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: C

Rationale: The correct answer is C: Fifth month. Nurse Vera should explain that the fetal heart can typically be heard using a Doppler ultrasound device around the fifth month of pregnancy. This is because the baby's heart is developed enough to produce audible sounds by this time. Choices A, B, and D are incorrect because in the ninth month, the baby is ready for delivery, in the third month the heart is still developing, and in the first month the heart is just beginning to form and is not yet audible.

Correct Answer: B

Rationale: The correct initial step before starting TPN is to evaluate the patient's tolerance to glucose. This is crucial to ensure the patient can metabolize the glucose effectively and avoid complications such as hyperglycemia. Assessing affordability (A) is important but not the immediate concern. Identifying allergies (C) should be done but is not the first step. Assessing the patient's understanding (D) is important but not as critical as evaluating glucose tolerance before starting TPN.

Correct Answer: B

Rationale: The correct answer is B: Psoriasis. Psoriasis is characterized by pruritic, erythematous patches with silvery scales, commonly found on the elbows, knees, and scalp. This presentation matches the patient's symptoms. Eczema (choice A) typically presents with red, inflamed, and itchy skin patches. Pityriasis rosea (choice C) manifests as a herald patch followed by smaller scaly patches in a "Christmas tree" distribution. Seborrheic dermatitis (choice D) involves oily, yellowish, scaly patches mainly on the scalp, face, and ears, and does not typically present with silvery scales.

Correct Answer: D

Rationale: The correct answer is D: Diabetic retinopathy. This condition is a common complication of diabetes that occurs due to the thickening of capillaries and arterioles in the eye, leading to damage to the retina. This can result in vision problems and even blindness if left untreated. A: Papilledema is the swelling of the optic disc due to increased intracranial pressure, not related to diabetes. B: Glaucoma is a condition characterized by increased pressure within the eye, not directly caused by diabetes. C: Retinal detachment is the separation of the retina from the underlying tissues, which is not primarily caused by diabetes-related capillary changes.

Correct Answer: D

Rationale: The correct answer is D because an ethical dilemma arises when there is a conflict between two or more ethical principles, leading to a difficult decision-making situation for Nurse Mauve. This involves weighing the benefits and consequences of each ethical principle to determine the best course of action. Choice A is incorrect as time pressure does not define an ethical dilemma. Choice B is incorrect because ethical dilemmas involve conflicting choices, not unclear ones. Choice C is incorrect as the conflict in an ethical dilemma is not necessarily with a superior but can be internal or with other stakeholders.

Correct Answer: B

Rationale: The correct answer is B: pulse rates. Pulse rates can be analyzed on the ratio level of measurement because they have a true zero point and allow for meaningful ratios to be calculated. This means that we can perform operations such as addition, subtraction, multiplication, and division on pulse rate data. In contrast, the other options (A: eye color, C: ethnicity, D: gender) are categorical data that do not have a true zero point and therefore cannot be analyzed on the ratio level. Eye color, ethnicity, and gender are all examples of nominal data which only allow for qualitative classification and do not have a numerical value that can be used in mathematical operations.

Correct Answer: A

Rationale: The correct answer is A: Justice. Nurse Erika is ensuring fairness by including all newly hired nurses in her project without discrimination. Justice in healthcare promotes equity and equal opportunities. Nonmaleficence (B) refers to the duty to do no harm, not relevant here. Autonomy (C) relates to respecting individuals' right to make decisions for themselves, not evident in the scenario. Respect (D) is important but not the primary ethical principle demonstrated here.

Correct Answer: B

Rationale: The correct answer is B: Provides reality orientation to patient. Orienting the patient to time, place, date, and events helps them stay connected to reality and improves their awareness of their surroundings. This is crucial in assessing their cognitive functioning and ensuring they are grounded in the present moment. By providing reality orientation, healthcare providers can better understand the patient's current mental state and address any potential confusion or disorientation. This approach aids in establishing a therapeutic environment and enhances the patient's overall well-being. Choices A, C, and D do not capture the essence of reality orientation and its significance in maintaining the patient's mental clarity and connection to the present moment.