At the pre-Entry phase, which of the following is the FIRST step in the CO-PAR process

Correct Answer: D

Rationale: The correct answer is D: Create a core group. In the CO-PAR process, creating a core group is the first step in the pre-Entry phase as it establishes a team of committed individuals who will lead the participatory action research. This core group will provide leadership, coordination, and represent the diversity of the community. Surveying the community (choice A) comes after forming the core group to gather information. Training the technical working group (choice B) and holding a community assembly (choice C) are subsequent steps in the process after the core group is established.

Correct Answer: C

Rationale: Step 1: Incongruent message occurs when verbal and nonverbal communication do not align. Step 2: Choice C states "When what the nurse says and does do not agree," indicating a lack of alignment. Step 3: This inconsistency can lead to confusion or mistrust in communication. Step 4: Choices A, B, and D all describe situations with alignment between words and actions, making them congruent. Summary: Choice C is correct as it exemplifies incongruent communication, while Choices A, B, and D are incorrect as they describe congruent messages.

Correct Answer: C

Rationale: In a postpartum client who presents with severe abdominal pain, nausea, and vomiting, it is crucial to assess for signs of peritonitis or surgical abdomen. These signs may include rebound tenderness, guarding, rigidity, and fever. Peritonitis is a serious condition that may require immediate surgical intervention. Administering antiemetic medication, encouraging clear fluids, or providing a heating pad may not address the underlying cause of the symptoms and delay appropriate treatment. Assessing for signs of peritonitis or surgical abdomen is crucial for prompt identification and management of the client's condition.

Correct Answer: A

Rationale: The correct immediate action is to inform the surgeon and anesthesiologist (Choice A) because a sudden decrease in oxygen saturation during surgery is a critical situation that requires prompt attention from the entire surgical team. The surgeon and anesthesiologist need to be made aware of the situation so that they can assess the patient's condition and make any necessary adjustments to the surgical procedure or anesthesia delivery. Increasing the flow rate of oxygen (Choice B) may help temporarily but does not address the underlying cause of the oxygen desaturation. Checking the endotracheal tube placement (Choice C) is important but may not be the immediate priority in this critical situation. Assessing the patient's respiratory status (Choice D) is important but should be done after informing the surgeon and anesthesiologist to ensure coordinated and timely interventions.

Correct Answer: A

Rationale: Correct Answer: A: To help control the intra-ocular pressure Rationale: 1. Eye surgery can lead to increased intra-ocular pressure. 2. Instilling eye drops can help reduce this pressure post-surgery. 3. Controlling intra-ocular pressure is crucial for proper healing and preventing complications. 4. Eye drops for infection (B) or pupil dilation/constriction (C, D) are not primary concerns post-eye surgery.

Correct Answer: A

Rationale: The correct answer is A because it includes all the major endocrine glands: pituitary, thyroid, parathyroid, adrenals, pancreatic islets, and hypothalamus. The pituitary gland is known as the "master gland" as it controls other endocrine glands. The thyroid gland regulates metabolism, while the parathyroid glands regulate calcium levels. The adrenal glands produce hormones involved in stress response. Pancreatic islets produce insulin and glucagon. The hypothalamus plays a key role in hormone regulation. Choice B is incorrect because it includes ovaries and testes, which are not endocrine glands. Choice C is incorrect because it omits the hypothalamus. Choice D is incorrect because it includes ovaries and testes which are not endocrine glands.

Correct Answer: C

Rationale: The scenario described in the question is consistent with acute cholecystitis, which is inflammation of the gallbladder usually caused by an impacted gallstone in the cystic duct. The key clinical features of acute cholecystitis include fever, chills, right upper quadrant abdominal pain (which can be localized to the right upper quadrant), tenderness in the right upper abdomen, and a positive Murphy's sign (pain and inspiratory arrest upon palpation of the right upper quadrant). This condition is more common in pregnant women due to hormonal changes that can lead to gallstone formation and subsequent inflammation of the gallbladder. Ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion typically present with different clinical features compared to those described in acute cholecystitis.

Correct Answer: B

Rationale: The correct answer is B: IgA. In multiple myeloma, there is a proliferation of abnormal plasma cells, leading to a decrease in normal antibody production. IgA is the most abundant immunoglobulin in mucosal secretions and plays a crucial role in mucosal immunity. Therefore, a deficiency in IgA is common in patients with multiple myeloma. IgG is the most abundant immunoglobulin in the blood and is typically less affected in multiple myeloma. IgM is the first antibody produced in response to an infection and is less likely to be deficient in this case. IgE is primarily involved in allergic responses and is not typically affected in multiple myeloma.

Correct Answer: B

Rationale: The correct initial step before starting TPN is to evaluate the patient's tolerance to glucose. This is crucial to ensure the patient can metabolize the glucose effectively and avoid complications such as hyperglycemia. Assessing affordability (A) is important but not the immediate concern. Identifying allergies (C) should be done but is not the first step. Assessing the patient's understanding (D) is important but not as critical as evaluating glucose tolerance before starting TPN.