Correct Answer: B

Rationale: Meconium-stained amniotic fluid indicates that the fetus may have passed stool in utero, which can lead to potential respiratory problems once born due to meconium aspiration. The priority action for the nurse in this situation is to prepare for immediate delivery to expedite the removal of the fetus from the contaminated environment and provide necessary interventions such as suctioning of the airway to prevent aspiration of meconium. Prompt delivery is crucial to minimize the risk of complications related to meconium aspiration syndrome. Administering oxygen, inserting a urinary catheter, and notifying the neonatal resuscitation team can be important subsequent actions, but the immediate focus should be on delivering the baby.

Correct Answer: C

Rationale: Insulin glargine (Lantus) is a long-acting insulin that is typically administered once daily at the same time each day to help maintain a steady level of insulin in the body. It is important to rotate injection sites within the same body region (such as the abdomen, thigh, or upper arm) to prevent lipodystrophy (lumpiness or dents in the skin) and to ensure consistent absorption of the insulin. Proper rotation of injection sites helps to prevent tissue damage and ensures optimal insulin absorption, improving the effectiveness of insulin therapy. It is not necessary to inject insulin glargine before meals, vigorously shake the vial, or administer it with a rapid-acting insulin.

Correct Answer: B

Rationale: The patient's symptoms of unilateral nasal congestion, facial pain, and purulent nasal discharge with tenderness over the affected sinus are suggestive of acute sinusitis. Acute sinusitis is typically caused by a viral or bacterial infection leading to inflammation and swelling of the sinus mucosa, resulting in the characteristic symptoms described. The tenderness over the affected sinus indicates inflammation in that area. Allergic rhinitis typically presents with bilateral nasal congestion, clear nasal discharge, and itching, rather than facial pain and purulent discharge. Nasal polyps are associated with chronic conditions and usually lead to more gradual onset of symptoms. A deviated nasal septum may contribute to chronic sinus issues but typically does not present with acute symptoms of infection like purulent discharge and facial pain.

Correct Answer: B

Rationale: Negligence refers to the failure to perform a duty of care that a reasonable person would have exercised in the same situation, resulting in harm or injury to another person. In this scenario, the nurse failed to perform an ordered irrigation of a feeding tube, which is a standard nursing duty. This failure to act according to the orders resulted in harm to the patient, indicating negligence on the part of the nurse. Malpractice is a specific type of negligence that occurs when a professional fails to provide the standard level of care, so in this case, it falls under the broader category of negligence. Harm to the patient is the consequence of the nurse's negligence, and failure to follow the nurse practice act may be a contributing factor to the negligence, but the primary issue is the failure to provide proper care - which is negligence.

Correct Answer: B

Rationale: Refeeding syndrome is a potentially dangerous condition that can occur in malnourished individuals when nutrition is reintroduced too quickly. It is characterized by shifts in electrolytes, fluid imbalance, and metabolic abnormalities. Monitoring for decreased bowel sounds, nausea, bloating, and abdominal distention is the priority action to prevent complications associated with refeeding syndrome. These symptoms can indicate gastrointestinal issues such as ileus or overfeeding, which can lead to further complications. Early recognition and intervention can help prevent serious consequences of refeeding syndrome.