Correct Answer: C

Rationale: Upon arrival, checking the lungs for equal breath sounds bilaterally is the first action. This is crucial to assess airway patency and breathing effectiveness in a patient with a history of diving accident and intubation. Ensuring proper oxygenation takes precedence over other actions. Taking vital signs, inserting an IV line, and performing a neurologic check can wait until airway and breathing are adequately assessed.

Correct Answer: C

Rationale: During outcome identification and planning, outcomes are derived from the problem statement of the nursing diagnoses. This is because the problem statement clearly defines the patient's health issue or condition that needs to be addressed, thus guiding the development of specific, measurable, and achievable outcomes. The defining characteristics (choice A) describe the signs and symptoms of the health problem but do not directly lead to outcome identification. The related factors (choice B) represent the potential causes or contributing factors to the health problem and are not used to derive outcomes. The database (choice D) consists of the patient's health history, assessment data, and laboratory findings, which are essential for diagnosing but do not directly determine outcomes. Therefore, the correct answer is C as it directly informs the outcomes to be achieved.

Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct: 1. Safety: Morbidly obese patients are at higher risk of falls during transfers. 2. Assistance: Having two other personnel ensures safe transfer. 3. Weight distribution: Distributing the patient's weight among multiple helpers reduces strain. 4. Proper body mechanics: Allows for proper positioning and technique while assisting. Summary of why other choices are incorrect: B. Medication doesn't address the safety concern of transferring a morbidly obese patient. C. Reviewing activity orders is not the immediate action needed for the patient's first bathroom transfer. D. Offering a walker may not provide sufficient support for a morbidly obese patient during the transfer.

Correct Answer: C

Rationale: The correct answer is C: “You may not be able to use desmopressin nasally if you have nasal discharge or blockage.” Rationale: 1. Desmopressin is available in intranasal form for diabetes insipidus. 2. Nasal discharge or blockage may prevent proper absorption of the medication. 3. Instructing the client about this potential issue ensures optimal drug effectiveness. Summary: A: Incorrect. Temperature of desmopressin suspension doesn't affect its efficacy. B: Incorrect. A medical identification bracelet is necessary for chronic conditions like diabetes insipidus. D: Incorrect. Monitoring fluid intake and output is crucial when taking desmopressin.

Correct Answer: D

Rationale: Step 1: Hypernatremia is defined by elevated serum sodium levels (>145mEq/L). Step 2: Serum osmolality of 245mOsm/kg is high, consistent with hypernatremia. Step 3: Urine specific gravity below 1.003 indicates dilute urine, a common finding in hypernatremia. Step 4: The combination of elevated serum sodium, high serum osmolality, and low urine specific gravity confirms hypernatremia. Summary: A: Incorrect, as high serum osmolality (not 245mOsm/kg) is associated with hypernatremia. B: Incorrect, as low urine specific gravity (not below 1.003) is seen in hypernatremia. C: Incorrect, as serum sodium needs to be >145mEq/L to indicate hypernatremia.