The biopsy of Mr. Gonzales confirms the diagnosis of cirrhosis. Mr. Gonzales is at increased risk for excessive bleeding primarily because of:

Correct Answer: A

Rationale: The correct answer is A: Impaired clotting mechanism. Cirrhosis can lead to decreased production of clotting factors by the liver, resulting in impaired blood clotting ability. This puts Mr. Gonzales at a higher risk of excessive bleeding. Varix formation (B) can cause bleeding but is not the primary reason in this case. Inadequate nutrition (C) may contribute to overall health but is not directly linked to bleeding risk. Trauma of invasive procedure (D) is a potential risk but not the primary concern in cirrhosis.

Correct Answer: C

Rationale: The correct answer is C: Ensure the safety of the victim. This is the primary nursing intervention for a victim of child abuse because ensuring the safety of the child is the most urgent and critical priority. By ensuring the safety of the victim, the nurse can prevent further harm and protect the child from ongoing abuse. Assessing the scope of the problem (choice A) and analyzing family dynamics (choice B) are important but secondary to ensuring the immediate safety of the child. Teaching coping skills (choice D) can be beneficial, but it is not the primary intervention needed to address the immediate safety concerns of a child abuse victim.

Correct Answer: A

Rationale: The correct answer is A because returning the child to school immediately with family support helps them confront their fears gradually, reducing anxiety over time. This approach exposes the child to the school environment in a supportive manner, promoting desensitization. Choice B only provides information but doesn't address the child's emotional distress. Choice C may exacerbate the child's anxiety by singling them out, making them feel more self-conscious. Choice D may create dependency and hinder the child's ability to cope independently.

Correct Answer: D

Rationale: The correct answer is D: Administering Librium as ordered. This is the priority because Librium is a medication prescribed for specific therapeutic reasons, such as managing withdrawal symptoms or anxiety. Administering it as ordered ensures the client's safety and well-being. Monitoring vital signs (A) is important but not the priority over administering necessary medication. Providing a quiet, dim room (B) and encouraging fluids and nutrition (C) are important for comfort and health but do not address immediate medical needs like medication administration.

Correct Answer: C

Rationale: The correct answer is C because approaching the nurse and talking out her feelings is a proactive and healthy intervention. By discussing her emotions with a healthcare professional, the client can receive support and guidance to address the underlying causes of her urge to starve. This intervention promotes open communication and helps the client develop coping strategies to manage her feelings in a constructive manner. Option A is incorrect as allowing the client to starve can lead to serious health consequences and does not address the root of the issue. Option B may provide temporary distraction but does not address the emotional aspect of the urge to starve. Option D involves seeking external validation rather than addressing the client's emotional needs directly.