A young child is admitted for treatment of lead poisoning. The nurse recognizes that the most serious effect of chronic lead poisoning is

Correct Answer: A

Rationale: Corrected Rationale: Chronic lead poisoning can lead to severe and irreversible damage to the central nervous system, including cognitive and developmental delays. Central nervous system damage is the most serious effect of chronic lead poisoning because it can have long-lasting consequences on a child's cognitive function and overall development. Moderate anemia (Choice B), renal tubule damage (Choice C), and growth impairment (Choice D) can also occur due to lead poisoning, but they are not as severe or potentially irreversible as the damage to the central nervous system.

Correct Answer: C

Rationale: The correct answer is C: Impaired gas exchange. In a client with an acute myocardial infarction, impaired gas exchange is a priority nursing diagnosis due to compromised heart function, which affects oxygenated blood circulation. Close monitoring and interventions are crucial to ensure adequate oxygenation. Choices A, B, and D are incorrect: A) Constipation related to immobility is not the priority in this acute situation; B) High risk for infection is not the immediate concern related to the client's primary diagnosis; D) Fluid volume deficit, while important, is not the priority compared to addressing impaired gas exchange in acute MI.

Correct Answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

Correct Answer: B

Rationale: In the context of community health nursing, understanding and managing organizational change is crucial for ensuring continuity of care and maintaining staff morale. The correct answer, option B, is the most appropriate choice because explaining to the unit staff why change is necessary helps create a shared understanding and motivation for the upcoming transition. Option A, discussing defensive behavior, is not the best choice in this scenario as it focuses on individual reactions rather than addressing the need for organizational change. Option C, assisting staff during the acceptance of new changes, is a step that typically occurs after the "unfreezing" phase and may be premature at this stage. Option D, clarifying changes to the community and hospital, is important but not the primary focus during the initial phase of "unfreezing." Educationally, it is important for nurses to understand the stages of change management, such as "unfreezing," to effectively guide teams through transitions. By explaining the rationale behind the correct answer and contrasting it with the other options, nurses can develop skills in leading change processes, fostering team cohesion, and maintaining quality care delivery during periods of organizational transformation.

Correct Answer: C

Rationale: The correct answer is C: Auditory expiratory wheezing. Expiratory wheezing is a common sign of reactive airway disease, such as asthma, where airways are constricted, making it difficult to expel air from the lungs. Choices A, B, and D are incorrect as they are not typically associated with reactive airway disease. Auditory gurgling may suggest airway secretions or fluid accumulation, inspiratory laryngeal stridor indicates upper airway obstruction, and frequent dry coughing is more commonly seen in conditions like upper respiratory infections or postnasal drip.