The physician prescribes decongestant intranasal spray. The nurse instructs the client on the proper use of the spray. Which of the following procedures is the CORRECT method?

Correct Answer: D

Rationale: The correct answer is D: Tilt the head slightly forward and angle the bottle toward the side of the nostril. This method allows for proper administration of the spray into the nasal passage, ensuring effective delivery of the medication. Tilted head helps direct the spray towards the nasal cavity without causing discomfort or leakage. It also helps prevent the medication from dripping down the back of the throat. Choices A, B, and C are incorrect: A: Finishing instillation in one nostril before moving to the other can lead to uneven distribution of medication and reduced effectiveness. B: Inhaling quickly may cause irritation and discomfort to the mucous membranes due to the forceful intake of the spray. C: Blowing the nose after spraying can expel the medication before it has a chance to be absorbed, decreasing its efficacy.

Correct Answer: B

Rationale: The correct answer is B: Equity in services. Collaboration and teamwork in public health are crucial to ensure equal access to services for all populations, regardless of their background or socioeconomic status. By working together, public health professionals can identify disparities and implement strategies to address them, ultimately leading to improved equity in healthcare services. A: Staff performance - While collaboration and teamwork can positively impact staff performance, the primary focus in public health is on achieving equity in services for all individuals. C: Proper use of resources - Collaboration can help optimize resource allocation, but the main goal in public health is to ensure equitable access to services. D: Quality healthcare - While collaboration can enhance the quality of healthcare, the primary emphasis in public health is on promoting equity in services to address health disparities.

Correct Answer: D

Rationale: The correct answer is D: Osteoporosis. Long-term use of inhaled corticosteroids can lead to decreased bone density and an increased risk of osteoporosis. Corticosteroids can interfere with calcium absorption and bone formation, resulting in bone weakening. Oral thrush (Choice A) is a common side effect of inhaled corticosteroids, but it is not associated with long-term use. Hypertension (Choice B) and hyperglycemia (Choice C) are more commonly seen with systemic corticosteroid use rather than inhaled corticosteroids.

Correct Answer: A

Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition. B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour. C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder. D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.

Correct Answer: B

Rationale: The correct answer is B: Bright red and spurts with the heartbeat. This type of bleeding indicates arterial bleeding, which is oxygen-rich blood coming directly from the arteries. Arterial bleeding is bright red in color due to the high oxygen content and spurts with the heartbeat as it is under higher pressure. This rapid spurting is characteristic of arterial bleeding and requires immediate attention to control the bleeding source. Choices A, C, and D are incorrect because they describe characteristics of venous bleeding, not arterial bleeding. Venous bleeding is dark in color, flows slowly, and generally oozes as it is oxygen-depleted blood returning to the heart. Therefore, the correct answer is B based on the specific characteristics of arterial bleeding.

Correct Answer: B

Rationale: The correct answer is B: Prevents postpartum hemorrhage. Methylergonovine maleate is a uterotonic medication used to prevent and treat postpartum hemorrhage by causing strong uterine contractions, which help to control bleeding after delivery. It is not used to reduce lochia drainage (choice A), decrease uterine contractions (choice C), or maintain normal blood pressure (choice D). By understanding the pharmacological action of methylergonovine maleate in preventing postpartum hemorrhage, we can confidently select choice B as the correct answer.

Correct Answer: A

Rationale: The correct answer is A because a viral illness few weeks before can trigger Guillain-Barre Syndrome (GBS) due to the body's immune response attacking the peripheral nerves. Encephalitis (B), severe bacterial infection (C), and meningitis (D) are not directly linked to GBS pathophysiology. Viral infections are known to precede GBS development, making choice A the most appropriate option.

Correct Answer: C

Rationale: The correct answer is C: Pancreas. The pancreas is responsible for producing digestive enzymes and bicarbonate-rich pancreatic juice. It secretes enzymes like amylase, lipase, and protease to break down carbohydrates, fats, and proteins in the small intestine. The bicarbonate-rich juice helps neutralize stomach acid. The liver (A) produces bile stored in the gallbladder (B), which aids in fat digestion. The spleen (D) is involved in immune function and blood filtration, not digestive enzyme production.

Correct Answer: C

Rationale: The correct answer is C: Hyponatremia. SSRI medications can lead to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), causing hyponatremia. This occurs due to increased levels of serotonin affecting the hypothalamus, leading to excessive ADH release. Hyponatremia can result in neurological symptoms and must be closely monitored. A: Bradycardia is not a common adverse effect of SSRIs. B: Hyperkalemia is not typically associated with SSRIs. D: Hypertension is not a common adverse effect of SSRIs; they may actually lower blood pressure.