Correct Answer: A

Rationale: The nurse sharing Mr. Steve's medical records with a group of visiting members of a medical mission team violates his right to expect that all communications and records pertaining to his care should be treated as confidential. Patient confidentiality is a fundamental ethical principle in healthcare that protects a patient's privacy and sensitive information. Sharing medical records without the patient's consent breaches this confidentiality and can lead to legal and ethical consequences. It is important for healthcare providers to maintain the confidentiality of patient information to uphold trust between patients and healthcare professionals.

Correct Answer: C

Rationale: Methotrexate is a medication commonly used in the treatment of rheumatoid arthritis. It is known to have potential hepatotoxic effects, meaning it can harm the liver. Monitoring liver function tests (such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin levels) is essential to detect any liver damage early on during methotrexate therapy. By closely monitoring liver function tests, healthcare providers can assess the medication's impact on the liver and determine if any dose adjustments or discontinuation of the drug is necessary to prevent further liver damage. Regular monitoring of liver function tests helps ensure the safe and effective use of methotrexate in patients with rheumatoid arthritis.

Correct Answer: C

Rationale: It is crucial to have a complete set of surgical instruments for any surgical procedure to ensure patient safety and the success of the surgery. If the nurse notices that the surgical instrument tray is incomplete, the best course of action is to inform the sterile processing department immediately. By doing so, the missing instruments can be promptly provided, ensuring that the surgical team has all the necessary tools for the procedure. Proceeding with the procedure using incomplete instruments can compromise patient safety and the quality of care provided. Documenting the missing instruments in the surgical count log is important for record-keeping purposes but should not delay the immediate action of requesting additional instruments. Borrowing instruments from another OR is not recommended as it can create confusion, potential cross-contamination, and disrupt the workflow of another surgical team.

Correct Answer: A

Rationale: The healthcare team should prioritize administering lactulose or other ammonia-lowering agents to manage hepatic encephalopathy in a patient with acute liver failure. Hepatic encephalopathy is a neuropsychiatric syndrome that occurs in patients with liver dysfunction, leading to the accumulation of ammonia and other neurotoxic metabolites in the bloodstream. Lactulose works by acidifying the colon, which promotes the conversion of ammonia to ammonium, a less toxic form that can be excreted in the stool. By reducing the levels of ammonia, lactulose helps improve the neurological symptoms associated with hepatic encephalopathy.

Correct Answer: B

Rationale: The gallbladder is the structure responsible for storing and concentrating bile produced by the liver until it is needed for digestion. Bile is a digestive fluid that helps in the breakdown of fats during the digestive process. When food containing fats enters the small intestine, the gallbladder contracts and releases bile into the small intestine to aid in the digestion and absorption of fats. The gallbladder acts as a reservoir for bile, storing it until it is needed for digestion.