The first standard-step-in oxygen therapy that the nurse should do is which of the following?

Correct Answer: D

Rationale: Before initiating any oxygen therapy, it is crucial for the nurse to first assess the patient's condition. This step allows the nurse to determine the patient's oxygen saturation levels, respiratory rate, lung sounds, and overall respiratory status. Understanding the patient's baseline condition helps in selecting the appropriate oxygen delivery method and flow rate that will best meet the patient's needs. Additionally, assessing the patient's condition allows the nurse to monitor the effectiveness of the oxygen therapy and make any necessary adjustments throughout the treatment process. Therefore, assessing the patient's condition is the necessary first step in providing safe and effective oxygen therapy.

Correct Answer: D

Rationale: The primary purpose of a pregnancy test is to confirm whether a woman is pregnant or not. Once pregnancy is confirmed, it is crucial for the individual to begin prenatal care as early as possible to ensure a healthy pregnancy and delivery. Early initiation of care can help monitor the health of both the mother and the developing fetus, detect any potential issues or complications early on, and provide necessary interventions or treatments. Therefore, the main objective of a pregnancy test is to enable early initiation of care for the pregnant individual.

Correct Answer: A

Rationale: The correct nursing intervention for Almira would be to advise her to eat her meals. This is important in promoting her health and well-being, especially if she has been neglecting her own nutrition due to stress or caring for her son, Jay. Providing proper nutrition is a basic aspect of nursing care that supports the overall health and recovery of the patient. By encouraging Almira to prioritize her own nutrition, the nurse can help ensure that she has the physical strength and energy needed to take care of herself and her son effectively.

Correct Answer: D

Rationale: Since Nadine is just four years old, determining her favorite toys is not a critical aspect for Nurse Alma to consider in terms of routines and rituals. While knowing Nadine's favorite toys may help provide comfort or distraction, it is not as essential as ensuring proper feeding, sleep patterns, and toilet training for a young child's well-being and development. The focus should primarily be on aspects that directly impact her physical health, growth, and daily routines at this age.

Correct Answer: D

Rationale: An elevation of blood pressure would warrant stoppage of pills. High blood pressure, or hypertension, in a 4-year-old child is abnormal and needs prompt medical attention. Giving pills without monitoring or stopping them if blood pressure is elevated can lead to serious health complications. It is important to address the underlying cause of high blood pressure in a child, which may require further evaluation and management by a healthcare provider.