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: 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: A

Rationale: The correct answer is A because in a mass casualty incident, triage principles dictate that care should be prioritized to those with the greatest chance of survival to maximize overall survival rates. This ensures that limited resources are used efficiently. Choices B, C, and D are incorrect: B: Using only community resources first may not be sufficient in a large-scale disaster and could delay the response, leading to unnecessary loss of life. C: State assistance may not be automatically available in every disaster situation and is typically coordinated based on the severity and impact of the disaster. D: Emergency operating plans should be tailored to individual facilities' needs and capabilities, as a one-size-fits-all approach may not be effective in all scenarios.

Correct Answer: A

Rationale: Rationale: A: Correct. Nurses with different education levels (e.g., associate vs. bachelor's degree) have varied scope of practice. BSN-prepared nurses typically have a broader scope compared to ADN-prepared nurses. B: Incorrect. Nursing licenses can be revoked or suspended for various reasons such as misconduct or negligence. C: Incorrect. Nurse practice acts outline licensure requirements, but not specifically for initial licensure. D: Incorrect. States may inquire about the mental or physical status of applicants to ensure they are fit to practice safely.

Correct Answer: B

Rationale: The correct answer is B because it accurately reflects the impact of Florence Nightingale's efforts during the Crimean War on nursing care during the Civil War. Nightingale advocated for sanitary conditions which led to improved housing for soldiers in the Civil War. This is supported by historical evidence. A is incorrect because the emphasis on nursing care differed between the wars, with the Crimean War focusing more on basic care and the Civil War emphasizing sanitary conditions. C is incorrect because black nurses faced discrimination and unequal compensation during both wars, and Mary Seacole's contributions were not widely recognized during the Civil War. D is incorrect because Nightingale did not complete formal nursing training before her work in the Crimean War, and Dix was already an experienced nurse before the Civil War.