Correct Answer: D

Rationale: The BEST rationale for the conduct of the program is to deliver safe and quality nursing care to patients on intravenous therapy (IV). This directly ties the purpose of the program to the real-world outcome it seeks to achieve - providing optimal care for patients requiring intravenous therapy. Ensuring safe practice in the hospital (Option A) is important but it is not specific to the focus of the IV therapy program. Improving nursing practice in general (Option B) is a noble goal but the program should have a specific and targeted objective. Providing knowledge and skills to all nursing staff in IV Therapy (Option C) is essential, but the primary aim should be centered on improving patient care outcomes. Therefore, delivering safe and quality nursing care to patients on IV therapy aligns most closely with the core purpose of the program and should be the primary rationale.

Correct Answer: A

Rationale: The FIRST action of the nurse should be to reassess the client experiencing dyspnea despite continuous oxygen therapy. Reassessment would involve checking the client's respiratory status, oxygen saturation levels, vital signs, and overall condition to gather more information about the situation. This will help the nurse identify any potential causes of the dyspnea and determine the appropriate next steps for intervention. Assessing the client before proceeding with any other actions is crucial in providing safe and effective care.

Correct Answer: B

Rationale: The most appropriate intervention for a patient with difficulty swallowing due to end-stage ALS and concerns about choking is to refer the patient to a speech therapist for swallowing exercises and techniques (Choice B). Speech therapists are trained to assess and manage swallowing difficulties in patients, especially those with neurodegenerative diseases like ALS. They can provide specific exercises and strategies to help the patient swallow safely and reduce the risk of choking. This intervention focuses on addressing the underlying issue causing the difficulty swallowing and aims to improve the patient's quality of life by enhancing their ability to eat and drink. The other options are not as effective or appropriate in addressing the patient's concerns.

Correct Answer: A

Rationale: Signs such as using tissues to doorknobs suggest that the patient is unconsciously controlling unacceptable impulses or feelings. This behavior falls under the category of defense mechanisms, specifically displacement, where the individual redirects their emotions from a threatening target to a safer one. In this case, the patient may be experiencing anxiety or fear related to contamination or germs, leading them to use tissues to avoid touching doorknobs directly. It is a way for the patient to manage their underlying emotions, albeit unconsciously, through this compulsive behavior.

Correct Answer: A

Rationale: X-ray is the most appropriate imaging modality for evaluating wrist involvement in rheumatoid arthritis. It can show joint space narrowing, erosions, soft tissue swelling, and periarticular osteopenia. X-rays are readily available, cost-effective, and provide valuable information about joint damage and disease progression in rheumatoid arthritis. In this case, X-ray would be able to confirm the presence of erosions, joint deformities, and assess the severity of the disease in the wrist joint. While MRI and ultrasound can also be helpful in evaluating rheumatoid arthritis, X-ray remains the initial imaging modality of choice due to its convenience and ability to assess bony changes. Dual-energy X-ray absorptiometry (DEXA) scan is not indicated for evaluating wrist involvement in rheumatoid arthritis.