Correct Answer: A

Rationale: The correct order for the massage is to start around the feces (4), then work downwards (1), followed by moving towards the sides (5), then back to the top (2), continuing to the sides again (3), and finally finishing at the top (6). This sequence ensures a thorough and effective massage process. Other choices have different orders that do not follow the logical flow of massaging around the feces and working down as specified in the question.

Correct Answer: B

Rationale: The correct answer is B because the patient's inability to count fingers indicates severe visual impairment. Testing hand motion perception is a more appropriate initial assessment for patients with such significant visual losses. This method can differentiate between light perception and no light perception, providing valuable information about the patient's visual acuity. The other choices are incorrect because assessing vision using a Snellen chart (A) requires more visual acuity than just being able to see hand motion. Performing a detailed examination of external eye structures (C) and palpating periocular regions (D) are not relevant for assessing visual acuity and do not provide information on the patient's ability to perceive hand motion.

Correct Answer: D

Rationale: The correct answer is D: "I need to call the doctor if I see flashing lights." This is because seeing flashing lights after cataract extraction with intraocular lens implant can be a sign of a serious complication like retinal detachment. Prompt reporting is crucial to prevent vision loss. Choice A is incorrect because nausea is not typically a sign of a complication related to cataract surgery. Choice B is also incorrect as a light morning discharge is normal post-surgery unless it's excessive or associated with pain or visual changes. Choice C is incorrect as a scratchy feeling is common after surgery and usually resolves on its own.

Correct Answer: D

Rationale: The correct answer is D: Discuss a referral for hospice care. Hospice care provides specialized care for patients with terminal illnesses, focusing on comfort and quality of life. This option aligns with the patient's wish to die at home and ensures his care needs are met. Hospice care also provides emotional and spiritual support for both the patient and family. A: Discuss a referral for rehabilitation hospital - This option focuses on rehabilitation, which is not suitable for a patient with a terminal illness like extensive stage small-cell lung cancer. B: Panel the patient for a personal care home - Personal care homes may not provide the level of specialized care needed for a terminally ill patient. C: Discuss a referral for acute care - Acute care is more focused on treating acute illnesses and injuries, not providing end-of-life care for a patient with a terminal illness.

Correct Answer: B

Rationale: The correct answer is B: Hearing loss may occur with a decibel level in this range. Prolonged exposure to sound levels between 80-90 dB can lead to hearing damage over time. This range is considered high and can cause irreversible damage to the hair cells in the inner ear, leading to hearing loss. Choices A, C, and D are incorrect because hearing can be affected at this decibel level, the sound can be harsh to the ear, and earplugs can help reduce the risk of hearing damage at these levels.