While examining a client's leg, the nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressings is most appropriate for the nurse in charge to apply?

Correct Answer: C

Rationale: Granulation tissue in an open wound indicates healing, with new, red, vascular tissue forming. Moist, sterile saline gauze (Choice C) is most appropriate because it maintains a moist environment, promoting cell migration and preventing desiccation of granulation tissue, which could halt healing. Dry sterile dressing (Choice A) adheres to the wound, damaging granulation tissue upon removal and delaying healing. Sterile petroleum gauze (Choice B) supports healing but is costlier and less practical for interim use, often reserved for specific wounds like burns. Povidone-iodine-soaked gauze (Choice D) is cytotoxic to healing cells, irritating granulation tissue and slowing repair, making it unsuitable. Research supports moist wound healing (e.g., Winter's 1962 study), showing faster epithelialization with moisture. Until the specialist arrives, moist saline gauze balances efficacy, availability, and safety, protecting the delicate healing process. Thus, Choice C is the correct dressing choice.

Correct Answer: D

Rationale: Jugular vein distention (JVD)visible neck vein bulgingindicates elevated central venous pressure, typically from fluid overload (Choice D). This occurs when excess volume (e.g., heart failure, IV overload) backs up into the venous system, distending the jugular veins. Chest pain and shortness of breath align with this, suggesting cardiac strain (e.g., right heart failure). A neck tumor (Choice A) might compress veins, but JVD requires systemic pressure, not local obstruction, and lacks respiratory symptoms. Electrolyte imbalance (Choice B) affects cellular function, not directly venous pressure. Dehydration (Choice C) collapses veins, opposite to JVD. For example, in congestive heart failure, fluid retention raises venous return, causing JVD, detectable at 45° elevation. Fluid overload's pathophysiology fits the presentation, making Choice D the correct cause.

Correct Answer: C

Rationale: The circadian cycle orchestrates sleep via physiological shifts, notably lowering body temperature (by ~1°C) and releasing 'melatonin' from the pineal gland at dusk, signaled by the suprachiasmatic nucleus (SCN). Melatonin promotes drowsinesse.g., levels rise from 10 pg/mL daytime to 100 pg/mL at nightaligning sleep with darkness. 'Neonephrine' is fictitious; norepinephrine, if meant, promotes arousal, not sleep. 'Seratonin' , likely a misspelling of serotonin, aids mood and melatonin synthesis but isn't directly released for sleep onset. 'Dopamine' drives wakefulness and reward, peaking daytimee.g., its suppression at night aids sleep. For example, a nurse might note a patient's melatonin spike at 10 p.m., cooling their core temperature, per Taylor's circadian biology. Choice C is the correct chemical, critical for sleep preparation.

Correct Answer: A

Rationale: Stimulus control reconditions the bedroom as a sleep cue, per CBT-I protocols. 'Use the bedroom for sleep and sex only' is correct; limiting activitiese.g., no TV or workstrengthens the bed-sleep link, cutting sleep latency (e.g., from 40 to 15 minutes). Choice B, 'use the bedroom for reading and eating,' undermines this; multi-use (e.g., snacking at 10 p.m.) signals wakefulness, per sleep science. Choice C, 'go to bed at the same time every night,' is sleep hygiene, not stimulus control's coree.g., it's complementary, not defining. Choice D, 'sleep alone with minimal coverings,' is irrelevant; company or blankets don't dictate conditioning unless disruptive. For example, a patient leaving the bedroom if awake >20 minutes reinforces sleep association, per Taylor's behavioral approach. Choice A is the precise, correct recommendation.

Correct Answer: B

Rationale: Medication ordering reflects patient need and flexibility. 'P.r.n' , or 'as needed,' is most common for sleep medse.g., zolpidem 10 mg PRN allows use only when insomnia strikes, per hospital norms in Taylor. 'Stat' is immediate, one-timee.g., post-op, not routine sleep. 'Single order' is once-only, like stat, not ongoinge.g., one 5 mg dose. 'Daily dose' is schedulede.g., 10 mg qHSless common as it assumes constant need, risking tolerance. PRN's adaptabilitye.g., 3 nights weeklyfits sleep's variability, making Choice B the correct, prevalent method.