Two adult siblings are caring for their ill mother, who requires 24-hour care: she needs assistance with feeding, bathing, and toileting. One of the siblings takes time to exercise after work. The other sibling goes directly to the mother's home before and after work each day. The nurse recognizes that people may react differently to the same stressors depending on various factors. What are some of these factors? Select all that apply.

Correct Answer: A

Rationale: The correct answer is A: Amount of perceived stress. This is because individuals may react differently to stressors based on how they perceive the level of stress they are experiencing. Factors such as previous experiences, personality, and support systems can influence how stress is perceived. Hair color (B) and skin type (D) are not relevant factors in how individuals react to stress. Individual coping skills (C) are important, but they are more about how individuals manage stress rather than how they initially perceive it.

Correct Answer: C

Rationale: Step 1: Reviewing the events leading up to each medication administration error is the most crucial first step. It allows the committee to understand the root causes of the errors, identify patterns or common factors contributing to errors, and develop targeted interventions to prevent future errors. Step 2: Providing an inservice on medication administration to all nurses (Choice A) is important but should come after understanding the specific issues causing errors. Step 3: Requiring staff nurses to demonstrate competency by passing an examination (Choice B) is not the most effective initial strategy as it focuses on individual performance rather than systemic issues. Step 4: Developing a quality improvement program for nurses involved in errors (Choice D) is important but should follow the analysis of the errors to ensure the program's effectiveness in addressing the identified issues.

Correct Answer: C

Rationale: Step-by-step rationale for choice C being correct: 1. ARDS patients have increased capillary permeability leading to fluid leakage into the lungs. 2. Mild fluid restriction helps prevent fluid overload and pulmonary edema. 3. Diuretics help manage any excess fluid accumulation. 4. Hydration using colloids (choice A) can exacerbate fluid overload. 5. Surfactant (choice B) is used in neonatal respiratory distress syndrome, not ARDS. 6. Keeping hemoglobin level >12 g/dL (choice D) is unrelated to fluid balance in ARDS.

Correct Answer: B

Rationale: The correct answer is B: Clear and light sample. This is because sputum should ideally be clear and light in color, indicating a lower presence of mucus and other contaminants. A cloudy, thick sample (choice A) may indicate an infection or presence of pus. Choices C and D are likely left blank as they are irrelevant or incorrect responses. In summary, a clear and light sputum sample is preferred for accurate testing and diagnosis.

Correct Answer: C

Rationale: The correct answer is C. Transferring a client to the discharge location would be the lowest priority for the nurse during a disaster simulation. Priority should be given to immediate actions that ensure the safety and well-being of all clients. Here's a step-by-step rationale: 1. Preventing cross-contamination (choice A) is crucial to prevent the spread of the toxic substance. 2. Performing concise client assessment (choice B) is essential to identify and prioritize care for clients based on their needs. 3. Maintaining a client tracking system (choice D) is vital for ensuring accountability and continuity of care. 4. Transferring a client to the discharge location (choice C) can be delayed as it is not immediately life-threatening or crucial for the initial response.