The nurse observes that Mr. Adams begins to have increased difficulty breathing. She elevates the head of the bed to the high Fowler position, which decreases his respiratory distress. The nurse documents this breathing as:

Correct Answer: C

Rationale: Orthopnea is a condition where a person experiences difficulty breathing when lying flat but finds relief when sitting up or standing. Elevating the head of the bed to the high Fowler position helps alleviate this symptom. Tachypnea refers to rapid breathing, eupnea is normal breathing, and hyperventilation is breathing excessively fast or deep.

Correct Answer: B

Rationale: The correct answer is B: Mashed potatoes and broiled chicken. Both mashed potatoes and broiled chicken are typically low in sodium content, making them suitable choices for a 500-mg low sodium diet. The other options, such as a ham and Swiss cheese sandwich on whole wheat bread, a tossed salad with oil and vinegar and olives, and chicken bouillon, may contain higher amounts of sodium and are not typically recommended for a low sodium diet.

Correct Answer: D

Rationale: The correct answer is D. When a physician orders a maintenance dose of subcutaneous heparin, nursing responsibilities include reviewing daily activated partial thromboplastin time (APTT) and prothrombin time to monitor the patient's coagulation status, reporting an APTT above 45 seconds to the physician as it may indicate a risk of bleeding, and assessing the patient for signs and symptoms of frank and occult bleeding, which are potential adverse effects of anticoagulant therapy. Therefore, all the options listed are essential nursing responsibilities when a patient is on subcutaneous heparin therapy.

Correct Answer: D

Rationale: The correct answer is D because it accurately reflects the four metaparadigm concepts universally recognized in nursing theory: **person**, **environment**, **health**, and **nursing**. These concepts form the foundational framework for nursing practice, research, and education. 1. **Person**: Central to nursing, this refers to the recipient of care, whether an individual, family, or community, acknowledging their holistic needs. 2. **Environment**: Encompasses external factors influencing health, including physical, social, and cultural contexts, recognizing that surroundings impact well-being. 3. **Health**: Represents the patient’s state of wellness, illness, or recovery, emphasizing the dynamic and subjective nature of health experiences. 4. **Nursing**: Defines the profession’s role, actions, and responsibilities in promoting health and providing patient-centered care. ### Why Other Options Are Incorrect: **Option A (Person, nursing, environment, medicine)**: Incorrect because "medicine" is not a core nursing metaparadigm concept. Medicine pertains to medical practice and treatment, which, while related, is distinct from nursing’s theoretical focus. Nursing emphasizes care, advocacy, and holistic support rather than medical interventions alone. **Option B (Person, health, nursing, support systems)**: Incorrect because "support systems" are not a standalone metaparadigm concept. While support systems (e.g., family, community) are important, they are subsumed under the broader concept of "environment," which more comprehensively addresses external influences on health. **Option C (Person, health, psychology, nursing)**: Incorrect because "psychology" is a discipline separate from nursing’s foundational concepts. Though psychological factors influence health, they are integrated into the "person" or "health" domains rather than standing as an independent metaparadigm element. The metaparadigm in nursing (Option D) provides a universal structure for understanding the discipline’s scope, whereas other options either introduce extraneous elements or omit critical concepts. This framework ensures nursing theories and practices remain cohesive and patient-centered, distinguishing nursing from other healthcare fields. Understanding these concepts helps students grasp nursing’s unique focus on holistic care within contextual and relational dynamics.

Correct Answer: D

Rationale: In Maslow's hierarchy of needs, physiological needs form the base of the pyramid, representing the most fundamental requirements for human survival. These needs must be met before higher-level needs (such as safety, love, or esteem) can be addressed. Among physiological needs, *oxygen* (D) is the most critical because the human body can only survive for *minutes* without it. Cellular respiration, which provides energy for all bodily functions, depends entirely on oxygen. Without it, brain function ceases rapidly, leading to irreversible damage or death. This immediacy of oxygen's necessity makes it the highest priority. *Nutrition* (C) is essential for sustaining life, but the body can survive for *weeks* without food. While prolonged lack of nutrition leads to organ failure, the timeline for survival without food is far longer than without oxygen. Similarly, *elimination* (B), the removal of waste, is vital for maintaining homeostasis, but the body can endure *days* without proper waste elimination before severe complications arise. Both nutrition and elimination are undeniably important but are secondary to oxygen due to the difference in survival timelines. *Love* (A) is incorrect because it belongs to Maslow's third tier (social needs) and is not a physiological requirement for survival. While emotional connections contribute to mental well-being, they are irrelevant in immediate survival scenarios. A person deprived of love may suffer psychologically but will not die from it, unlike deprivation of oxygen. The prioritization of these needs aligns with biological imperatives: oxygen sustains cellular processes in real-time, while other needs become urgent only after longer periods of deprivation. This hierarchy reflects the body's adaptive mechanisms, where systems shut down in a predictable order when resources are scarce. Thus, oxygen's non-negotiable role in immediate survival makes it the need of greatest priority in Maslow's physiological tier.