The nurse understands that which of the ff. best describes the action of propanolol (Inderal)?

Correct Answer: C

Rationale: Step-by-step rationale: 1. Propranolol is a beta-blocker that acts on the heart. 2. It blocks beta-adrenergic receptors, leading to decreased heart rate and contractility. 3. Decreased heart rate and contractility result in reduced cardiac output. 4. Therefore, the correct answer is C - It decreases cardiac output. Summary: A, B, and D are incorrect because propranolol does not increase heart rate, fluid volume, or cardiac contractility.

Correct Answer: A

Rationale: The correct answer is A: Pyridoxine. Pyridoxine can reduce the effectiveness of Levodopa by converting it into dopamine before it reaches the brain, decreasing the therapeutic effects. Bromocriptine and Amantadine are actually used in combination with Levodopa to enhance its effects by different mechanisms. Choosing Amantadine as the answer is incorrect because it is listed twice in the choices and would not interfere with Levodopa's effectiveness.

Correct Answer: C

Rationale: The correct answer is C: Clinical pathways. Clinical pathways are standardized, evidence-based interdisciplinary plans of care used in case management to guide the treatment and management of clients. They outline the expected course of treatment, interventions, and outcomes for specific health conditions. Kardex care plans (A) are outdated paper-based patient information systems, not specifically for interdisciplinary care plans. Computerized plans of care (B) may refer to electronic health records but do not necessarily imply standardized interdisciplinary plans. Student care plans (D) are educational tools for students and not typically used in case management for clients.

Correct Answer: C

Rationale: During the evaluation phase, the nurse performs the key action of determining the effectiveness of the care plan. This involves assessing whether the client's goals are being met, if interventions are achieving the desired outcomes, and if any modifications are necessary. This step is crucial to ensure the care plan is successful and the client's needs are being addressed appropriately. Choice A is incorrect because diagnosing the client's condition is typically done in the assessment phase, not during evaluation. Choice B is incorrect as identifying nursing interventions is part of the planning phase. Choice D is incorrect as developing goals and outcomes is part of the planning phase as well. Overall, the evaluation phase focuses on assessing the effectiveness of the care plan rather than diagnosing, identifying interventions, or developing goals.

Correct Answer: A

Rationale: The correct answer is A: Disturbed thought processes. This is the problem statement because it identifies the specific nursing diagnosis that reflects the client's cognitive impairment. "Disturbed thought processes" directly addresses the issue the nurse is observing in the client. The other choices are not the problem statement. "Related to" is the etiology or cause of the problem, "Alzheimer’s disease" is the medical condition, and "Incoherent language" is the defining characteristic or evidence of the problem. Therefore, A is the correct answer as it clearly states the client's primary issue.

Correct Answer: D

Rationale: The correct action for the nurse to take is to notify the physician stat (choice D). Firstly, the patient presents with painful bladder spasms and blood-tinged urine, indicating a potential complication post-TURP. This warrants immediate medical attention to assess for possible bladder injury or hemorrhage. Giving Demerol (choice A) or B&O suppository (choice B) may provide symptomatic relief but does not address the underlying issue. Warming the irrigation solution (choice C) is not a priority in this situation and does not address the potential serious complications. Notifying the physician immediately allows for prompt evaluation and appropriate intervention to address the patient's condition effectively.

Correct Answer: A

Rationale: The correct answer is A: Deficient fluid volume related to osmotic diuresis. With a serum glucose level of 618mg/dl, the client is likely experiencing diabetic ketoacidosis, leading to excessive urination (osmotic diuresis) and dehydration. The priority is to address fluid volume deficit to prevent hypovolemic shock. The other options are not the priority because: B: Decreased cardiac output is a result of the increased heart rate, not the primary issue. C: Imbalanced nutrition is important but not as urgent as fluid volume deficit. D: Ineffective thermoregulation is a concern but not the priority in this scenario.

Correct Answer: C

Rationale: The correct answer is C: 3, 4, 2005. HIV can be transmitted through breast milk, blood, and semen due to the presence of the virus in these bodily fluids. Saliva, tears, and other body fluids do not typically contain enough of the virus to transmit HIV. Therefore, choices A, B, and D are incorrect as they include saliva, tears, and other non-transmissible fluids. It is crucial for the nurse to educate the patient on the modes of transmission to prevent the spread of HIV.

Correct Answer: A

Rationale: The correct answer is A because it follows the correct format of a nursing diagnosis: "Problem related to Etiology." In this case, "Decreased cardiac output" is the problem, and "altered myocardial contractility" is the cause. This format helps identify the specific issue and its underlying cause, allowing for targeted interventions. Choice B is incorrect as it doesn't follow the problem-etiology format and lacks specificity. Choice C is also incorrect as it lacks a clear nursing diagnosis and specific etiology. Choice D is incorrect as it presents a symptom rather than a nursing diagnosis with an associated cause. Overall, choice A is the best option as it provides a clear, specific nursing diagnosis that guides appropriate nursing interventions.