When working in a facility that uses focus charting, the nurse will use which of the following as a focus of care?

Correct Answer: D

Rationale: Focus charting prioritizes client concerns and strengths, like anxiety or resilience, guiding care around current issues and assets. Initial problems or functioning levels are static, and goals are outcomes, not foci. This method keeps nursing care dynamic and client-centered, enhancing relevance in daily practice.

Correct Answer: C

Rationale: Eggs are a complete protein, containing all essential amino acids, unlike olives, rice, or nuts (incomplete). Nurses teach this for nutrition.

Correct Answer: B

Rationale: Using a transfer belt enhances safety during transfers for patients with limited mobility, offering stability and support while allowing caregivers to maintain proper mechanics, reducing injury risk. Independent transfers without aid heighten fall chances, sliding boards aren't universal, and rapid lifting is unsafe. Nurses employ this tool to ensure controlled, secure movement, balancing patient safety with caregiver ergonomics, a key technique in mobility-limited care settings.

Correct Answer: D

Rationale: Ensuring adequate oxygen supply to the brain (D) is the primary indication for oxygen therapy in TBI with altered status and low SpO2, preventing hypoxic brain damage. Cerebral edema (A) or BP stabilization (C) involves other interventions. Neurological improvement (B) follows oxygenation. Adequate oxygen supports cerebral metabolism, per neurotrauma care, critical to limit secondary injury.

Correct Answer: C

Rationale: Nasal dryness and discomfort (C) indicate inadequate humidification with a Venturi mask, necessitating flow or humidity adjustment. SpO2 98% (A) and RR 16 (B) are normal. 4 L/min (D) may be correct but doesn't address symptoms. Adjustment, per respiratory care, improves tolerance and efficacy.