Correct Answer: A

Rationale: Administering a stool softener as ordered is the most appropriate nursing intervention for a postpartum client experiencing severe perineal pain and difficulty passing stools following a vaginal delivery. Stool softeners help to soften the stool, making it easier for the client to pass without straining, which can exacerbate perineal pain. It is important to follow the healthcare provider's orders when administering medications to ensure proper dosing and effectiveness. Encouraging the client to refrain from defecation may lead to constipation and worsen the situation. Applying ice packs to the perineum can provide temporary pain relief, but addressing the underlying issue of constipation with a stool softener is more effective in the long term. Providing education on proper perineal hygiene is important for overall postpartum care, but addressing the immediate issue of constipation with a stool softener takes precedence in this scenario.

Correct Answer: D

Rationale: The symptoms described by the patient indicate a potential transfusion reaction, such as a hemolytic reaction or allergic reaction. The immediate action the nurse should take in such a situation is to stop the infusion of the packed red blood cells. This will help prevent further complications and ensure the safety of the patient. After stopping the infusion, the nurse should assess the patient's condition, monitor vital signs, and inform the healthcare team, including the physician, regarding the situation. Once the patient is stable, further investigations can be conducted to determine the cause of the reaction.

Correct Answer: D

Rationale: The desired nursing action to help the pregnant patient make a decision on breastfeeding is to assist in identifying a breastfeeding goal and plan. When patients are indecisive about breastfeeding, it is essential for the nurse to support them in setting specific goals and creating a plan that aligns with their values and circumstances. This approach can help the patient feel empowered and confident in their decision-making process. Providing pamphlets and books (choice A) may be helpful, but personalized assistance in identifying a breastfeeding goal and plan is more likely to address the patient's individual needs and concerns. Providing ample time for the patient to decide (choice B) is important, but guidance and support in setting a clear goal can facilitate the decision-making process. Referring the patient to a nutritionist (choice C) may be beneficial for dietary concerns but may not directly address the decision-making process regarding breastfeeding.

Correct Answer: A

Rationale: Acute narrow-angle glaucoma is a medical emergency that requires timely intervention to reduce intraocular pressure. Acetazolamide (Diamox) is a medication commonly used to treat this condition as it works as a carbonic anhydrase inhibitor, reducing the production of aqueous humor in the eye. By reducing the production of aqueous humor, acetazolamide helps decrease intraocular pressure rapidly, which is crucial in managing acute narrow-angle glaucoma. Other options listed, such as Furosemide (Lasix), Atropine, and Urokinase (Abbokinase), are not typically used in the treatment of acute narrow-angle glaucoma.

Correct Answer: C

Rationale: Acute appendicitis is the most likely cause of the symptoms described in the pregnant woman. The classic presentation of acute appendicitis includes fever, chills, abdominal pain localized to the right lower quadrant, rebound tenderness, and guarding. Pregnant women are at a slightly higher risk of developing appendicitis due to anatomic changes and increased abdominal pressure during pregnancy, which can lead to an atypical presentation of symptoms. Prompt diagnosis and surgical intervention are crucial to prevent complications such as perforation, which can be detrimental for both the mother and the fetus.