Correct Answer: C

Rationale: The correct answer is C: Normal deep tendon reflexes. This indicates a therapeutic level of magnesium sulfate as it shows that the medication is effectively preventing hyperreflexia, a common sign of magnesium toxicity. Drowsiness (choice A) can indicate toxicity. Urinary output of 20 mL/hour (choice B) is not specific to magnesium sulfate levels. Respiratory rate of 10 to 12 breaths per minute (choice D) is indicative of respiratory depression, a sign of magnesium toxicity. Thus, choice C is the best assessment to indicate a therapeutic level of medication in a patient with preeclampsia taking magnesium sulfate.

Correct Answer: C

Rationale: The correct answer is C: Evidence of a more advanced lesion. A stoney hardening in the posterior lobe of the prostate gland that is not mobile is indicative of a more advanced lesion, such as prostate cancer. This finding suggests that the lesion has progressed beyond the early stages. In early prostate cancer, the prostate gland may feel firm but not stoney hard, and the lesion is usually mobile. Metastatic disease would involve spread of the cancer to other parts of the body, which is not evident from the DRE alone. A normal finding would not present as stoney hardening and lack of mobility in the prostate gland during a DRE.

Correct Answer: D

Rationale: Rationale for Correct Answer (D): Checking with the pharmacy for availability of liquid forms of medications is the best action because it reduces the risk of clogging the nasogastric tube. Liquid medications are less likely to cause blockages compared to nonliquid medications. Additionally, liquid forms are easier to administer through the tube. By using liquid medications, the nurse can ensure that the medications flow smoothly through the tube without causing any obstructions. Summary of Incorrect Choices: A: Instilling nonliquid medications without diluting can increase the risk of tube clogging. B: Irrigating the tube with water after all medications are given may not prevent clogging effectively and could introduce unnecessary moisture into the tube. C: Mixing all medications together can lead to potential drug interactions and may not address the issue of tube clogging effectively.

Correct Answer: C

Rationale: The correct answer is C because the patient's affect, which refers to their emotional expression, is inappropriate. The patient is smiling while expressing anger, which is a contradiction. This inconsistency indicates a possible underlying issue such as emotional distress or confusion. Choice A is incorrect because the issue is not about the patient's understanding of the term "cough and deep breathe." Choice B is incorrect as there is no mention of personal space violation. Choice D is incorrect as the issue is not related to the patient's vocabulary but rather their emotional expression.

Correct Answer: B

Rationale: The correct answer is B: Refer the woman to her primary care provider to have the medication changed. Rationale: 1. Rash after taking the first dose of an antibiotic suggests a possible allergic reaction. 2. Allergic reactions can range from mild to severe, including anaphylaxis. 3. It is crucial to discontinue the suspected medication to prevent worsening of the reaction. 4. Referring the patient to their primary care provider ensures proper evaluation and management. 5. Changing the medication is necessary to avoid potential harm from continued exposure. Summary: A: Continuing the medication can worsen the allergic reaction and is not recommended. C: Going to the emergency department may be excessive at this point for a mild rash. D: Taking an antihistamine does not address the underlying issue of an allergic reaction.