Correct Answer: A

Rationale: The correct answer is A: Alarms that sound from various devices. In the critical care environment, alarms often indicate changes in the patient's condition, causing stress. Bright fluorescent lighting (B) may be bothersome but not directly related to patient stress. Lack of day-night cues (C) may disrupt sleep patterns but is not a direct stressor. Sounds from the mechanical ventilator (D) are essential for patient care and not inherently stressful.

Correct Answer: C

Rationale: Step-by-step rationale: 1. The Synergy Model emphasizes matching nurse competencies with patient needs. 2. A male nurse may not be culturally appropriate for a Muslim female patient due to religious beliefs. 3. Gender segregation is important in Islamic culture, especially concerning intimate care. 4. Therefore, assigning a new graduate male nurse to care for a Muslim female patient in critical condition is the most inappropriate choice. Summary: - Choice A is incorrect because being a new graduate does not impact cultural competence. - Choice B is incorrect as experience does not necessarily make a nurse the best fit for a specific patient. - Choice D is incorrect as postpartum experience is relevant, but cultural considerations are more critical in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Take them to a private area for initial explanations. This response is the best because it allows the nurse to address the family's concerns in a private and controlled environment. It promotes effective communication and enables the family to express their emotions and receive information without distractions. Choice A is incorrect because asking the family to leave may escalate the situation and not address their needs. Choice C is inappropriate as paging security to remove the family can worsen the family's distress and hinder communication. Choice D is not ideal as leaving the family alone may lead to misunderstandings and increased anxiety. Overall, choice B is the most therapeutic and effective approach in this situation.

Correct Answer: B

Rationale: To calculate the IV fluids for a 19.5 kg child: 1. For the first 10 kg: 1000 mL 2. For the weight between 10-20 kg: (19.5 kg - 10 kg) * 50 mL/kg = 475 mL Total IV fluids = 1000 mL + 475 mL = 1475 mL To convert to mL per hour: 1475 mL / 24 hours = ~61 mL/hr Therefore, the correct answer is B (61 mL/hr). Incorrect Choices: A (24 mL/hr): Incorrect, as it doesn't consider the additional fluids for the weight between 10-20 kg. C (73 mL/hr) and D (58 mL/hr): Incorrect, as these values are not obtained from the correct calculation based on the given formula.

Correct Answer: D

Rationale: The correct answer is D because positive end-expiratory pressure (PEEP) is a mode of ventilation where pressure is maintained in the lungs at the end of expiration. This helps prevent alveolar collapse and improves oxygenation. Option A is incorrect because PEEP does not deliver a full preset tidal volume with each breath initiation. Option B is incorrect because tidal volume in PEEP is not solely determined by the patient's ability to generate negative pressure. Option C is incorrect because in PEEP, breaths are delivered irrespective of the patient's respiratory drive.