After positioning the patient for surgery, the nurse notices signs of pressure injury on the patient's heels. What should the nurse do?

Correct Answer: A

Rationale: Pressure injuries on the heels are a concern as they can develop quickly and lead to serious complications, especially in surgical patients who are immobile for extended periods. Applying pressure-relieving devices, such as heel protectors or foam dressings, can help alleviate the pressure on the affected areas and prevent further damage. These devices are designed to distribute pressure evenly and reduce the risk of pressure injuries. It is important for the nurse to address the issue promptly to prevent additional harm to the patient's skin integrity.

Correct Answer: A

Rationale: Neutrophils are a type of white blood cell that play a crucial role in immune defense against pathogens, particularly in phagocytosis - the process by which they engulf and destroy invading microorganisms. In a severe fungal infection, impaired neutrophil function would most likely affect their ability to effectively perform phagocytosis, leading to a compromised immune response against the fungal pathogen. This would result in increased susceptibility to the infection and potentially severe outcomes for the patient. Antibody production, cytokine secretion, and mast cell degranulation are important components of the immune response, but neutrophils are primarily responsible for phagocytosis in the innate immune system.

Correct Answer: A

Rationale: The appropriate approach of the nurse in this situation would be to talk about the reality of death with the father. It is important to provide appropriate and compassionate communication, acknowledging the father's grief while also gently guiding him towards accepting the reality of the situation. By discussing the reality of death and offering support, the nurse can help the father start the grieving process and eventually come to terms with the loss of his son. It is important to provide emotional support and guidance in a sensitive and respectful manner during such a difficult time.

Correct Answer: A

Rationale: The BEST position for a patient in shock is the modified Trendelenburg position. In this position, the patient's legs are elevated above the level of the heart to enhance blood flow back to the heart and vital organs. Placing the patient in the modified Trendelenburg position helps increase venous return, improves cardiac output, and promotes perfusion to vital organs, which can be crucial in managing shock. This position can help stabilize the patient's condition while awaiting further medical intervention.

Correct Answer: C

Rationale: The most effective strategy in preventing more incidence of dengue infection is to target the breeding places of the Aedes mosquitoes, which are the vectors responsible for transmitting the dengue virus. By eliminating stagnant water sources where these mosquitoes breed, such as uncovered containers, flower pots, and discarded tires, the mosquito population can be significantly reduced. This, in turn, helps to lower the risk of dengue transmission to humans. While healthy nutritious food, burning of leaves and garbage, and adequate rest and sleep are important for overall health and immune function, they do not directly address the primary cause of dengue transmission, which is the Aedes mosquito population.

Correct Answer: B

Rationale: The patient's presentation of well-demarcated, erythematous plaques with silvery scales on the trunk and extensor surfaces of the limbs is classic for psoriasis. Additionally, the family history of similar skin lesions further supports the diagnosis of psoriasis, as it is a condition with a genetic predisposition. Pityriasis rosea typically presents with a herald patch followed by oval, scaly lesions in a Christmas tree pattern. Erythema multiforme is characterized by target-like lesions. Lichen planus presents as purple, polygonal, flat-topped papules that may have fine white lines on their surface known as Wickham striae.

Correct Answer: B

Rationale: Tilt back Claudia's head slightly would have been the correct action to prevent her from blinking during eye drop instillation. By tilting her head back, you create a more stable position for instilling the eye drops, reducing the likelihood of accidental contact with her eyelid. Additionally, tilting the head back slightly helps in making it easier for the drops to enter the eye and stay within the conjunctival sac, improving the efficacy of the medication.

Correct Answer: B

Rationale: Ramona Mercer's becoming a mother (BAM) theory emphasizes the dynamic transformation and evolution of a woman's persona as she transitions into motherhood. This theory acknowledges that becoming a mother is a process involving significant changes in a woman's identity, roles, and relationships. It goes beyond just the physical aspects of giving birth and delves into the psychological, emotional, and social aspects of motherhood. Therefore, statement B aligns with the core principles of Mercer's BAM theory and fosters the understanding of the process of becoming a mother.

Correct Answer: B

Rationale: The Philippine Nurses Association, Inc. (PNA) is the accredited professional organization of nurses in the Philippines. PNA is recognized as the official organization of all registered nurses in the country, dedicated to fostering high standards of nursing practice, education, and professional growth. It plays a key role in advocating for the rights and welfare of nurses, as well as promoting the advancement of the nursing profession in the Philippines. Membership in the PNA provides nurses with access to valuable resources, networking opportunities, and support for continuous professional development.