Correct Answer: C

Rationale: The correct answer is C: Secures clean ties before removing soiled ones. This is the priority action because securing clean ties prevents accidental dislodgement of the tracheostomy tube, ensuring the patient's airway remains patent. Cutting the dressing (A) or cleaning the incisions (B) can be important but not as critical as securing the tube. Using clean technique (D) is essential but not the priority in this situation.

Correct Answer: D

Rationale: The correct answer is D because confirming the insertion site and direction using imaging guidance ensures precise placement of the chest tube, minimizing the risk of complications. Imaging guidance allows the nurse to visualize the exact location of the pneumothorax and guide the tube insertion accurately. A: Positioning the patient in a semi-Fowler's position with arms elevated may be beneficial for comfort but does not directly ensure proper chest tube placement. B: Marking the insertion site with a pen may help as a reference point but does not guarantee accurate placement. C: Administering analgesia is important for the patient's comfort but does not impact the placement of the chest tube. In summary, choice D is the most critical step to ensure the chest tube is correctly placed and effectively treats the pneumothorax.

Correct Answer: D

Rationale: The correct answer is D because the licensure examination aims to assess if candidates meet the expected competency standards to practice nursing safely and effectively. This process ensures that only qualified individuals enter the profession, maintaining high standards of care. Choice A is incorrect because the exam goes beyond applying theory to include practical skills. Choice B is incorrect as protecting the public is the outcome of ensuring competency. Choice C is incorrect as the exam evaluates the full scope of nursing practice, not just its application.

Correct Answer: B

Rationale: When a woman in active labor exhibits signs of prolonged second stage, such as ineffective pushing efforts and slow fetal descent, one of the maternal conditions that should be considered is pelvic floor dysfunction. The pelvic floor muscles play a crucial role in supporting the uterus, bladder, and rectum. If these muscles are weak or dysfunctional, it can lead to difficulty in pushing effectively and impede the descent of the fetus through the birth canal. This can result in prolonged labor and increase the risk of complications for both the mother and the baby. Therefore, assessing for pelvic floor dysfunction is important in addressing the abnormal labor pattern and providing appropriate interventions to support the progress of labor.

Correct Answer: D

Rationale: The correct answer is D: Bronchodilator therapy. Bronchodilators help to relax and open up the airways, which can improve airflow and reduce symptoms such as cough, sputum production, and dyspnea in patients with chronic bronchitis. This intervention can help manage the patient's symptoms and improve their quality of life by making it easier for them to breathe. A: Smoking cessation counseling is important for overall management of chronic bronchitis, but it does not directly address the patient's current symptoms. B: Oral antibiotic therapy may be indicated if there is evidence of a bacterial infection, but it is not the first-line treatment for managing chronic bronchitis symptoms. C: Home oxygen therapy may be necessary for patients with severe hypoxemia, but it is not typically the first intervention for managing symptoms of chronic bronchitis without evidence of significant oxygen desaturation.