A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?

Correct Answer: B

Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.

Correct Answer: B

Rationale: The correct answer is B: Prevents postpartum hemorrhage. Methylergonovine maleate is a uterotonic medication used to prevent and treat postpartum hemorrhage by causing strong uterine contractions, which help to control bleeding after delivery. It is not used to reduce lochia drainage (choice A), decrease uterine contractions (choice C), or maintain normal blood pressure (choice D). By understanding the pharmacological action of methylergonovine maleate in preventing postpartum hemorrhage, we can confidently select choice B as the correct answer.

Correct Answer: B

Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.

Correct Answer: A

Rationale: The correct answer is A because zero absenteeism and tardiness of pupils indicate that the school nursing programs are effectively promoting student health and well-being. This outcome shows that students are healthy, engaged, and present in school, which is a key goal of school nursing initiatives. Choice B is incorrect as teachers being observers does not directly measure the effectiveness of the nursing programs. Choice C is incorrect as limited information hinders the success and impact of school health initiatives. Choice D is incorrect as constant visits and phone calls from parents may not necessarily reflect the success of the nursing programs.

Correct Answer: A

Rationale: Correct Answer: A: To help control the intra-ocular pressure Rationale: 1. Eye surgery can lead to increased intra-ocular pressure. 2. Instilling eye drops can help reduce this pressure post-surgery. 3. Controlling intra-ocular pressure is crucial for proper healing and preventing complications. 4. Eye drops for infection (B) or pupil dilation/constriction (C, D) are not primary concerns post-eye surgery.

Correct Answer: A

Rationale: The correct answer is A: Malpractice. The nurse's failure to document and remove the over-the-counter medication, which led to a serious adverse drug reaction, constitutes malpractice. Malpractice refers to negligence or failure to provide the standard of care expected in a professional setting. In this case, the nurse's actions directly resulted in harm to the client, which is a clear example of malpractice. Incorrect Choices: B: Failure of duty to warn - This choice implies that the nurse had a duty to warn the client about the potential drug interaction, which may not necessarily be the case. The primary issue here is the nurse's failure to document and remove the medication, not a failure to warn. C: Assault - Assault involves intentional harm or threat of harm, which is not applicable in this scenario where the harm was due to negligence. D: Incompetence - While the nurse's actions may demonstrate incompetence, the more specific legal term for this situation would be malpractice, as it directly

Correct Answer: D

Rationale: The correct answer is D: Osteoporosis. Long-term use of inhaled corticosteroids can lead to decreased bone density and an increased risk of osteoporosis. Corticosteroids can interfere with calcium absorption and bone formation, resulting in bone weakening. Oral thrush (Choice A) is a common side effect of inhaled corticosteroids, but it is not associated with long-term use. Hypertension (Choice B) and hyperglycemia (Choice C) are more commonly seen with systemic corticosteroid use rather than inhaled corticosteroids.

Correct Answer: C

Rationale: The correct answer is C because communicating with the patient's primary care provider and community resources demonstrates continuity of care. This action ensures a seamless transition from the hospital to home by keeping all involved parties informed and involved in the patient's care. Option A (written discharge instructions only) may provide information but lacks coordination with other healthcare providers. Option B (discharging without follow-up care coordination) can lead to gaps in care. Option D (disregarding patient concerns) goes against patient-centered care and can disrupt the continuity of care.

Correct Answer: B

Rationale: The correct answer is B: How the nurse will behave. Standards of nursing care refer to the expected behaviors and practices that nurses should adhere to in providing quality care to patients. This encompasses ethical principles, professional conduct, and best practices in nursing. It is essential for nurses to follow these standards to ensure patient safety and quality outcomes. Explanation: - A: What protects the nurse. This choice is incorrect because standards of nursing care primarily focus on patient care and outcomes, rather than protecting the nurse. - C: How much work is done. This choice is incorrect as it does not directly relate to the behaviors and practices expected of nurses in providing quality care. - D: Ask the local officials. This choice is unrelated to the concept of standards of nursing care and is not relevant to the question.