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: A

Rationale: The correct answer is A: Hashimoto's thyroiditis. This autoimmune disorder results in chronic inflammation of the thyroid gland, leading to thyroid nodules and hypothyroidism. The colloid-filled spaces seen in the biopsy are characteristic of Hashimoto's. Choice B: Graves' disease is an autoimmune disorder causing hyperthyroidism, not hypothyroidism. Choice C: Diabetes mellitus is a metabolic disorder unrelated to the thyroid. Choice D: Thyroid nodules is a general term and does not explain the presence of colloid-filled spaces.

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: B

Rationale: The correct answer is B: Relieves pain by increasing pain threshold. Meperidine and codeine are opioid analgesics that work by binding to opioid receptors in the brain and spinal cord, thus increasing the pain threshold and reducing the perception of pain. This leads to pain relief without necessarily affecting sexual stimulation (choice A), craving for alcohol (choice C), or concentration/alertness (choice D). The primary physiological effect of these drugs is to modulate the perception of pain, making choice B the most appropriate answer in this context.

Correct Answer: D

Rationale: The correct answer is D: Create a core group. In the CO-PAR process, creating a core group is the first step in the pre-Entry phase as it establishes a team of committed individuals who will lead the participatory action research. This core group will provide leadership, coordination, and represent the diversity of the community. Surveying the community (choice A) comes after forming the core group to gather information. Training the technical working group (choice B) and holding a community assembly (choice C) are subsequent steps in the process after the core group is established.

Correct Answer: B

Rationale: The correct answer is B because actively listening, acknowledging the patient's concerns, and working towards rebuilding trust through transparency and reliability are essential steps in addressing distrust. By validating the patient's experiences and actively involving them in the process, the nurse can foster a supportive and trusting relationship. Choice A is incorrect because dismissing the patient's concerns can further damage trust and undermine the patient's feelings. Choice C is incorrect as ignoring the distrust can lead to a breakdown in communication and trust. Choice D is incorrect because telling the patient to trust the healthcare system without addressing their concerns is dismissive and unhelpful.

Correct Answer: C

Rationale: The correct answer is C because encouraging the patient to ask questions and express concerns promotes patient empowerment and active participation in self-care. This approach fosters communication, understanding, and collaboration between the nurse and patient, leading to better medication adherence. Choice A is incorrect as it lacks patient involvement. Choice B is helpful but does not necessarily empower the patient. Choice D is directive and does not encourage active participation or empowerment.

Correct Answer: C

Rationale: The correct answer is C: Hyponatremia. SSRI medications can lead to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), causing hyponatremia. This occurs due to increased levels of serotonin affecting the hypothalamus, leading to excessive ADH release. Hyponatremia can result in neurological symptoms and must be closely monitored. A: Bradycardia is not a common adverse effect of SSRIs. B: Hyperkalemia is not typically associated with SSRIs. D: Hypertension is not a common adverse effect of SSRIs; they may actually lower blood pressure.

Correct Answer: B

Rationale: The correct answer is B: Acute glomerulonephritis. Glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys, leading to symptoms like hematuria (blood in urine), proteinuria (excess protein in urine), and hypertension (high blood pressure). Acute tubular necrosis (A) involves damage to the renal tubules, not the glomeruli. Chronic kidney disease (C) refers to long-term kidney damage and may not always present with the classic symptoms mentioned. Nephrotic syndrome (D) involves excessive protein loss in urine but may not always involve inflammation of the glomeruli.