In which situation does the nurse have a duty to act?

Correct Answer: A

Rationale: In this scenario, option A is correct because when a patient is brought to the infirmary with apparent heat stroke, it constitutes a medical emergency that requires immediate intervention to prevent serious complications like organ damage or death. The nurse has a duty to act promptly in such situations to provide life-saving care and ensure the patient's safety. Option B is incorrect because although chest pain can be indicative of a serious medical condition like a heart attack, if the patient does not disclose this information, the nurse may not be aware of the situation and therefore cannot act without the patient's consent or knowledge. Option C is incorrect because while it is concerning that another nurse is incorrectly administering eyedrops, it does not pose an immediate threat to the patients' lives or well-being, and it is not the primary responsibility of the nurse to intervene in this situation unless it directly impacts patient care. Option D is incorrect because while reusing the same blade among multiple inmates poses a risk of infection transmission, it is not an immediate life-threatening situation that requires urgent action from the nurse. From an educational perspective, this question highlights the importance of prioritizing patient safety and emergency response in healthcare settings. Nurses must be able to differentiate between urgent situations that require immediate action and those that can be addressed through standard protocols or procedures. It underscores the critical role of nurses in identifying and responding to medical emergencies promptly to provide optimal care and outcomes for patients.

Correct Answer: B

Rationale: The correct answer is B) A, C, D, E only. In client-centered counseling, the individual is viewed as rational, socialized, constructive, and forward-moving. Option A is incorrect because it includes self-centeredness, which is not a characteristic emphasized in client-centered counseling. Option C is incorrect because it excludes the socialized aspect, which is important in understanding individuals within their social context. Option D is incorrect because it includes self-centeredness and excludes rationality, two key components in client-centered counseling. In an educational context, understanding the foundational principles of client-centered counseling is essential for healthcare professionals working in therapeutic settings. By grasping the belief that individuals possess rationality, socialization, constructive potential, and a forward-moving orientation, practitioners can better tailor their approaches to empower patients and create a supportive therapeutic environment conducive to growth and healing. This knowledge enhances the quality of care provided and fosters positive outcomes for long-term patient well-being.

Correct Answer: E

Rationale: In the context of long-term patient care and developing a therapeutic community, understanding multi-morbidity is crucial. The correct answer, "A) The co-occurrence of inter-related illnesses in an individual," is accurate because multi-morbidity refers to the presence of two or more chronic conditions in a single individual. This definition highlights the complexity and interconnectedness of health conditions in a person. Option B, "The prevalence of different types of chronic diseases in a community," is incorrect because multi-morbidity specifically refers to individual-level co-occurrence of illnesses, not community-level prevalence. Option C, "The total disease burden in a community," is incorrect as it does not capture the individual-level aspect of multi-morbidity. Option D, "The presence of multiple risk factors that predispose to ill health," is incorrect as it describes a different concept related to risk factors rather than the simultaneous presence of multiple chronic conditions. Educationally, understanding multi-morbidity is essential for healthcare professionals working in therapeutic communities to provide holistic care to patients with complex health needs. By recognizing and addressing multi-morbidity, healthcare providers can better tailor treatment plans, improve health outcomes, and enhance the quality of care within a therapeutic community setting.

Correct Answer: B

Rationale: In the case of a 68-year-old woman with primary hyperparathyroidism and a serum calcium concentration of 15 mg/dL scheduled for parathyroidectomy, the MOST appropriate initial management is IV normal saline (Option B). IV normal saline is the correct choice because hypercalcemia is often associated with dehydration, leading to reduced renal perfusion and impaired calcium excretion. Normal saline administration helps correct dehydration, increase renal blood flow, and promote diuresis, aiding in the excretion of excess calcium. Option A, Magnesium sulfate, is not appropriate for initial management of hypercalcemia. While magnesium can indirectly affect calcium homeostasis, it is not the primary treatment for acute hypercalcemia. Option C, Methylprednisolone, is not indicated in the initial management of hypercalcemia. Corticosteroids are not effective in lowering serum calcium levels in this context. Option D, Furosemide, is not the initial treatment for hypercalcemia. While loop diuretics like furosemide can increase urinary calcium excretion, they should not be used as first-line treatment due to the risk of volume depletion and worsening dehydration in hypercalcemic patients. In an educational context, understanding the appropriate initial management of hypercalcemia is crucial for healthcare providers managing patients with primary hyperparathyroidism or other causes of elevated serum calcium levels. This case highlights the importance of addressing dehydration and promoting diuresis to manage hypercalcemia effectively and prevent complications associated with high calcium levels.

Correct Answer: C

Rationale: The correct answer to the question is option C) Recurrent laryngeal nerve. When local anesthetic is instilled into the trachea via the cricothyroid membrane, the most likely nerve to be blocked is the recurrent laryngeal nerve. This is because the recurrent laryngeal nerve innervates the trachea below the level of the vocal cords, and by targeting this nerve, anesthesia can effectively be achieved in the lower trachea region. Option A) Hypoglossal nerve is incorrect because this nerve innervates the muscles of the tongue and is not directly involved in tracheal innervation. Option B) Internal branch of the superior laryngeal nerve is incorrect because this nerve supplies sensory innervation above the level of the vocal cords, not the trachea itself. Option D) Vagus nerve is incorrect because while it does give rise to the recurrent laryngeal nerve, it is not directly targeted when instilling local anesthetic into the trachea via the cricothyroid membrane. Understanding the innervation of the trachea and the specific nerves involved in providing sensation and motor function is crucial for healthcare professionals, especially when performing procedures that involve local anesthesia in this area. Knowing the correct nerve to target can help ensure the desired therapeutic effect while minimizing potential complications or side effects.