Which of the following statement is NOT true about teamwork in nursing?

Correct Answer: C

Rationale: Teamwork improves care (A), involves collaboration (B), shares goals (D) 'works best alone' (C) isn't true, team-based, per nursing. C's isolation contradicts teamwork, like Mr. Gary's team, making it untrue.

Correct Answer: B

Rationale: Bed making is the process of preparing a bed with fresh linens.

Correct Answer: A

Rationale: Unequal pupil size (A) reflects increased ICP, indicating brain compression affecting cranial nerves. Decreasing BP (B) is late. Tachycardia (C) isn't specific. Temperature drop (D) isn't typical. A is correct. Rationale: Pupil asymmetry signals herniation or pressure on the oculomotor nerve, a critical ICP sign, per neuroassessment standards.

Correct Answer: B

Rationale: Sunset sign downward eye deviation exposing sclera indicates neurological issues. Pyloric stenosis (choice A) causes vomiting, not eye signs. Hydrocephalus (choice B) raises intracranial pressure, pressing the brainstem, causing sunset sign as cranial nerves (III/VI) are affected. Tetralogy of Fallot (choice C) is cardiac, unrelated. Seizures (choice D) may alter gaze but not consistently this way. B is correct, a classic hydrocephalus feature. Nurses note it, measure head circumference, and support shunt placement, addressing pressure.

Correct Answer: B

Rationale: In the research process, the scientific literature review seeking what's already known follows problem identification and precedes framework selection. Here, the nurse gathers existing studies on a topic, like pain management, to avoid redundancy and build on prior work. Identifying the problem area defines the issue, triggering the review. The theoretical framework then guides variable relationships, while the problem statement sets direction. The review synthesizes findings like opioid alternatives' efficacy informing hypotheses and methods. This step ensures research is grounded, efficient, and relevant, preventing duplication and positioning the nurse to contribute meaningfully to nursing knowledge, aligning with evidence-based practice's emphasis on informed inquiry.

Correct Answer: C

Rationale: Primary prevention promotes health (A), includes immunization (B), educates (D) not when sick (C), per levels. C's illness focus is secondary/tertiary, making it untrue.

Correct Answer: D

Rationale: Clients with severe depression and suicidal ideation often struggle to express anger outwardly due to internalized emotions, a common psychological barrier in this condition. Depression can suppress verbal communication, particularly about intense feelings like anger, which may be directed inward, heightening suicidal risk. Low self-worth is a symptom they might feel but not the primary difficulty in expression. Remorse or guilt may be present, yet these are less tied to communication challenges than suppressed anger. Dependence on others might occur but isn't the core issue here. Nurses must recognize this pattern to address underlying emotions safely, using therapeutic techniques to encourage expression, reducing isolation and risk.

Correct Answer: D

Rationale: Decreased level of consciousness is an early sign of increased intracranial pressure (ICP) in closed head injury, reflecting brain compression before late signs like widening pulse pressure (Cushing's triad) emerge blood pressure and pupils may remain normal initially. Nurses prioritize this subtle change, reporting it promptly, as it guides interventions like mannitol or hyperventilation to reduce ICP and prevent herniation.

Correct Answer: B

Rationale: Changing TPN every 24 hours prevents bacterial growth in the hypertonic solution.