Correct Answer: A

Rationale: The nurse would question the order for a D-dimer test in this case. A D-dimer test is a blood test used to help rule out or diagnose blood clots. However, in a child with a fractured femur complaining of sudden chest pain and difficulty breathing, the symptoms suggest the possibility of a pulmonary embolism (PE). In this scenario, a D-dimer test may not be necessary because the clinical presentation warrants more advanced imaging studies such as V/Q scans, CT pulmonary angiography, or MR pulmonary angiography to definitively diagnose or rule out a PE. Therefore, the focus should be on imaging studies rather than a D-dimer test in this situation.

Correct Answer: A

Rationale: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, most often the liver and kidneys. Placental dysfunction is believed to be the main cause of preeclampsia. In a normal pregnancy, blood vessels in the placenta develop to supply the fetus with nutrients and oxygen. In preeclampsia, these blood vessels don't develop or function properly, leading to inadequate blood flow and reduced supply of nutrients to the placenta. This can result in high blood pressure and affect the function of other organs.

Correct Answer: D

Rationale: Immobility can contribute to the development of urolithiasis (the formation of urinary calculi or stones) due to decreased mobility leading to stagnant urine flow, which can result in the concentration of crystal-forming substances in the urine. Increasing fluid intake helps prevent urinary stasis and dilutes the urine, reducing the risk of stone formation. Adequate hydration can also help flush out any existing crystals or small stones before they grow larger. Therefore, increasing fluid intake to 3000 mL/day is essential in preventing urolithiasis in patients with immobility. Monitoring urine pH, administering calcium supplements, or maintaining an indwelling urinary catheter are not appropriate interventions for preventing urolithiasis in this situation.

Correct Answer: C

Rationale: Activity intolerance is the most appropriate nursing diagnosis for a client with cardiomyopathy who becomes short of breath with ambulation and eating and fatigued with routine care activities. Cardiomyopathy is a condition where the heart muscle becomes weakened, affecting its ability to pump blood effectively. As a result, the client may experience symptoms such as shortness of breath, fatigue, and decreased tolerance for physical activity. By identifying activity intolerance as a nursing diagnosis, the nurse can focus on addressing the client's limitations in performing activities and developing a plan of care to help improve the client's endurance and functional ability.

Correct Answer: C

Rationale: Sulfasalazine can cause photosensitivity, making the patient more prone to sunburn. Therefore, it is important for patients taking sulfasalazine to use sunscreen to protect their skin from harmful UV rays. This can help prevent sunburn and skin damage while on the medication. It is not necessary to take vitamin C with this drug, take it on an empty stomach, or limit fluid intake to 1500 mL per day.