If more than one vaccine is given, the following guidelines should be observed, EXCEPT.

Correct Answer: D

Rationale: It is NOT recommended to use the same syringe and needle in administering two different vaccines. This is to prevent contamination or mixing of different vaccines, which could potentially affect their effectiveness or pose a risk to the individual receiving the vaccines. It is important to use separate syringes and needles for each vaccine to ensure proper administration and prevent any adverse reactions.

Correct Answer: A

Rationale: Showing positive interpersonal relationships is the best evidence of a family coping well when their family coping index on therapeutic competence is rated as coping well. Positive interpersonal relationships indicate that family members are effectively communicating, supporting each other, and resolving conflicts in a healthy manner. This reflects strong family dynamics, emotional resilience, and adaptability which are important aspects of effective coping. While the other options (B, C, D) are beneficial activities or behaviors, positive interpersonal relationships directly demonstrate the family's ability to cope well together, making it the most relevant evidence for a high therapeutic competence rating.

Correct Answer: A

Rationale: A normal thyroid state is referred to as euthyroid, which means the thyroid gland is functioning within normal parameters and the levels of thyroid hormones in the body are balanced. In contrast, hyperthyroid refers to an overactive thyroid gland, causing excessive production of thyroid hormones, while parathyroid is a different gland responsible for regulating calcium levels in the body. Panthroid is not a recognized medical term related to thyroid function. Therefore, the best response to the patient's question about the normal thyroid state is "Euthyroid."

Correct Answer: B

Rationale: Hodgkin's disease commonly affects young adults between the ages of 15 to 35 and older adults over the age of 50. It is not a disease that occurs most often in older adults. In fact, Hodgkin's disease has a bimodal distribution, meaning it peaks in young adults and again in older adults. It is important to consider the age distribution when suspecting Hodgkin's disease and not exclusively associate it with older adults.

Correct Answer: B

Rationale: In hypovolemic shock, isotonic electrolyte solutions are commonly used for fluid replacement to restore the circulating blood volume. The commonly used isotonic electrolyte solutions for this purpose are 0.9% sodium chloride (normal saline) and lactated Ringer's solution.

Correct Answer: C

Rationale: It is crucial to have a complete set of surgical instruments for any surgical procedure to ensure patient safety and the success of the surgery. If the nurse notices that the surgical instrument tray is incomplete, the best course of action is to inform the sterile processing department immediately. By doing so, the missing instruments can be promptly provided, ensuring that the surgical team has all the necessary tools for the procedure. Proceeding with the procedure using incomplete instruments can compromise patient safety and the quality of care provided. Documenting the missing instruments in the surgical count log is important for record-keeping purposes but should not delay the immediate action of requesting additional instruments. Borrowing instruments from another OR is not recommended as it can create confusion, potential cross-contamination, and disrupt the workflow of another surgical team.

Correct Answer: C

Rationale: In a critically ill patient admitted to the ICU with acute renal failure requiring renal replacement therapy (RRT), the healthcare team should prioritize the initiation of continuous renal replacement therapy (CRRT). CRRT is preferred in critically ill patients with hemodynamic instability as it allows for slow and continuous removal of solutes and fluids, making it a safer option compared to intermittent hemodialysis. CRRT can also provide better control of volume status and electrolyte imbalances over a longer period, which is beneficial in critically ill patients who are hemodynamically unstable. Peritoneal dialysis is not commonly used in the ICU setting for acute renal failure requiring RRT, and loop diuretics are not effective in treating acute renal failure. Temporary hemodialysis catheters may also be used, but CRRT is generally preferred in critically ill patients for better hemodynamic tolerance and control of solute and fluid removal.

Correct Answer: B

Rationale: The gallbladder is the structure responsible for storing and concentrating bile produced by the liver until it is needed for digestion. Bile is a digestive fluid that helps in the breakdown of fats during the digestive process. When food containing fats enters the small intestine, the gallbladder contracts and releases bile into the small intestine to aid in the digestion and absorption of fats. The gallbladder acts as a reservoir for bile, storing it until it is needed for digestion.

Correct Answer: C

Rationale: In the provided scenario, the patient is scheduled for Lithotripsy under spinal anesthesia. This means that the nurse needs to communicate with the department of anesthesia to coordinate and prepare for the procedure. Anesthesia departments are responsible for administering various types of anesthesia, including spinal anesthesia, to ensure patients are comfortable and pain-free during medical procedures. Therefore, contacting the department of anesthesia is crucial in this situation to ensure that the necessary arrangements are in place for the patient's lithotripsy procedure.