Correct Answer: B

Rationale: Elevating the head of the bed to improve respiratory mechanics is the most appropriate intervention for managing paroxysmal nocturnal dyspnea in a patient with end-stage heart failure. By keeping the head of the bed elevated, gravity helps reduce the pooling of fluid in the lungs, making it easier for the patient to breathe and reducing dyspnea. This strategy can help improve oxygenation and decrease the sensation of breathlessness, providing relief for the patient. Administering diuretic medications (Option A) can also be beneficial to reduce fluid overload, although positioning remains a key intervention. Encouraging the patient to sleep in a reclined position (Option C) can help alleviate symptoms, but specifically elevating the head of the bed is a more targeted approach. Referring the patient to a sleep specialist (Option D) may not be necessary at this time, as the primary concern is managing the acute symptom of paroxysmal nocturnal dyspnea

Correct Answer: B

Rationale: The distribution of patient satisfaction forms by Nurse Jen directly relates to patient care. By collecting feedback from admitted patients, the hospital can assess the quality of care being provided and identify areas for improvement. This initiative falls under patient care as it focuses on enhancing the overall experience and well-being of the patients, aligning with quality standards that prioritize patient satisfaction and outcomes.

Correct Answer: A

Rationale: The statement "I will have to avoid drinking nonalcoholic beer" indicates a potential misunderstanding as nonalcoholic beer is generally permitted on most diets. The client may need further teaching to clarify this misconception. The other statements indicate a good understanding of the dietary guidelines and do not raise concerns about misunderstanding.

Correct Answer: C

Rationale: The described clinical presentation of a yellowish-white spot on the cornea with a ring of inflammation, along with branching, filamentous opacities extending from the corneal lesion, is highly suggestive of fungal keratitis. Fungal keratitis is commonly caused by filamentous fungi such as Fusarium and Aspergillus species. The characteristic finding of branching, filamentous opacities seen on slit-lamp examination is classic for fungal infections of the cornea. It is important to promptly diagnose and treat fungal keratitis since delayed or inadequate management can result in vision-threatening complications.

Correct Answer: D

Rationale: The priority nursing initiative for Nurse May should be to set up a mental health program in the community. This proactive approach focuses on prevention, early intervention, and support for individuals experiencing mental health issues. By setting up a mental health program, Nurse May can address the root causes of mental problems in young adults in the community, provide education and awareness, offer counseling services, and promote mental well-being. This initiative can have a long-term impact on the mental health of individuals and help reduce the incidence of mental problems in the community. Setting up a mental health program is a holistic and sustainable approach to addressing mental health issues in the community.