Which of the following is NORMAL in pregnancy?

Correct Answer: D

Rationale: Step-by-step rationale for why option D is correct: 1. During pregnancy, the hormone relaxin causes the symphysis pubis to widen to accommodate childbirth. 2. This widening of the symphysis pubis is a normal physiological change in pregnancy to facilitate the passage of the baby. 3. It is essential for the baby to pass through the birth canal during labor. 4. Therefore, a widened symphysis pubis is a normal finding in pregnancy. Summary of why other choices are incorrect: A. "Increased residual lung volume" is not normal in pregnancy as lung volume decreases due to the elevation of the diaphragm. B. "Decreased plasma volume" is not normal in pregnancy as plasma volume increases to support the growing fetus. C. "Decreased total RBC mass" is not normal in pregnancy as RBC mass increases to meet the increased oxygen demands.

Correct Answer: C

Rationale: The correct answer is C: Traumatic brain injury. In this scenario, the patient's response to fluid resuscitation indicates that her hemodynamic instability is likely due to ongoing blood loss rather than blunt cardiac injury, inadequate resuscitation, or traumatic brain injury. The improvement in BP and HR after fluid infusion suggests that the patient is responding appropriately to volume replacement, making ongoing blood loss the most likely cause of her hemodynamic changes. Blunt cardiac injury could lead to similar symptoms, but the patient's response to fluid makes it less likely. Inadequate resuscitation would lead to persistent hypotension, which is not the case here. Traumatic brain injury typically does not cause acute hemodynamic changes like the ones observed in this case.

Correct Answer: B

Rationale: The correct answer is B: Dementia. Dementia is characterized by a serious decline in cognitive abilities such as memory, thinking, and reasoning. It is not a terminal illness (A), a heart disease (C), or a chronic disorder (D). Dementia specifically refers to the loss of mental abilities, which distinguishes it from the other choices.

Correct Answer: A

Rationale: The correct answer is A: Keeping a resident's information confidential. This is ethical behavior as it upholds the resident's right to privacy and maintains trust. Revealing confidential information violates ethical principles and can harm the resident. Choices B, C, and D are incorrect. B contradicts transparency and honesty, which are essential in healthcare. C involves deception and impersonation, which is unethical and can lead to legal consequences. D is inappropriate as it can burden the resident with unnecessary information and is unprofessional.

Correct Answer: D

Rationale: The correct answer is D because responding immediately when the resident calls for help shows attentiveness and care, building trust with the resident's family and friends. This action demonstrates the NA's dedication to the resident's well-being and emphasizes their commitment to providing timely assistance. A is incorrect as avoiding talking to the resident when he has visitors can signal indifference and lack of engagement. B is incorrect because letting the family take care of the resident's needs themselves may suggest neglect of the NA's responsibilities. C is incorrect as telling stories about the resident without their consent may invade their privacy and potentially create uncomfortable situations. In summary, choice D is the most effective way for an NA to establish a positive relationship with a resident's family and friends by prioritizing the resident's needs and ensuring prompt assistance.