Correct Answer: D

Rationale: The correct answer is D: Excessive administration of chloride. Normal anion gap acidosis is commonly caused by an excessive intake of chloride-containing solutions like normal saline during treatment. This leads to an increase in the plasma chloride concentration, causing a decrease in the anion gap. Metastases (A) are not typically associated with normal anion gap acidosis. Excessive potassium intake (B) would not lead to normal anion gap acidosis but rather hyperkalemia. Water intoxication (C) can lead to dilutional hyponatremia but not normal anion gap acidosis.

Correct Answer: C

Rationale: Rationale: Guillain-Barr syndrome can cause inadequate ventilation due to paralysis of the respiratory muscles. This results in respiratory acidosis. Endocarditis, multiple myeloma, and amphetamine overdose do not directly affect ventilation. Endocarditis is an infection of the heart valves, multiple myeloma is a cancer of plasma cells, and amphetamine overdose primarily affects the central nervous system and cardiovascular system, not ventilation. Therefore, Guillain-Barr syndrome is the most likely diagnosis in this case.

Correct Answer: B

Rationale: The correct answer is B because limiting fluids can lead to dehydration, which can cause confusion and dry mucous membranes. Adjusting the timing of fluids can help maintain hydration without causing frequent nighttime bathroom trips. Choice A is incorrect because hospital readmission is not necessary at this point. Choice C is incorrect as it normalizes confusion post-surgery and dangerous practice of avoiding urination at night. Choice D is incorrect because urine accumulation in the bladder does not directly cause confusion; dehydration is the primary concern.

Correct Answer: B

Rationale: The correct answer is B: Prepare to assist with chest tube insertion. Chest pain and difficulty breathing after subclavian central venous catheter insertion could indicate a pneumothorax, a potential complication. Chest tube insertion is indicated to help re-expand the lung and relieve the pressure in the thoracic cavity. This intervention takes priority over the other options because it addresses the potential life-threatening complication of a pneumothorax. Administering nitroglycerin (choice A) is not indicated for chest pain in this scenario. Placing a sterile dressing over the IV site (choice C) is not appropriate for managing chest pain and difficulty breathing. Re-positioning the client into the Trendelenburg position (choice D) is not effective in addressing a pneumothorax and may worsen the client's condition.

Correct Answer: A

Rationale: The correct answer is A: Initiate a dedicated team to insert access devices. This intervention is the most effective in decreasing complications related to IV therapy because having a dedicated team specialized in inserting access devices ensures that the procedure is done correctly each time, reducing the risk of complications such as bloodstream infections. Choice B is not as effective because additional education for all nurses may not guarantee consistent skill levels in IV insertion. Choice C may limit access but does not address the root cause of complications. Choice D focuses on skin preparation, which is important but not as impactful as having a specialized team for IV insertion.