Correct Answer: A

Rationale: The most appropriate nursing diagnosis for a client with advanced Parkinson's disease and gait issues is "A: Impaired Physical Mobility." This diagnosis accurately reflects the client's limited ability to move due to the disease's impact on coordination and muscle control. Impaired Physical Mobility addresses the specific issue of gait problems commonly seen in Parkinson's patients. Choice B, "Impaired Role Performance," does not directly address the physical limitations caused by the disease. Choice C, "Ineffective Role Performance," focuses more on the client's inability to fulfill societal roles rather than the physical aspect of gait issues. Choice D, "Powerlessness," does not capture the primary concern of impaired movement and mobility in this scenario.

Correct Answer: A

Rationale: The most appropriate nursing diagnosis for a client with advanced Parkinson's disease and gait issues is "A: Impaired Physical Mobility." This diagnosis accurately reflects the client's limited ability to move due to the disease's impact on coordination and muscle control. Impaired Physical Mobility addresses the specific issue of gait problems commonly seen in Parkinson's patients. Choice B, "Impaired Role Performance," does not directly address the physical limitations caused by the disease. Choice C, "Ineffective Role Performance," focuses more on the client's inability to fulfill societal roles rather than the physical aspect of gait issues. Choice D, "Powerlessness," does not capture the primary concern of impaired movement and mobility in this scenario.

Correct Answer: A

Rationale: The correct first step is to immobilize the spine (A) in a suspected spinal cord injury to prevent further damage. This helps to stabilize the spine and prevent any potential movement that could worsen the injury. Providing pain relief (B) should come after immobilization. Assessing for signs of spinal shock (C) is important but comes after immobilization. Placing the client in a supine position (D) can be part of immobilization but is not the first step.

Correct Answer: C

Rationale: The correct answer is C: Check for dehydration. When a client has a high fever, assessing for dehydration is crucial because fever can lead to increased fluid loss through sweating and increased respiratory rate. Dehydration can exacerbate the client's condition and needs to be addressed promptly. Monitoring respiratory rate (choice A) and pulse (choice D) are important assessments but do not address the immediate need to identify dehydration. Obtaining a blood sample (choice B) may be necessary at some point but is not the initial priority in a client with a high fever. Thus, checking for dehydration should be assessed first to ensure proper management of the client's condition.

Correct Answer: A

Rationale: The correct answer is A: Chest pain. A symptom is a subjective indication of a condition experienced by the patient. Chest pain is a subjective sensation that a patient reports, making it a symptom. Clammy skin, serum potassium level, and temperature are all objective signs or measurements, not subjective experiences reported by the patient. Symptoms are what the patient feels or experiences, while signs are objective findings that can be measured or observed by healthcare providers.