What is the proper hand position when performing chest percussion?

Correct Answer: A

Rationale: The proper hand position for chest percussion is to cup the hands, creating a hollow space to allow for effective transmission of percussion vibrations. Cupping the hands helps to produce the desired percussion sound and ensures proper force distribution. Using the side of the hands (B) may not provide enough surface area for effective percussion. Flattening the hands (C) may not generate the desired percussive effect, and spreading the fingers of both hands (D) can result in uneven force application. Therefore, cupping the hands is the most appropriate hand position for chest percussion.

Correct Answer: B

Rationale: The correct answer is B: increased fibrinogen. In DIC, there is consumption of coagulation factors leading to decreased fibrinogen levels. Heparin therapy helps by inhibiting further thrombus formation, allowing the body to replenish fibrinogen levels. Increased fibrinogen indicates a positive response. Incorrect choices: A) increased platelet count is not specific to Heparin therapy in DIC, C) decreased fibrin split products indicate ongoing coagulation, not a positive response, and D) decreased bleeding is a general response and not specific to Heparin therapy in DIC.

Correct Answer: B

Rationale: The correct answer is B because moving the wheelchair close and pivoting on the unaffected extremity is the safest way to transfer a client with hemiparesis. This method minimizes strain on the affected side and reduces the risk of falls. First, ensure the wheelchair is positioned close to the bed. Then, assist the client to pivot by placing weight on the unaffected side and using proper body mechanics. This technique maintains stability and prevents injury. Choice A is incorrect because standing and walking the client to the wheelchair puts excessive strain on the affected side, increasing the risk of falls. Choice C is incorrect as pivoting on the affected extremity can lead to injury and instability. Choice D is incorrect as having the client stand and push to the wheelchair can be dangerous and may cause further harm.

Correct Answer: A

Rationale: The correct answer is A: Reorient the client. This is the first step because confusion post-operatively could be due to anesthesia, pain medications, or disorientation. Reorienting the client helps bring them back to reality and decrease anxiety. B: Monitoring for signs of infection would be important but not the initial step for confusion. C: Monitoring serum electrolytes is important but not the immediate priority for confusion. D: Applying a cold compress is not relevant for confusion in a post-operative client.

Correct Answer: A

Rationale: The correct answer is A: Administer bronchodilators. During an acute asthma attack, the priority intervention is to immediately open the airways to improve breathing. Bronchodilators, such as albuterol, work rapidly to dilate the bronchioles and relieve bronchospasms, making it the most effective initial treatment. Corticosteroids (B) are used for long-term control, not immediate relief. Applying oxygen and administering albuterol (C) is close, but bronchodilators should be given first for quicker relief. Applying a cold compress (D) is not appropriate for managing an asthma attack.

Correct Answer: A

Rationale: The correct answer is A: Administer epinephrine. Epinephrine is the first-line treatment for anaphylaxis as it helps to quickly reverse severe symptoms by constricting blood vessels and opening airways. Administering corticosteroids (B) is not the immediate priority. Placing the client on their side (C) is important to prevent aspiration but does not address the anaphylactic reaction. Monitoring blood pressure (D) is essential but administering epinephrine takes precedence in managing anaphylaxis.

Correct Answer: A

Rationale: The correct answer is A, contusion. A contusion is a soft-tissue injury caused by blunt force resulting in bruising, without breaking the skin. This is different from the other choices. Strain (B) refers to an injury to a muscle or tendon due to overstretching. Sprain (C) is an injury to a ligament from overstretching. Dislocation (D) involves the displacement of bones at a joint, not a soft-tissue injury. Therefore, the term that specifically aligns with a soft-tissue injury from blunt force is contusion.

Correct Answer: A

Rationale: The correct answer is A: Administer bronchodilators. In an acute asthma attack, the priority is to open the airways and improve breathing. Bronchodilators work quickly to relax the muscles around the airways, allowing the client to breathe easier. Corticosteroids are used for long-term control, not immediate relief. Oxygen therapy may be needed if the client's oxygen levels are low. Pain medication is not indicated for an acute asthma attack as the primary issue is airway constriction, not pain. Administering bronchodilators first helps address the immediate breathing difficulty in an asthma attack.

Correct Answer: D

Rationale: The correct answer is D: Create home care safety. Nursing activities that promote health and prevent disease focus on educating individuals on maintaining their health and preventing diseases, rather than specifically creating home care safety. The other choices (A, B, C) are correct as they accurately reflect the goals of nursing activities - reducing disease risk, maintaining optimal functioning, and reinforcing good habits to promote overall health and well-being. Choice D is incorrect because while ensuring home care safety is important, it is not the primary focus of nursing activities aimed at health promotion and disease prevention.