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: Having a tracheostomy means that a patient has an artificial opening in their neck to help them breathe. Therefore, any issues related to breathing, such as blockages in the tracheostomy tube or difficulty in clearing secretions, can pose a major problem for a patient with a tracheostomy. It is crucial to monitor the patient's respiratory status closely and intervene promptly if any breathing difficulties arise to prevent potential respiratory distress or complications.

Correct Answer: B

Rationale: The formulation of a vision and mission statement in a health facility is an essential aspect of leadership and management. A well-crafted vision and mission statement provide the organization with a clear direction and purpose, guiding management and health personnel in their daily activities. It helps in aligning individual goals with organizational objectives, fostering teamwork, and enhancing overall performance. Effective leadership and management ensure that the vision and mission are communicated effectively, understood by all stakeholders, and implemented throughout the organization to achieve quality standards. By setting the tone for organizational culture and values, leadership and management play a crucial role in shaping the quality of care and services provided by the health facility.

Correct Answer: D

Rationale: Nurse Merle has to renew her license on or before January 6, 2022, as that date falls at the end of the standard two-year license renewal cycle for nurses in many jurisdictions. Renewing on or before this date will ensure that Nurse Merle maintains her active licensure status and can continue practicing legally without any interruptions. It is important for healthcare professionals like nurses to stay current with their licensure to uphold professional standards and provide quality care to patients.

Correct Answer: D

Rationale: For a diagnostic pelvic ultrasound, one important preparation is to have the patient void or empty their bladder before the procedure. This allows for better visualization of the pelvic organs and structures during the ultrasound scan. A full bladder can obstruct the view and make it difficult to obtain accurate images. Therefore, it is essential for the patient to follow instructions to empty their bladder before the pelvic ultrasound to ensure the best results.

Correct Answer: A

Rationale: The nurse sharing Mr. Steve's medical records with a group of visiting members of a medical mission team violates his right to expect that all communications and records pertaining to his care should be treated as confidential. Patient confidentiality is a fundamental ethical principle in healthcare that protects a patient's privacy and sensitive information. Sharing medical records without the patient's consent breaches this confidentiality and can lead to legal and ethical consequences. It is important for healthcare providers to maintain the confidentiality of patient information to uphold trust between patients and healthcare professionals.

Correct Answer: C

Rationale: Reflecting the patient's feelings and expressions is a therapeutic communication technique that involves mirroring back the patient's emotions and thoughts. By doing this, the nurse validates the patient's experiences and helps them explore their feelings further. This technique can enhance the patient's self-awareness and promote emotional expression, leading to a deeper understanding of their conflicting emotions. Offering advice (Option A) may not be as effective because the focus should be on helping the patient process their own emotions. Providing reassurance and false hope (Option B) can hinder the patient's emotional exploration and may lead to trust issues if the reality does not align with the false reassurance. Redirecting the conversation to a different topic (Option D) avoids addressing the patient's conflicting emotions, which is crucial for therapeutic communication and support.

Correct Answer: D

Rationale: Patients prescribed proton pump inhibitors (PPIs) for the treatment of GERD should be closely monitored for the development of osteoporosis. PPIs have been associated with an increased risk of developing osteoporotic fractures, particularly in long-term users. This risk is thought to be due to decreased calcium absorption as stomach acidity is reduced by PPIs, leading to potential alterations in bone metabolism and density. Therefore, it is important for healthcare providers to assess bone health, educate patients on calcium and vitamin D supplementation, and consider other risk factors for osteoporosis in individuals taking PPIs long-term. While hypoglycemia, hyperkalemia, and Clostridium difficile infection may be seen as adverse effects with other medications or conditions, osteoporosis is the adverse effect most closely monitored in patients taking PPIs for GERD.

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.