Correct Answer: D

Rationale: The correct answer is D because a patient with a history of fluid overload due to heart failure is at the greatest risk of developing acute kidney injury. Heart failure can lead to decreased kidney perfusion causing acute kidney injury. In this scenario, the patient's fluid overload exacerbates the situation, further compromising kidney function. Choice A is incorrect as aminoglycosides can cause kidney injury but the duration of 6 days is less concerning compared to chronic fluid overload from heart failure in choice D. Choice B is incorrect because controlled hypertension does not directly increase the risk of acute kidney injury. Choice C is incorrect as the patient being discharged 2 weeks earlier after aminoglycoside therapy does not necessarily indicate a higher risk compared to chronic fluid overload.

Correct Answer: B

Rationale: The correct answer is B: The patient may require fluid resuscitation. A decrease in arterial blood pressure during the inspiratory phase of ventilation suggests decreased preload, indicating possible hypovolemia. This can be addressed by administering fluid resuscitation to improve cardiac output and blood pressure. Incorrect Choices: A: The mechanical ventilator is malfunctioning - There is no evidence to suggest a ventilator malfunction based on the arterial pressure change. C: The arterial line may need to be replaced - The arterial line itself is unlikely to cause the observed pressure change. D: The left limb may have reduced perfusion - This is less likely as the pressure change is likely systemic due to decreased preload.

Correct Answer: B

Rationale: The correct answer is B: Notify the physician immediately of the assessment findings. The significantly higher PAOP could indicate a potential complication or a change in the patient's condition that needs immediate medical attention. By notifying the physician, further assessment and interventions can be initiated promptly to address the underlying cause. Increasing supplemental oxygen (choice A) may not directly address the elevated PAOP, obtaining a chest x-ray (choice C) may delay urgent intervention, and zero referencing the catheter (choice D) is not a priority in this situation. Notifying the physician ensures timely and appropriate management of the patient's condition.

Correct Answer: B

Rationale: The correct answer is B: Cluster nursing activities so that the patient has uninterrupted rest periods. Rationale: 1. Clustering nursing activities allows for uninterrupted rest periods, essential for improving sleep quality and addressing disturbed sensory perception. 2. Administering sedatives or opioids (Option A) can lead to drug dependence, tolerance, and adverse effects in older adults. 3. Silencing alarms (Option C) compromises patient safety by impeding timely monitoring and response to critical events. 4. Eliminating assessments (Option D) between 0100 and 0600 disregards the necessity of monitoring vital signs and assessing patient condition around the clock.

Correct Answer: A

Rationale: The correct answer is A: Vaccine. Smallpox is a contagious and potentially deadly disease caused by the variola virus. The smallpox vaccine is the most effective way to prevent and control the spread of smallpox. By obtaining adequate quantities of the smallpox vaccine, the ED nurse manager can protect healthcare workers and the public from contracting the virus in case of a smallpox bioterrorism event. Atropine (B) is used to treat certain types of nerve agent poisoning, not smallpox. Antibiotics (C) are ineffective against viruses like smallpox. Whole blood (D) is not specifically needed for smallpox treatment.