The nurse is caring for a client who reports chronic pain that is worse in the morning. What would the nurse suggest?

Correct Answer: B

Rationale: The nurse would suggest applying heat to the area for chronic pain worse in the morning, as heat boosts blood flow, relaxes stiff muscles, and eases joint paincommon with conditions like arthritis, where inactivity overnight stiffens tissues. This targets morning exacerbation. Choice A, increase activity, may help later but risks strain when pain peaks; gradual movement post-relief is better. Choice C, take medication at noon, misses the morning windowpain needs earlier control (e.g., bedtime dosing). Choice D, sleep later, avoids the issue; pain persists regardless of wake time. Choice B is correct, offering a practical, nonpharmacological fix nurses recommend, paired with meds if needed, to reduce morning stiffness and improve daily function for chronic pain clients.

Correct Answer: B

Rationale: Primary prevention focuses on preventing health issues before they occur, such as through immunizations or health education. Administering a measles, mumps, and rubella (MMR) immunization to an infant (Choice B) is a classic example of primary prevention because it protects against diseases before exposure. In contrast, administering digoxin (Choice A) is a treatment for an existing condition (heart failure), making it tertiary prevention aimed at managing or reducing complications. Obtaining a Papanicolaou smear (Choice C) is secondary prevention, as it involves early detection of cervical cancer rather than preventing it outright. Similarly, using occupational therapy for arthritis (Choice D) is tertiary prevention, helping a patient manage an existing condition rather than preventing its onset. The distinction lies in the timing and intent: primary prevention occurs before any disease process begins, and the MMR vaccine fits this definition perfectly by building immunity proactively. Thus, Choice B is correct, aligning with the goal of stopping health problems at their root.

Correct Answer: D

Rationale: The nursing process is a dynamic, cyclical framework guiding patient care, and revision of a care plan occurs during the evaluation step (Choice D). In evaluation, the nurse assesses whether the established goals (set during planning) were met, partially met, or unmet, using outcome criteria. If goals aren't achievede.g., a patient's pain remains uncontrolledthe nurse revises the plan, adjusting interventions or goals based on new data. Assessment (Choice A) is data collection, not revision, though it informs the process. Planning (Choice B) involves creating the initial care plan, not modifying it. Implementation (Choice C) is executing the plan, not evaluating or revising it. For example, if a wound isn't healing despite dressings, evaluation reveals the need for a new approach (e.g., different dressings), prompting revision. This step ensures care remains patient-centered and effective, adapting to changes in condition. Thus, Choice D, evaluation, is where revision occurs, making it the correct answer.

Correct Answer: B

Rationale: Maslow's hierarchy ranks human needs in five levels: physiological (base), safety, belonging, esteem, and self-actualization. Physiological needsair, water, food, shelter, and elimination (Choice B)are foundational, as survival depends on them. Elimination, encompassing urination and defecation, is critical; its impairment (e.g., urinary retention) can cause immediate harm like infection or organ damage. Security (Choice A) and safety (Choice C) are second-level needs, addressing stability and protection, but they're irrelevant if physiological needs aren't mete.g., a client can't feel safe if they can't breathe or eliminate waste. Belonging (Choice D), a third-level need, involves relationships, which are secondary to survival. For example, a postoperative client with a blocked catheter faces a life-threatening physiological crisis, trumping safety or social needs. Nurses prioritize based on this hierarchy, making elimination (Choice B) the highest priority and correct answer.

Correct Answer: B

Rationale: Team ineffectiveness despite individual competence often stems from poor group dynamics, with unexpected feelings and emotions among staff (Choice B) being the usual culprit. Emotions like mistrust, resentment, or unresolved conflict disrupt communication and collaboratione.g., a nurse feeling undervalued might withhold input. Unhappiness about leadership change (Choice A) could contribute but isn't universal; new leaders can inspire if communication is strong. Fatigue from overwork (Choice C) reduces productivity but typically affects individuals uniformly, not just teamwork. Failure to involve staff in decisions (Choice D) is a factor, but emotions underlie its impacte.g., feeling ignored breeds frustration. Research (e.g., Tuckman's group development) shows emotional undercurrents derail forming cohesive teams. Addressing feelings via open forums or team-building restores function, making Choice B the correct and most common reason.