A patient with upper body strength and ability to maintain balance best ambulates using:

Correct Answer: A

Rationale: The correct answer is A: A walker. A patient with upper body strength and balance should use a walker for optimal support and stability during ambulation. Walkers provide the most support and weight-bearing assistance among the options listed, making them suitable for individuals with these capabilities. Canes and crutches may not offer sufficient support, and handrails are stationary and do not provide the necessary assistance for walking. Therefore, a walker is the best choice for this patient based on their strength and balance.

Correct Answer: A

Rationale: The correct answer is A: Altered mental status and dehydration. In elderly patients with pneumonia, altered mental status and dehydration are often the first symptoms due to age-related changes in the body's response to infection. Dehydration can lead to electrolyte imbalances affecting brain function. Fever and chills (B) typically follow as the infection progresses. Hemoptysis and dyspnea (C) are less common in elderly pneumonia patients. Pleuritic chest pain and cough (D) usually occur later in the course of the illness.

Correct Answer: D

Rationale: The correct answer is D: Avoid straining during bowel movement or bending at the waist. After cataract removal with intraocular lens implant, it is crucial to avoid straining to prevent increased intraocular pressure that could lead to complications. Straining during bowel movements or bending at the waist can increase the risk of complications such as increased eye pressure or dislocation of the intraocular lens. It is important to follow this instruction to ensure proper healing and minimize the risk of postoperative complications. Choice A: Avoid lifting objects weighing more than 5 lb (2.25 kg) is incorrect as lifting restrictions are usually not necessary after cataract surgery unless advised by the surgeon. Choice B: Lie on your abdomen when in bed is incorrect as it is not a standard postoperative instruction after cataract removal with intraocular lens implant. Choice C: Keep rooms brightly lit is incorrect as it is not a specific discharge instruction related to cataract surgery.

Correct Answer: C

Rationale: The correct answer is C: To determine the extent of lesions. A chest X-ray is ordered for a client with a positive Mantoux test to assess the presence and extent of any lesions in the lungs, which may indicate active tuberculosis disease. This helps in determining the severity of the infection and guiding appropriate treatment. Explanation for incorrect choices: A: Chest X-ray does not confirm the diagnosis of tuberculosis, as other diagnostic tests like sputum culture are needed. B: A repeat skin test is not determined by a chest X-ray but by guidelines based on the initial Mantoux test result. D: Chest X-ray does not differentiate between primary and secondary infection, as this distinction is typically based on clinical history and other factors.

Correct Answer: A

Rationale: The correct answer is A: Away from the body. This is because opening the first flap away from the body reduces the risk of contaminating the sterile contents inside the package. By opening the flap away from the body, any potential contaminants on the outside of the envelop such as dust or germs are less likely to come in contact with the sterile items inside. Opening the flap in any other direction (B, C, or D) increases the chances of introducing contaminants into the sterile package, compromising its sterility. It is crucial to follow proper aseptic techniques to maintain the sterility of medical supplies and prevent infections.