When a nurse commits an error in the progress notes the BEST action she should do is to

Correct Answer: C

Rationale: The correct action in this scenario is to choose option C: put a line across the sentence, make the correction over it, and sign. This method is recommended because it maintains the integrity of the original record by showing what was initially written and clearly indicating the correction. By crossing out the error, making the correction, and signing the entry, the nurse acknowledges and takes responsibility for the mistake while ensuring the accuracy and transparency of the documentation. Option A is incorrect as crossing the error many times can make the note illegible and may not clearly indicate the correction. Option B is incorrect because using correction fluid can make the note messy and may raise suspicions of tampering with the record. Option D is incorrect as erasing with a rubber eraser can damage the document and also raise concerns about the validity of the information. In summary, option C is the best choice as it allows for a clear and professional correction without compromising the integrity of the progress notes.

Correct Answer: B

Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status. A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence. C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress. D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.

Correct Answer: B

Rationale: The correct answer is B because the nurse's role is to address the holistic needs of the patient, including financial concerns. Providing information about financial assistance programs and resources shows empathy and supports the patient in making informed decisions. Choice A is incorrect because dismissing the patient's concerns can lead to a breakdown in trust and communication. Choice C is incorrect as ignoring the patient's concerns is not addressing the patient's needs. Choice D is incorrect because financial concerns are valid and should be considered in decision-making.

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: A

Rationale: The correct answer is A: Bleeding. Chemotherapy can lead to low platelet counts (thrombocytopenia), increasing the risk of bleeding. The priority goal of the nurse is to prevent bleeding by taking precautions such as avoiding invasive procedures, using soft toothbrushes, and monitoring for signs of bleeding. Infection (B) is important but not the priority as bleeding can be life-threatening. Hypotension (C) is not directly related to thrombocytopenia. Diarrhea (D) is a potential side effect of chemotherapy but is not the priority when considering thrombocytopenia.

Correct Answer: A

Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation. Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.

Correct Answer: B

Rationale: Plantar fasciitis is the correct answer. It is characterized by inflammation of the plantar fascia, leading to heel pain, especially in the morning. The plantar fascia is a band of tissue that connects the heel bone to the toes. The pain is usually worse with the first steps after resting. Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain at the back of the heel and ankle. Morton's neuroma is a condition involving a thickening of tissue around a nerve in the ball of the foot, leading to sharp, burning pain in the toes. Stress fracture of the calcaneus refers to a small crack in the heel bone due to repetitive stress or overuse, resulting in heel pain that may worsen with activity, but not specifically with the first steps in the morning.

Correct Answer: C

Rationale: The correct answer is C: Systematic sampling. Nurse Sandy is adopting systematic sampling by selecting every third patient with MI after a random start. This method ensures equal chance of selection for each patient and maintains randomness. In contrast, simple random sampling (A) entails each patient having an equal chance of being selected independently. Stratified sampling (B) divides patients into groups based on certain characteristics, which is not the case here. Cluster sampling (D) involves grouping patients and selecting entire groups, which is different from the individual selection in this scenario.

Correct Answer: D

Rationale: The correct answer is D: advocacy. Advocacy involves actively supporting and promoting the welfare and rights of the patient. Nurses advocate for their patients by ensuring their health, safety, and personal rights are upheld. This ethical principle goes beyond just fulfilling responsibilities or being accountable for one's actions. Responsibility (A) focuses on duties and tasks, accountability (B) is about being answerable for one's actions, and confidentiality (C) pertains to maintaining patient privacy. In this context, advocacy is the most appropriate choice as it encompasses actively working to protect and promote the best interests of the patient.