Correct Answer: D

Rationale: Nursing diagnosis is the tool used by nurses in the community setting for assessing health needs and problems of families that is similar to the family coping index. Nursing diagnosis involves systematic assessment of a patient's health status, analysis of data, and identification of actual or potential health problems. Just like the family coping index, nursing diagnosis helps nurses to identify key issues and develop a plan of care that addresses the specific needs and challenges faced by the family. This process allows nurses to provide individualized care that supports the family in coping with their health needs and improving their overall well-being.

Correct Answer: A

Rationale: The client is exhibiting signs and symptoms of respiratory alkalosis. When a person is experiencing respiratory alkalosis, there is an excessive loss of carbon dioxide (CO2) from the body, leading to elevated blood pH. The marked increase in the rate and depth of respirations as well as symptoms of anxiety, restlessness, and irritability are characteristic of respiratory alkalosis. This condition can be caused by hyperventilation, anxiety, or fever, which result in excessive elimination of CO2 from the body, leading to an imbalance in the acid-base status. Treatment for respiratory alkalosis involves addressing the underlying cause, such as providing reassurance to decrease anxiety or managing the breathing pattern to normalize CO2 levels.

Correct Answer: B

Rationale: Sunken fontanels are one of the earliest signs of dehydration in infants. Fontanels are soft spots on an infant's head where the skull bones have not yet fused together. If a baby's fontanel appears sunken, it indicates that the baby is likely dehydrated. This occurs because when there is a lack of fluid in the body, the soft spots on the head will appear depressed or sunken. It is crucial for Nurse Juvy to closely monitor the fontanels of Baby Sharon, as identifying dehydration early is essential for prompt intervention and preventing complications.

Correct Answer: B

Rationale: The nurse's appropriate response is to provide the requested information clearly and directly. In this case, the client asked for the time, so the best response is to say "It is 10 o'clock" to answer their question promptly. Options A, C, and D do not address the client's question and may be perceived as dismissive or unhelpful.

Correct Answer: A

Rationale: The primary responsibility for obtaining informed consent lies with the surgeon who will be performing the procedure. Informed consent is a process where the healthcare provider explains the procedure, benefits, risks, and alternatives to the patient, allowing them to make an informed decision about their care. While other healthcare team members may also participate in this process, the ultimate responsibility typically rests with the surgeon as they are the one performing the surgery.