During a support group meeting, Nurse Donato, in a teasing manner, has made several provocative remarks about your appearance and behavior as a group leader. Select your MOST appropriate response.

Correct Answer: D

Rationale: Choosing option D, "Donato, what you are saying is inappropriate," is the most appropriate response in this situation. It directly addresses Nurse Donato's behavior without escalating the situation or being overly confrontational. By calmly pointing out that the remarks are inappropriate, you are setting a boundary and letting Nurse Donato know that such behavior is not acceptable in a professional setting. This response also signals to the rest of the group that you are aware of the inappropriate comments and are taking action to address them. It is important to address such behavior professionally and assertively to maintain a respectful and supportive environment during the support group meeting.

Correct Answer: D

Rationale: The "Rights of Medication Administration" include the following fundamental principles to ensure safe medication administration: right patient, right medication, right dosage, right route, right time, and right documentation. The price of the medication is not a part of these essential rights. These rights help to prevent medication errors and ensure that patients receive the correct medication in the correct way.

Correct Answer: C

Rationale: Preoperative nursing intervention that is essential for preparing a patient with a history of coronary artery disease for coronary artery bypass graft (CABG) surgery is assisting the patient with deep breathing and coughing exercises. These exercises are crucial to prevent postoperative complications such as atelectasis and pneumonia, which are common risks after surgery. Deep breathing exercises help to expand the lungs and improve ventilation, while coughing exercises help to clear secretions and prevent respiratory complications. By assisting the patient with these exercises preoperatively, the nurse can help optimize the patient's respiratory function and decrease the risk of complications during and after surgery. Administering aspirin, providing education about pain management, and obtaining informed consent are also important aspects of preoperative care, but assisting with deep breathing and coughing exercises is particularly essential for patients undergoing CABG surgery due to the increased risk of respiratory complications in this population.

Correct Answer: B

Rationale: Nurses are bound by strict confidentiality and privacy regulations in their profession. If a nurse fails to keep a patient's personal information confidential and discloses it without authorization, they can be charged with invasion of privacy. Invasion of privacy is the wrongful intrusion into a person's private affairs without their consent, and it is a serious violation of ethical and legal standards in healthcare. Nurses must always prioritize patient confidentiality to maintain trust and uphold ethical standards in their practice.

Correct Answer: C

Rationale: The patient's presentation of swelling of the ankles, dyspnea on exertion, and orthopnea is highly suggestive of heart failure. The echocardiogram findings of decreased left ventricular ejection fraction and dilated left ventricle are characteristic of heart failure with reduced ejection fraction (HFrEF), also known as systolic heart failure. In this condition, the heart's ability to pump blood effectively is compromised, leading to symptoms of congestion and decreased cardiac output. The decreased ejection fraction indicates that the heart is not able to efficiently pump out blood with each contraction. Dilatation of the left ventricle is a compensatory mechanism in response to increased volume overload.

Correct Answer: B

Rationale: The statement that the preschooler can alternate feet when climbing is not true. Typically, preschoolers at this age group are still developing their coordination and may not have mastered the skill of alternating feet while climbing. It is more common for them to use one foot after the other while climbing. This skill usually requires more advanced motor development and coordination, which may come later in the preschool years.

Correct Answer: C

Rationale: An abstract is a concise summary of a research study that provides an overview of the purpose, methods, results, and conclusions of the research. It is usually the first section of a research report or article and serves to give the reader a quick understanding of the study without having to read the full document. In this case, Nurse Sandy has completed the study and is preparing to submit a written brief summary to the Research department, which is typically in the form of an abstract. It highlights the key points of the study, allowing others to quickly grasp the main findings and implications.

Correct Answer: B

Rationale: Normal saline is the preferred solution for wound irrigation because it is isotonic and will not damage healthy tissue or delay wound healing. It helps to remove debris and pathogens from the wound, promoting a clean environment for healing. Sterile water can be used if normal saline is not available, but it may cause cellular damage if used in large volumes. Hydrogen peroxide and Betadine solution are not recommended for wound irrigation as they can be cytotoxic to the tissues and interfere with the wound healing process. It's important for the nurse to use evidence-based practice and follow recommended guidelines to promote optimal wound healing outcomes.

Correct Answer: A

Rationale: The clinical presentation of gross hematuria, flank pain, palpable abdominal mass, along with imaging findings of a large heterogeneous renal mass with necrosis and calcifications are highly suggestive of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer in adults. The presence of necrosis and calcifications are characteristic features of RCC. Imaging modalities such as CT scans or MRI can confirm the diagnosis by showing the typical features of RCC, including a solid mass with areas of necrosis and calcifications. It is important to further evaluate this patient, likely with a biopsy, to confirm the diagnosis and determine the extent of the disease for appropriate management.