The physician orders a platelet count to be performed on Mrs. Smith after breakfast. The nurse is responsible for:

Correct Answer: A

Rationale: The nurse's responsibility in this scenario is to instruct the patient about the diagnostic test ordered by the physician. This includes explaining the purpose of the test, any necessary preparations, and what to expect. The nurse is not responsible for writing the order, as this is the physician's role. Additionally, providing breakfast is not directly related to the platelet count test. Therefore, the correct answer is A, which aligns with the nurse's role in educating and supporting the patient regarding the test.

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.

Correct Answer: B

Rationale: When a family is open to organ donation after a loved one has been declared brain-dead, the nurse's role is to provide compassionate, honest, and non-coercive support while addressing their concerns. The correct choice (B) emphasizes active listening and truthful communication, which is critical in this sensitive situation. Families need accurate information to make an informed decision, and the nurse must create a safe space for them to express doubts, fears, or questions without pressure. This approach respects their autonomy, acknowledges their grief, and ensures they understand the process, including the medical and ethical aspects of organ donation. Choice (A) is incorrect because delaying the decision until grief eases is medically impractical. Organ donation must occur promptly after brain death to ensure the viability of organs for transplantation. Postponing the discussion risks the loss of life-saving opportunities for recipients. While grief is a significant factor, the nurse’s responsibility is to guide the family through the decision-making process with empathy, not defer it indefinitely. Choice (C) is inappropriate as it pressures the family into a quick decision without adequate time for reflection or discussion. Organ donation is a deeply personal choice, and rushing the family could lead to regret or resentment. Ethical practice requires ensuring the family fully comprehends the implications of donation and consents voluntarily, not under duress or haste. Choice (D) is misleading and factually incorrect. Organ donation does not preclude the possibility of a wake or funeral. The surgical recovery of organs is performed with respect for the donor’s body, and funeral arrangements can proceed as planned. Providing inaccurate information could unnecessarily distress the family or dissuade them from considering donation. Transparency about the process, including how the body will be treated, is essential to maintaining trust. The nurse’s primary responsibilities in this scenario are to educate, support, and advocate for the family while upholding ethical standards. By listening attentively and answering questions honestly (B), the nurse helps the family navigate this difficult decision with clarity and dignity, ensuring their choice aligns with their values and the patient’s wishes.