A patient presents with chest pain that increases when lying flat and low-grade fever. Assessment reveals muffled heart sounds, tachycardia, and 3+ edema in the lower extremities. The nurse asks the patient to learn forward, which eases respiratory efforts. The nurse then places the stethoscope at which area on the chest to facilitate auscultation? The above question represents which type of alternate-format question written at which level of Bloom's taxonomy?

Correct Answer: B

Rationale: The correct answer is B: Hot-spot item, analysis level. In this scenario, the patient's symptoms suggest pericardial effusion or cardiac tamponade. To facilitate auscultation, the nurse should place the stethoscope at the point of maximal intensity of the heart sounds, which is typically at the apex of the heart or the lower left sternal border. This requires the nurse to analyze the patient's symptoms and apply knowledge of cardiac anatomy to determine the optimal auscultation site. A: Multiple-response item, comprehension level - This choice involves selecting multiple correct answers from a list of options based on understanding the presented information. It doesn't require the critical thinking and analysis needed in this scenario. C: Chart/exhibit item, application level - This choice involves interpreting information presented in a chart or exhibit to apply it to a specific situation. While it involves application, it doesn't require the same level of analysis as determining the best auscultation site. D: Drag-and

Correct Answer: A

Rationale: The correct answer is A because placing supplies on the nursing unit helps accommodate aging nursing workforce by reducing physical strain from frequent trips to supply rooms. This change supports ergonomic principles and promotes efficiency. Choice B may not directly address the physical challenges of aging nurses. Choice C addresses a different issue unrelated to accommodating aging nurses. Choice D, while important, focuses on one specific aspect of accommodation and may not be as universally beneficial as having supplies readily available.

Correct Answer: B

Rationale: The correct answer is B: shock or rejection. This phase of reality shock is characterized by feelings of being overwhelmed, confused, and unsure of how to proceed despite having knowledge. The novice nurse is experiencing a sense of rejection towards the situation due to the gap between theoretical knowledge and practical application. This phase is common among new healthcare professionals as they transition from academic learning to real-world clinical practice. A: Honeymoon phase refers to the initial period of excitement and enthusiasm in a new role. C: Recovery phase is when the individual starts to adapt and become more comfortable with the new role. D: Resolution phase is the final stage where the individual fully integrates into the role and becomes confident and competent. In this scenario, the novice nurse is clearly struggling and feeling overwhelmed, indicating that they are in the shock or rejection phase, making choice B the correct answer.

Correct Answer: A

Rationale: The correct answer is A because libel refers to written defamatory statements. In this scenario, subjective comments written in the nurse's notes can be considered libel as they are documented in writing. Choice B is incorrect because it describes negative comments made verbally, which would be considered slander, not libel. Choice C is incorrect as it involves verbal communication, which falls under slander, not libel. Choice D is incorrect as it describes repeating prejudiced comments verbally, which is also considered slander, not libel.

Correct Answer: A

Rationale: The correct answer is A: mal ojo. In Hispanic culture, red yarn around the wrist is believed to protect against mal ojo, or "evil eye." This belief stems from the idea that envy or admiration can lead to negative energy being directed at a person, particularly children, causing harm or illness. By complimenting the child's "jewelry," the nurse is acknowledging and respecting the cultural belief in warding off mal ojo. Summary: - A: Mal ojo is the correct answer as the red yarn is believed to protect against it. - B: Susto is a condition related to fright or soul loss, not associated with red yarn. - C: Bilis refers to bile and is not relevant to the red yarn. - D: Empacho is a digestive illness, unrelated to the red yarn tradition.

Correct Answer: A

Rationale: The correct answer is A because Medicare covers hospital stays for individuals aged 65 and older, which would include a 70-year-old client. Choice B is incorrect because Medicare typically covers dialysis for individuals with end-stage renal disease, not nursing home costs. Choice C is incorrect because Medicare does not typically cover rehabilitation care for individuals under 65. Choice D is incorrect because AFDC is a separate program from Medicare that provides assistance for low-income families, and prescription costs for the young mother would likely be covered under a different program.

Correct Answer: C

Rationale: Rationale: Choice C is correct because asking the nurse to represent the unit on the budget planning committee will directly expose them to the financial budget goals. This involvement will provide insight into the importance of accurate documentation and resource utilization. It offers a practical understanding of how decisions impact the unit's financial health. Summary: A: Working in payroll does not directly connect the nurse to the unit's financial goals. B: Personal finance CEUs are not specific to the unit's budget goals. D: Monitoring supplies is important but does not provide a comprehensive understanding of the unit's financial budget goals.

Correct Answer: B

Rationale: The correct answer is B because the role of a parish nurse primarily focuses on health promotion and disease prevention within a faith-based community. Parish nurses typically work to integrate spiritual care with traditional healthcare services. This choice aligns with the core responsibilities of a parish nurse and accurately reflects the primary focus of their practice. Summary of other choices: A: Incorrect. While certification may be available for parish nurses, the process and requirements are not solely defined by state regulations; it usually involves additional training in faith-based healthcare practices. C: Incorrect. The role of a parish nurse is typically guided by professional standards and organizational protocols rather than being solely dictated by the doctrines of a specific denomination. D: Incorrect. While the ANA may acknowledge the role of parish nursing, it does not have specific practice guidelines for this specialty.

Correct Answer: C

Rationale: The correct answer is C because pay for performance initiatives incentivize nurses to improve patient outcomes by reducing errors and following best practices. This directly links economic incentives to nursing practice. Choice A is incorrect because the DRG system primarily affects hospital reimbursement, not nursing shortages. Choice B is incorrect as it focuses on the type of care, not the economic impact on nursing practice. Choice D is incorrect as economic factors like funding, resources, and reimbursement significantly influence nursing practice.