The nurse would expect a client with somatic pain to report which of the following?

Correct Answer: B

Rationale: The nurse expects a dull ache in somatic pain, as it arises from musculoskeletal tissues (e.g., bones, muscles) due to injury or inflammation, producing a localized, throbbing or aching qualitydistinct from neuropathic pain's neural feel. Choice A, burning sensation, fits neuropathic pain (e.g., nerve damage), not somatic's mechanical origin. Choice C, tingling, also suggests neuropathy (e.g., pinched nerve), not the deeper ache of somatic pain like fractures. Choice D, numbness, indicates nerve dysfunction or anesthesia, not pain itselfsomatic pain is felt, not absent. Choice B is correct, guiding nurses to identify somatic pain's hallmarke.g., post-op or arthritis discomfortprompting treatments like NSAIDs or rest, tailored to its tissue-based source, unlike neuropathic options.

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.

Correct Answer: C

Rationale: Excessive sleep, or hypersomnia, often stems from central nervous system dysfunction, particularly the hypothalamus , which regulates sleep-wake cycles via the suprachiasmatic nucleus (SCN) and orexin neurons. Injury heree.g., from trauma or tumordisrupts circadian rhythm and arousal, causing prolonged sleep, as seen in conditions like narcolepsy or post-traumatic hypersomnia. The spinal cord conducts signals but doesn't control sleep; injury might cause paralysis, not hypersomnia. The pancreas manages glucose, and while hypoglycemia can induce fatigue, it doesn't directly govern sleep duration. The thyroid influences metabolism; hypothyroidism causes lethargy, but not abnormally long sleep periods distinct from fatigue. For example, a hypothalamic lesion might reduce orexin, a wake-promoting neurotransmitter, leading to 16-hour sleep days versus a normal 7-9. Nursing assessments would note this brain region's role in sleep homeostasis, per Taylor's text, confirming Choice C as the correct answer.