There is an outbreak of measles in some areas of the community where Nurse Rona is assigned. Which of the following-steps of an outbreak investigation should Nurse Rona and her team begin ?

Correct Answer: A

Rationale: The correct answer is A: Identify and count cases. In the initial stages of an outbreak investigation, it is crucial to identify and count cases to understand the scope and magnitude of the outbreak. By counting cases, Nurse Rona and her team can track the spread of the disease, identify common characteristics among those affected, and determine the extent of the outbreak. This step helps in guiding further investigation and control measures. Summary of other choices: B: Define and identify cases - While defining cases is important, it is not the initial step in outbreak investigation. C: Verify diagnosis - Verifying diagnosis is important but comes after identifying and counting cases. D: Prepare for field work - Field work is important in outbreak investigations, but it typically comes after the initial step of identifying and counting cases.

Correct Answer: C

Rationale: Step 1: Incongruent message occurs when verbal and nonverbal communication do not align. Step 2: Choice C states "When what the nurse says and does do not agree," indicating a lack of alignment. Step 3: This inconsistency can lead to confusion or mistrust in communication. Step 4: Choices A, B, and D all describe situations with alignment between words and actions, making them congruent. Summary: Choice C is correct as it exemplifies incongruent communication, while Choices A, B, and D are incorrect as they describe congruent messages.

Correct Answer: A

Rationale: The correct answer is A: Administering proton pump inhibitors (PPIs) concomitantly. Aspirin and clopidogrel can increase the risk of gastrointestinal bleeding. PPIs help reduce this risk by decreasing gastric acid production. Therefore, administering PPIs with dual antiplatelet therapy is essential for preventing bleeding complications. Encouraging increased fluid intake (B) may not directly address the risk of bleeding. Monitoring for signs of thrombocytopenia (C) is important but may not directly prevent bleeding in this case. Providing education on fall prevention measures (D) is important for overall safety but does not directly address bleeding risks associated with dual antiplatelet therapy.

Correct Answer: B

Rationale: The correct answer is B: To provide a patent airway. When caring for a patient with a tracheostomy, ensuring a clear and unobstructed airway is the top priority to maintain adequate oxygenation and ventilation. This involves suctioning, maintaining proper tube placement, and monitoring for any signs of respiratory distress. Choices A, C, and D are incorrect as they do not address the immediate need for airway management, which is crucial for the patient's safety and well-being.

Correct Answer: C

Rationale: The correct answer is C because independence for the elderly means they have the freedom to make choices and decisions about their own lives. This empowers them to live according to their preferences and values. Choice A is incorrect because it doesn't consider individual circumstances; choice B is important but doesn't capture the essence of independence; choice D is too broad and doesn't specifically address the concept of personal autonomy and agency for the elderly.

Correct Answer: C

Rationale: The correct answer is C: Umbilicus. The nurse begins assessing the uterine fundus at the level of the umbilicus as it is a standard reference point for postpartum fundal height measurement. This location allows for consistency and accuracy in tracking the descent of the uterus back into the pelvic cavity. Starting at the umbilicus also helps in monitoring the involution process and prevents potential errors in fundal height assessment. Symphysis pubis (A) is too low and not typically used as a reference point for uterine fundal assessment. Midline (B) is vague and does not provide a specific anatomical landmark. Sides of the abdomen (D) do not give a standardized starting point for measuring the uterine fundus, leading to potential variability in assessment.

Correct Answer: B

Rationale: The correct answer is B: 20-Gauge. The smaller the gauge number, the larger the diameter of the catheter. Blood transfusions typically require a larger catheter size to prevent hemolysis and ensure proper flow. A 20-Gauge catheter is larger than 22-Gauge, 18-Gauge, and 12-Gauge, making it suitable for administering blood. 22-Gauge is too small and can cause hemolysis, 18-Gauge is smaller than the recommended size for blood transfusions, and 12-Gauge is too large and can cause damage to the vein.

Correct Answer: D

Rationale: The correct answer is D: Diabetes insipidus. This condition is characterized by excessive thirst, large volumes of dilute urine, low urine osmolality, hypernatremia, and elevated serum osmolality. The underlying cause is a deficiency in or insensitivity to antidiuretic hormone (ADH), leading to the inability of the kidneys to concentrate urine properly. Hyperthyroidism (choice A) and hypothyroidism (choice B) do not directly affect urine concentration. While diabetes mellitus (choice C) can also present with polyuria and polydipsia, it would typically have high urine osmolality due to the presence of glucose. Therefore, diabetes insipidus is the most likely endocrine disorder responsible for these specific symptoms.

Correct Answer: A

Rationale: The correct answer is A: Implement environmental modifications to promote sleep hygiene. Delirium is often triggered by environmental factors like noise, light, and disruption of sleep. By optimizing the environment for rest and minimizing stimuli, the patient's delirium can improve. This approach focuses on addressing the root cause rather than just managing symptoms. Choice B is incorrect because antipsychotic medications can worsen delirium and are not recommended as first-line treatment. Choice C is not the priority as ruling out focal deficits may be important but does not directly address the delirium. Choice D is incorrect as benzodiazepines can exacerbate delirium and are not recommended due to their potential to worsen cognitive function.