After the nurse reviewed the client's lab results, the client's serum phosphorus (phosphate) level was found to be at 1.8 mg/dL (0.58 mmol/L) level. What condition is most likely to cause the serum phosphorus level?

Correct Answer: C

Rationale: Malnutrition causes hypophosphatemia (1.8 mg/dL) due to inadequate intake. Hypoparathyroidism lowers calcium, not phosphorus. Kidney failure and tumor lysis raise phosphorus. Nurses, per NCLEX, recognize dietary deficiency as a key cause, making C correct.

Correct Answer: A

Rationale: Talking directly to the next shift staff is the best communication method, per the answer key, ensuring clear, immediate, and reliable transfer of resident information. Writing on loose paper risks loss, white boards lack privacy and detail, and relying on the resident (part of D) is unreliable. Choice D (originally E: 'All of the above') combines all but overcomplicates and dilutes effectiveness. Direct verbal handoff, per AHRQ guidelines, aligns with nursing standards for shift reports, minimizing miscommunication in long-term care settings where continuity is critical.

Correct Answer: B

Rationale: In end-of-life care, the primary goal shifts from curing to ensuring comfort and dignity, which involves managing pain and providing emotional support to both the patient and their family. Pain management addresses physical suffering, while emotional support helps alleviate fear, anxiety, or spiritual distress, aligning with holistic comfort principles. Choice A, aggressive treatment, contradicts this goal, as it may prolong suffering rather than enhance comfort. Choice C, limiting family visits, is inappropriate because family presence often provides emotional solace and supports the patient's psychosocial needs. Choice D, focusing only on physical symptoms, neglects the emotional, spiritual, and social dimensions critical in end-of-life care. Choice B stands out as the most appropriate, integrating comprehensive pain relief with emotional care to promote peace and comfort during this sensitive phase.

Correct Answer: B

Rationale: Physical or emotional stress is a common trigger for fibromyalgia pain, exacerbating the widespread musculoskeletal discomfort characteristic of the condition. Stress, whether from injury, overexertion, or psychological strain like anxiety, disrupts the central nervous system's pain processing, a key factor in fibromyalgia's pathology. Choice A, warm weather, might actually ease symptoms for some, as cold often worsens stiffness and pain. Choice C, regular exercise, while beneficial in moderation to maintain mobility, isn't a triggeroverdoing it might be, but that's distinct. Choice D, adequate rest, typically helps manage symptoms, not provoke them, though poor sleep can worsen pain. Choice B correctly identifies stress as a primary trigger, aligning with clinical observations that fibromyalgia patients experience flare-ups during stressful periods, making stress management a critical nursing focus.

Correct Answer: B

Rationale: The nurse anticipates widespread pain in a client with fibromyalgia reporting disturbed sleep and fatigue, as it's a hallmark symptom of the condition. Fibromyalgia involves chronic, diffuse musculoskeletal pain across multiple body regions, often exacerbated by poor sleep and fatigue, which disrupt pain modulation in the central nervous system. Increased appetite (Choice A) isn't typicalfatigue might reduce appetite due to low energy, not increase it. Headache (Choice C) can occur but isn't a core feature; fibromyalgia's pain is broader, not localized to the head. Bradycardia (Choice D), a slow heart rate, has no direct link to fibromyalgia, which doesn't typically affect cardiac rhythm. Widespread pain (Choice B) aligns with diagnostic criteria, making it the expected finding. Nurses assess this to tailor interventions like pain management, sleep aids, or stress reduction, addressing the triad of pain, sleep issues, and fatigue that defines fibromyalgia's impact on quality of life.