Which of the following actions is a violation of a psychiatric patient's rights?

Correct Answer: C

Rationale: In this scenario, the action that violates a psychiatric patient's rights is option C, where staff members confiscated written letters done by patients addressed to the local newspaper. Patients have the right to communicate freely and express their thoughts and feelings through various means, such as letter-writing. Confiscating these letters is a violation of their rights to free expression and communication. It is essential to respect and uphold the rights of psychiatric patients, including their right to communicate with others.

Correct Answer: D

Rationale: It is NOT recommended to use the same syringe and needle in administering two different vaccines. This is to prevent contamination or mixing of different vaccines, which could potentially affect their effectiveness or pose a risk to the individual receiving the vaccines. It is important to use separate syringes and needles for each vaccine to ensure proper administration and prevent any adverse reactions.

Correct Answer: C

Rationale: The nurse should prioritize checking the patency of the NG tube by aspirating gastric contents before initiating tube feeding. This is important to ensure that the NG tube is in the correct position and that it is functioning properly. By aspirating gastric contents, the nurse can confirm that the tube is in the stomach and not in the lungs or surrounding tissues. If no gastric contents are obtained upon aspiration, it may indicate that the tube is not properly placed or may be occluded, which would require further assessment and intervention before proceeding with tube feeding. Checking the patency of the NG tube is a crucial step in ensuring the safety and effectiveness of enteral nutrition delivery.

Correct Answer: C

Rationale: Battery occurs when there is an intentional touching of another person without their consent. In this case, the nurse began cardiopulintary resuscitation on a client who had requested a "Do Not Resuscitate" (DNR) order, which means the client did not consent to the resuscitation. This action can be considered as battery because the client's wishes were not respected, and the nurse proceeded with a medical intervention against those wishes, leading to harm and potential legal consequences. This is different from assault, which involves a threat of force, and from defamation and fraud, which are not applicable to this situation.

Correct Answer: C

Rationale: In a conscious trauma patient with a suspected head injury, maintaining cervical spine immobilization is crucial. The presence of a head injury raises concerns for potential concomitant cervical spine injury. Therefore, it is vital to prevent any movement of the cervical spine to avoid exacerbating a potential spinal cord injury. Maintaining immobilization involves stabilizing the patient's head and neck in a neutral position until appropriate imaging studies can assess the extent of any spinal injury. This action helps prevent further harm and ensures the safety of the patient during assessment and management of their injuries.

Correct Answer: A

Rationale: The presentation described in the question is classic for anterior uveitis. Anterior uveitis is an inflammatory condition affecting the iris and ciliary body and is characterized by redness, pain, and photophobia. Slit-lamp examination typically reveals ciliary injection (redness around the iris), corneal edema, and a mid-dilated pupil with a fixed reaction to light due to inflammation causing spasm of the iris muscles. Acute angle-closure glaucoma would present with similar symptoms but would also have increased intraocular pressure, which is not mentioned in the presentation. Endophthalmitis is an infection of the intraocular cavities and would typically present with more severe symptoms, such as severe pain, vision loss, and presence of pus in the eye. Corneal abrasion would present with pain, foreign body sensation, and possibly tearing but would not cause ciliary injection or fixed pupil reaction as

Correct Answer: D

Rationale: Referring the client to a lactation consultant for specialized support should be prioritized to support successful breastfeeding in this situation. Breast augmentation surgery may impact milk production, let-down reflex, and proper latch due to alterations in breast tissue and nerve pathways. A lactation consultant can provide individualized guidance and support to address these specific challenges. Additionally, the consultant can assist in establishing a breastfeeding plan tailored to the client's unique needs, helping to optimize the breastfeeding experience for both the mother and the baby. It is crucial to seek expert assistance in navigating any potential difficulties that may arise from breastfeeding after breast augmentation to promote successful breastfeeding outcomes.

Correct Answer: A

Rationale: Physiologic jaundice in newborns is a common and typically benign condition caused by the immaturity of the newborn's liver. The correct statement about physiologic jaundice is that it occurs due to an imbalance between the production and elimination of bilirubin. In contrast, Option A is the false statement because it incorrectly states that physiologic jaundice is caused by impairment in the removal of bilirubin deficiency in the production of glucuronide transferase. This statement is inaccurate as physiologic jaundice results from the immature liver's reduced ability to conjugate bilirubin.

Correct Answer: A

Rationale: In collecting a sputum specimen, the nurse should instruct Roy to breathe slowly, cough, and then expectorate into the specimen container. This ensures that the sputum sample is collected from the lower respiratory tract where it is most likely to contain pathogens or other relevant substances for analysis. By instructing Roy to breathe slowly, it helps him to take deep breaths and effectively cough to produce a good sputum sample. Additionally, asking him to expectorate directly into the specimen container helps prevent contamination from saliva or other sources, ensuring the accuracy of the specimen collected for testing.