B

Rationale: The correct answer is B: To provide a patent airway. When caring for a patient with a tracheostomy, ensuring a clear and unobstructed airway is the top priority to maintain adequate oxygenation and ventilation. This involves suctioning, maintaining proper tube placement, and monitoring for any signs of respiratory distress. Choices A, C, and D are incorrect as they do not address the immediate need for airway management, which is crucial for the patient's safety and well-being.

Correct Answer: D

Rationale: The correct answer is D because a journal article about a study using large, previously unpublished databases is a primary source as it presents original research findings firsthand. It contributes new knowledge to the field. A textbook (A) compiles existing information, not original research. A doctoral dissertation (B) critiques research but is not a primary source. A published commentary (C) interprets others' findings, making it a secondary source.

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: C

Rationale: The correct answer is C: Food and water. Typhoid fever is primarily transmitted through contaminated food and water by the bacterium Salmonella typhi. The bacteria are shed in the feces of infected individuals and can contaminate water sources or food prepared with contaminated water. This transmission route aligns with the typical epidemiology of typhoid fever outbreaks. Now, let's discuss why the other choices are incorrect: A: A vector - Typhoid fever is not transmitted by a vector such as mosquitoes or ticks. B: Blood and body fluids - Typhoid fever is not typically spread through blood or body fluids but rather through ingestion of contaminated food or water. D: Air - Typhoid fever is not an airborne disease and is not transmitted through the air.

Correct Answer: D

Rationale: The correct answer is D: Breastfeeding. HIV transmission from mother to infant can occur through breast milk due to the presence of the virus in breast milk. Other choices such as A: Bathing, B: Bottlefeeding, and C: Washing of vagina do not involve direct contact with potentially infected body fluids like breast milk, making them less likely to transmit the virus. Breastfeeding is a well-documented mode of HIV transmission from mother to infant, hence it is the correct choice in this scenario.