"The dress code in this facility does not include wearing blue jeans while on duty". This statement is an example of using which step in giving constructive criticism?

Correct Answer: B

Rationale: The statement provided clearly outlines the expectation regarding the dress code in the facility. By explicitly mentioning that wearing blue jeans while on duty is not included in the dress code, the individual is being informed about a specific expectation they are expected to adhere to. Stating expectations is a crucial step in giving constructive criticism as it sets a clear standard for behavior or performance. In this case, by mentioning the dress code policy, it helps guide the individual on what is acceptable and what is not when it comes to attire while at work.

Correct Answer: B

Rationale: Administering ice packs to the perineum is the priority nursing intervention to provide relief for perineal pain and discomfort in a postpartum client. Ice packs help to reduce swelling and inflammation in the perineal area, which can help alleviate pain. It is a safe and effective method to provide immediate relief and promote comfort for the client. Other interventions such as encouraging ambulation, administering analgesics, and recommending warm sitz baths can also be beneficial, but in the initial management of perineal pain, ice packs are the most appropriate choice.

Correct Answer: D

Rationale: Administering oxygen inhalation is the priority nursing action for a patient presenting with clinical manifestations related to endocrine disorders. Patients with hyperthyroidism, Cushing syndrome, and hypothyroidism can all experience respiratory distress due to various reasons such as thyroid storm, adrenal crisis, or myxedema coma. Oxygen inhalation helps improve oxygenation and tissue perfusion, providing immediate support to the patient's respiratory system. It is crucial to ensure adequate oxygenation before addressing other assessments or interventions. Once the patient's breathing is stabilized, further assessments and treatments can be initiated as necessary.

Correct Answer: B

Rationale: The patient's presentation of well-demarcated, erythematous plaques with silvery scales on the trunk and extensor surfaces of the limbs is classic for psoriasis. Additionally, the family history of similar skin lesions further supports the diagnosis of psoriasis, as it is a condition with a genetic predisposition. Pityriasis rosea typically presents with a herald patch followed by oval, scaly lesions in a Christmas tree pattern. Erythema multiforme is characterized by target-like lesions. Lichen planus presents as purple, polygonal, flat-topped papules that may have fine white lines on their surface known as Wickham striae.

Correct Answer: C

Rationale: The indicators listed indicate measures that Nurse Cirila can take to maintain a safe environment for her pediatric patients. However, assessing the competencies of staff before delegating a task is more related to ensuring effective delegation and appropriate task assignment rather than directly ensuring a safe environment for patients. While it is important to delegate tasks to qualified staff, this specific action does not directly contribute to maintaining a safe environment in the same manner as the other indicators listed (proper waste disposal, infection control, emergency protocols).

Correct Answer: B

Rationale: The patient's presenting symptoms of chest pain worsened by inspiration and relieved by sitting forward, with associated DVT in the lower extremity, suggest a high likelihood of pulmonary embolism. Chest pain that worsens with inspiration due to pleuritic involvement is a classic symptom of pulmonary embolism. Additionally, the presence of DVT in the lower extremity represents a risk factor for the development of pulmonary embolism, as clots originating in the deep veins can travel to the pulmonary circulation to cause an obstruction. Patients with pulmonary embolism may also exhibit signs of right heart strain, such as tachycardia, tachypnea, and sometimes hemoptysis.

Correct Answer: A

Rationale: Patients with COPD often experience dyspnea, which makes it difficult for them to breathe. When they have a full stomach, their diaphragm is compressed, which can further increase difficulty in breathing. Teaching patients with COPD to avoid having a full stomach even when in dyspneic condition is important to prevent exacerbation of breathing problems. It is advisable for them to have small, frequent meals to ensure adequate nutrition without compromising their ability to breathe comfortably.

Correct Answer: A

Rationale: In cases of poisoning, the main goals are to inactivate the poison to prevent further harm, administer the specific antidote if available to counteract the effects of the poison, and support vital organ functions to help the patient recover. Inducing the patient to vomit (III) is not always recommended as it can potentially cause more harm, especially if the ingested substance is corrosive. Therefore, the most appropriate goals in poisoning are to inactivate the poison, administer the specific antidote, and support vital organ functions.

Correct Answer: A

Rationale: The presentation of well-demarcated, hypopigmented macules with fine scaling on the trunk and proximal extremities is classic for tinea versicolor. Tinea versicolor is a common superficial fungal infection caused by Malassezia spp., which leads to hypo- or hyperpigmented patches on the skin. The condition often occurs in individuals with increased sebum production due to factors such as hot and humid climates, sweating, and oily skin. History of sun exposure and outdoor activities is also commonly reported by patients with tinea versicolor. Treatment usually involves antifungal medications applied topically or taken orally to eliminate the fungus. Differentiating tinea versicolor from other skin conditions, such as vitiligo, pityriasis rosea, or seborrheic keratosis, is important for appropriate management.