Nurse Cay inspects a client's back and notices small hemorrhagic spots. The nurse documents that the client has:

Correct Answer: C

Rationale: Small hemorrhagic spots on the skin are petechiae (Choice C), pinpoint, non-blanching red or purple marks caused by capillary bleeding under the skin. They indicate conditions like thrombocytopenia, vasculitis, or infection (e.g., meningitis), requiring prompt investigation. Extravasation (Choice A) is fluid leakage into tissues, typically from IV infiltration, not hemorrhagic spots. Osteomalacia (Choice B) is bone softening from vitamin D deficiency, unrelated to skin findings. Uremia (Choice D), excess urea in blood from kidney failure, may cause pruritus or pallor, not petechiae specifically. For example, petechiae in a client with low platelets (e.g., 20,000/µL) signal bleeding risk, distinct from extravasation's swelling or uremia's systemic symptoms. Accurate documentation as petechiae guides diagnosis and treatment, making Choice C the correct term.

Correct Answer: A

Rationale: Teaching parents to place a newborn supine (on the back) aims to reduce sudden infant death syndrome (SIDS), a leading cause of infant mortality. 'Prone position increases the risk for sudden infant death syndrome' is correct; studies (e.g., AAP guidelines since 1992's 'Back to Sleep' campaign) show prone sleeping raises SIDS risk 2-13 times, possibly via airway obstruction or rebreathing CO2-rich air. Choice B, 'prone position decreases the risk,' is false, contradicting evidence. Choice C, 'supine position may alter the size and shape of the infant's head,' notes positional plagiocephaly (flat head), but this cosmetic issue is manageable (e.g., tummy time) and less critical than SIDS. Choice D, 'supine position makes changing diapers and feeding difficult,' is impractical and unfounded; supine is standard for sleep, not care tasks. For example, SIDS rates dropped 50% post-campaign, prioritizing safety over minor concerns. Choice A reflects this life-saving rationale, making it correct.

Correct Answer: C

Rationale: Irregular snoring with silence and snorts suggests a sleep disorder needing evaluation. 'Yes, this is an indicator of obstructive apnea' is correct; obstructive sleep apnea (OSA) features airway collapse, pausing breathing (apnea)e.g., 10-second silencesthen gasping snorts, per AASM criteria. Choice A, 'snoring has varied patterns,' dismisses the pattern's specificity; normal snoring lacks prolonged pauses. Choice B, 'this is normal snoring,' is false; healthy snoring is rhythmic, not interruptede.g., no 30-second gaps. Choice D, 'the bed partner is unable to sleep,' focuses on the partner, not the patient's health risk (e.g., hypoxia). OSA, linked to hypertension and fatigue, requires polysomnography, per Taylor's nursing assessment. Choice C flags this red flag correctly.

Correct Answer: D

Rationale: Independent nursing actions don't require orders, aiding sleep autonomously. 'Giving a back massage' is correct; it relaxes muscles and boosts parasympathetic tonee.g., 10 minutes reduces cortisol, cutting sleep latency by 15 minutesper nursing scope in Taylor. 'Administering prescribed sleep medications' is dependent, needing a physician's ordere.g., zolpidem isn't nurse-initiated. 'Changing the bed with fresh linens' comforts but doesn't directly induce sleepe.g., no physiological trigger. 'Encouraging naps during the daytime' disrupts night sleepe.g., a 2 p.m. nap delays 11 p.m. onset. Massage, a hands-on skill, promotes rest without drugs, making Choice D the correct independent action.

Correct Answer: A

Rationale: Chronic pain persists beyond healing, typically >3-6 months. 'A patient with rheumatoid arthritis' fitse.g., joint pain for years, per Taylor's pain typology, from ongoing inflammation. 'A patient with pneumonia' has acute paine.g., pleuritic pain resolves with antibiotics in weeks. 'A patient with controlled hypertension' rarely has paine.g., asymptomatic unless crisis. 'A patient with the flu' has acute myalgiae.g., 5-7 days, not chronic. RA's unremitting naturee.g., daily stiffnesscontrasts with temporary illnesses, making Choice A correct.