Nurse is performing dressing change for client with a sacral wound using negative pressure wound therapy. Which of the following actions should the nurse take first?

Correct Answer: C

Rationale: First, the nurse should prioritize safety and infection control by donning sterile gloves to prevent contamination during the dressing change. This is essential to maintain asepsis and prevent wound infection. Applying skin preparation (A) can wait until after the gloves are on. Normal saline (B) is typically used during wound cleaning but is not the first step. Determining pain level (D) is important but not the immediate priority for this procedure.

Correct Answer: D

Rationale: The correct answer is D: Social skills training. This is the most effective intervention for a child engaging in bullying because it directly addresses the underlying behavior by teaching appropriate social behaviors and communication skills. Social skills training can help the child understand the impact of their actions, develop empathy, and learn how to interact positively with others. A: Psychoeducation may provide information about bullying but does not necessarily teach the child new skills to change their behavior. B: Bibliotherapy involves reading books to promote understanding, which may not be as effective as directly teaching social skills. C: Early intervention programs are important, but social skills training specifically targets the behavior of bullying and provides practical strategies for change.

Correct Answer: C

Rationale: The correct answer is C because it respects the client's right to autonomy and confidentiality. By offering to see if Mr. Hawkins wants to talk, the nurse is acknowledging his autonomy to make decisions about who he interacts with. This response also maintains confidentiality by not confirming or denying his presence without his consent. Choice A is incorrect as it does not respect Mr. Hawkins' autonomy and does not offer him the choice to speak with the caller. Choice B is incorrect because it does not protect Mr. Hawkins' confidentiality by potentially revealing his presence. Choice D is incorrect as it does not consider Mr. Hawkins' wishes and simply denies the call without involving him in the decision-making process.

Correct Answer: A

Rationale: The correct answer is A: Social skills training. Clients with schizoid personality traits often struggle with forming and maintaining social relationships. Social skills training can help them improve their ability to interact with others, which is a key component of their care. Anger management training (B) is not typically a priority for clients with schizoid personality traits as they tend to avoid emotional expression. Relaxation techniques (C) may be helpful for managing anxiety but may not directly address the client's social difficulties. Coping skills training (D) is broad and may not specifically target the social deficits of clients with schizoid personality traits.

Correct Answer: A

Rationale: The correct answer is A because waving fists, cursing, and shouting threats indicate aggressive and confrontational behavior, which are common signs of a behavioral crisis. This behavior poses a potential threat to others and requires immediate intervention. In contrast, choices B and C show distress or withdrawal, not crisis-level behavior. Choice D depicts an unusual behavior but does not necessarily indicate a crisis. In summary, the correct answer best aligns with the aggressive and threatening behavior typically seen in a behavioral crisis.