A PEFR less than 80% of the personal best indicates that the patient is in the yellow zone where changes in therapy are needed to prevent progression of the airway narrowing.

Correct Answer: A

Rationale: Rationale: The correct answer is A) 320. Peak Expiratory Flow Rate (PEFR) measures the maximum speed at which a person can exhale air. A PEFR less than 80% of the personal best indicates the patient is in the yellow zone, signaling a cautionary stage where changes in therapy are necessary to prevent worsening airway constriction. Option B) 400, Option C) 500, and Option D) 600 are incorrect because they exceed the 80% threshold. In conditions like asthma, a PEFR value below 80% of the personal best indicates a decline in lung function and signals the need for treatment adjustments. Therefore, options B, C, and D would falsely suggest the patient is not in the yellow zone, potentially delaying necessary interventions. In an educational context, understanding PEFR values is crucial for healthcare professionals, especially those dealing with patients with respiratory conditions. Knowledge of PEFR ranges and zones helps in assessing the severity of airway narrowing, guiding treatment decisions, and preventing exacerbations. Educating students on interpreting PEFR values equips them with essential skills for managing patients with respiratory issues effectively.

Correct Answer: A

Rationale: The correct answer is A) Teach the client about cobalamin therapy. This is the best action by the nurse because a sore tongue (glossitis) is a classic symptom of B12 deficiency, also known as pernicious anemia. Cobalamin therapy involves the administration of vitamin B12 to address the deficiency and alleviate symptoms like glossitis. Educating the client about this therapy is crucial for promoting their understanding of the condition and its treatment. Option B) Ordering genetic testing for the client is incorrect because the symptoms presented (sore tongue and inability to eat) are indicative of a nutritional deficiency rather than a genetic condition. Genetic testing would not be the appropriate next step in this scenario. Option C) Encouraging a high-fiber diet is also incorrect as this would not directly address the underlying cause of the client's symptoms, which is a B12 deficiency. While a healthy diet is important for overall well-being, it would not be the primary intervention needed in this case. Option D) Placing the client on protective precautions is not relevant to the client's symptoms of a sore tongue and inability to eat. Protective precautions are typically implemented to prevent the spread of infections and would not be indicated in this situation. In an educational context, it is essential for nurses to be able to recognize common signs and symptoms of various health conditions, such as glossitis in the context of B12 deficiency. Understanding the rationale behind treatment options is crucial for providing effective care to clients and promoting positive health outcomes. Educating clients about their conditions and treatment options empowers them to take an active role in managing their health.

Correct Answer: B

Rationale: The correct answer is option B: "My shoes fit tighter by the end of the day." This statement alerts the nurse to the presence of edema, specifically peripheral edema, which is a common sign of fluid retention in the body. Edema causes swelling in the extremities, leading to tightness in shoes or clothing. This symptom is crucial for the nurse to identify as it can indicate underlying health issues such as heart failure, kidney disease, or liver problems affecting fluid balance. Option A, "I wake up to go to the bathroom at night," is unrelated to edema and suggests a possible issue with nocturia, which could be due to various reasons such as urinary tract infections or prostate problems. Option C, "I seem to be feeling more anxious lately," does not provide any information related to edema or fluid retention but rather hints at a psychological or emotional concern. Option D, "I drink at least eight glasses of water a day," is a general statement about hydration and does not directly relate to the presence of edema. In fact, adequate hydration is important for overall health and can help prevent edema by maintaining fluid balance in the body. Understanding the signs and symptoms of edema is crucial for nurses to assess a patient's health status accurately. Recognizing peripheral edema can lead to early intervention and appropriate management to address the underlying cause, ultimately improving patient outcomes and quality of care.

Correct Answer: B

Rationale: In the scenario presented, the correct answer is B) Anticonvulsant. Magnesium sulfate is commonly used in the management of severe preeclampsia to prevent seizures, which can occur as a complication of this condition. Magnesium sulfate acts as a central nervous system depressant and helps to prevent and control seizures by blocking neuromuscular transmission and decreasing the release of acetylcholine at the myoneural junction. Option A) Tocolytic is incorrect because tocolytics are medications used to inhibit uterine contractions and delay preterm labor, not to prevent seizures in preeclampsia. Option C) Antihypertensive is incorrect because while preeclampsia is characterized by hypertension, magnesium sulfate is not primarily used to lower blood pressure but rather to prevent seizures. Option D) Diuretic is incorrect because diuretics are used to promote diuresis and reduce fluid retention, not to prevent seizures in preeclampsia. In an educational context, understanding the correct classification of medications used in the management of preeclampsia is crucial for nurses and healthcare providers caring for pregnant individuals. Knowing the specific actions and indications of medications like magnesium sulfate can help ensure safe and effective care for patients with this condition. This knowledge also highlights the importance of accurate medication administration and monitoring to prevent complications and optimize outcomes in obstetric patients.

Correct Answer: B

Rationale: In the context of ARDS, or Acute Respiratory Distress Syndrome, understanding the factors that contribute to the poorest outcomes is crucial for effective nursing practice. The correct answer, option B, an African American male with sepsis, aligns with evidence-based research that indicates a higher risk of mortality in ARDS among males, African Americans, and individuals with sepsis. Exploring the incorrect options provides valuable educational context. Option A, a Hispanic male with pneumonia, may have a better prognosis compared to those with sepsis due to the different underlying causes and severity of illness. Option C, a Caucasian female with sepsis, is less likely to have the poorest outcome as compared to African American males, based on existing data on ARDS outcomes. Option D, an African American female with chest trauma, is not directly linked to the factors associated with poor outcomes in ARDS, such as sepsis. Educationally, this question highlights the importance of recognizing the disparities in health outcomes among different demographic groups and the impact of comorbid conditions on disease progression. By understanding these risk factors, nurses can tailor their care to address the specific needs of patients with ARDS, ultimately improving patient outcomes and quality of care.