Mr. Garcia, a 41-year old chronic alcohol drinker is admitted to the hospital after vomiting bright red blood. He was diagnosed to have a bleeding gastric ulcer and suddenly develops sudden sharp pain in the midepigastric region with a rigid boardlike abdomen. This likely indicates:

Correct Answer: C

Rationale: The sudden sharp pain in the midepigastric region with a rigid boardlike abdomen in a patient with a bleeding gastric ulcer indicates a perforation of the ulcer. Perforation leads to leakage of gastric contents into the peritoneal cavity, causing peritonitis. This presentation requires immediate surgical intervention. Option A is incorrect as intestinal development does not correlate with the symptoms described. Option B is incorrect because inflammation of the esophagus would not lead to a rigid boardlike abdomen. Option D is incorrect as the sudden onset of symptoms is more indicative of a complication like perforation rather than the development of additional ulcers.

Correct Answer: D

Rationale: The correct answer is D: Whisper voice test. This test is used as an initial screening for hearing loss because it is simple, quick, and easily administered by a nurse. The nurse would whisper words or numbers at a specific distance from the patient to assess their ability to hear and repeat the whispered sounds accurately. This test provides a quick indication of potential hearing impairment. The other choices are incorrect: A: Romberg test assesses balance and not hearing. B: Caloric test evaluates the vestibular system, not hearing. C: Otoscopic examination is used to examine the ear canal and tympanic membrane, not to screen for hearing loss.

Correct Answer: B

Rationale: The correct answer is B: Communicating the client’s progress to the interdisciplinary team. During the evaluation phase, the nurse plays a crucial role in ensuring continuity of care by effectively communicating the client’s progress to the interdisciplinary team. This action allows for collaborative decision-making based on the latest information, promotes coordination of care, and ensures that all team members are informed and involved in the client's care plan. Rewriting the care plan (A) is important but may not be the most immediate action during the evaluation phase. Reassessing the client (C) is valuable for gathering additional data but may not directly contribute to continuity of care during this phase. Providing emotional support (D) is essential but may not specifically address continuity of care during evaluation.

Correct Answer: D

Rationale: The correct answer is D: Refer the client to the American Cancer Society’s Reach for Recovery program or another support program. This choice is the best option as it provides the client with additional support and resources specifically tailored to individuals coping with cancer and mastectomy. The Reach for Recovery program offers emotional support, education, and practical assistance which can immensely benefit the client during this challenging time. A: Involving the client's spouse or partner is important, but support programs like Reach for Recovery can offer specialized assistance that may not be fully covered by the spouse's support alone. B: While proceeding with the next phase of treatment is important, emotional support and coping mechanisms are equally crucial, which support programs can provide. C: Asking the client to remain cheerful may put pressure on her and may not address her emotional needs adequately, unlike a support program that is designed to provide comprehensive support.

Correct Answer: D

Rationale: The correct answer is D: error in word choices. In left hemisphere stroke, language and speech centers are usually affected, leading to aphasia. This results in errors in word choices, difficulty expressing thoughts, and understanding language. Impulsivity and unsafe activities (choice A) are more commonly associated with frontal lobe damage. Motor deficits on the right eye (choice B) and left side of the body (choice C) are typical in strokes affecting the motor cortex, which is located in the contralateral hemisphere.

Correct Answer: C

Rationale: The correct answer is C: Break the task down into simple steps. This response is the best because it helps the patient by breaking down the task into manageable parts, making it less overwhelming and more achievable. By providing clear and simple steps, the patient can focus on one aspect at a time, reducing frustration and increasing the likelihood of successful completion. Choice A is incorrect because performing the task for the patient does not promote independence or skill development. Choice B is incorrect as it dismisses the patient's feelings of frustration without offering a solution. Choice D is incorrect because having another patient demonstrate may not address the specific needs and abilities of the recovering stroke patient.

Correct Answer: C

Rationale: The correct answer is C: Hypomagnesemia. 1. Hypertension and cardiac dysrhythmias can be exacerbated by low magnesium levels. 2. Magnesium plays a crucial role in maintaining normal heart rhythm and blood pressure. 3. Hypomagnesemia can lead to cardiac arrhythmias and worsen hypertension. 4. Metabolic acidosis (A) is not directly related to hypertension and dysrhythmias. 5. Hypernatremia (B) and hypercalcemia (D) are less likely to be associated with cardiac issues in this context. In summary, checking for hypomagnesemia is essential due to its direct impact on the client's hypertension and cardiac dysrhythmias.

Correct Answer: D

Rationale: The correct answer is D: Doing it according to his needs and abilities. This option is the most appropriate intervention for Mang Simon to maintain his exercise program. By tailoring the program to his needs and abilities, Mang Simon is more likely to adhere to it and prevent any potential injuries or health risks associated with overexertion. This approach ensures that the exercise routine is realistic and manageable for him, increasing his chances of long-term success. A: Writing down the exercise program may be helpful for organization but does not address the individualization needed for Mang Simon's specific situation. B: Thoroughly explaining the program to his wife, Aling Nena, may provide support but does not directly impact Mang Simon's ability to maintain the program. C: Positive motivation is important, but it alone may not be sufficient to address the practical aspects of adapting the exercise program to Mang Simon's needs and abilities.

Correct Answer: C

Rationale: The correct answer is C: 3.8 mL. To calculate the volume needed, first determine the concentration of the solution after reconstitution: 2.4 million units / 5,000,000 units = 0.48. Next, divide the desired dose by the concentration: 2.4 million units / 0.48 = 5 mL. Since the instructions state to dilute with 8 mL of sterile water, the total volume will be 13 mL. To find the volume of the powder to draw up, subtract the water volume from the total volume: 13 mL - 8 mL = 5 mL. Therefore, the nurse should draw up 5 mL of the reconstituted solution, which is equivalent to 3.8 mL of powder for injection. Incorrect choices: A, B, and D are incorrect because they do not consider the dilution factor of adding sterile water to the powder for injection. Option A is less than the