While preparing the operating room (OR) for a surgical procedure, the nurse notices a spill of bodily fluids on the floor. What is the nurse's priority action?

Correct Answer: A

Rationale: The nurse's priority action when noticing a spill of bodily fluids on the floor while preparing the operating room for a surgical procedure is to clean up the spill using appropriate infection control measures. This is essential to prevent the spread of infections and ensure a safe surgical environment for both patients and healthcare providers. Cleaning up the spill promptly and properly reduces the risk of contamination and subsequent infections. Once the spill is cleaned up, the nurse can then proceed with documenting the spill, placing warning signs to alert others, and continuing with the preparation of the OR as planned. But the initial priority is to eliminate the immediate threat posed by the spill through proper cleaning and infection control measures.

Correct Answer: B

Rationale: The symptoms described in the patient, such as tremors, rigidity, bradykinesia (slow movement), and postural instability, along with the presence of a shuffling gait, stooped posture, and masked facies, are classic features of Parkinson's disease. These motor symptoms are primarily caused by the degeneration of dopamine-producing neurons in the substantia nigra region of the brain. This results in an imbalance of neurotransmitters, particularly dopamine, leading to motor dysfunction and characteristic movement abnormalities seen in Parkinson's disease.

Correct Answer: A

Rationale: Crisis intervention is an important part of secondary prevention in the care of families. Secondary prevention involves activities that aim to reduce the impact of a crisis or event that has already occurred. Crisis intervention provides immediate support and strategies to help families cope with and overcome a crisis situation. By addressing the crisis quickly and effectively, secondary prevention can help prevent further negative outcomes and promote the well-being of the family members.

Correct Answer: B

Rationale: Guillain-Barré Syndrome (GBS) is characterized by ascending motor weakness, starting typically in the lower extremities and progressing upwards. Patients with GBS often verbalize the early onset of symptoms as weakness starting in the legs and potentially spreading to involve the arms and sometimes the face. Therefore, the common verbalization of the patient with GBS regarding the early onset of symptoms is ascending motor weakness. Acute hemiplegia (choice A) and acute hemiparesis (choice D) involve weakness or paralysis typically limited to one side of the body, which is not a characteristic presentation of GBS. Weakness of the four lower extremities (choice C) is also not a typical description in GBS as the weakness usually starts distally and progresses proximally.

Correct Answer: D

Rationale: Complete abortion is the most likely cause of the symptoms described. In a complete abortion, all products of conception are expelled from the uterus. Symptoms include vaginal bleeding, passage of tissue, and dilation of the cervix. In this scenario, the presentation of a dilated cervix with visualized products of conception is classic for a complete abortion at 10 weeks gestation.

Correct Answer: C

Rationale: Feces, urine, blood, and other body fluids are considered as vehicles of transmission in the context of communicable diseases. These substances can carry and transmit disease-causing microorganisms such as bacteria, viruses, and parasites from infected individuals to others. Through close contact or exposure to these contaminated body fluids, the pathogens can enter the body of another person and cause infection. Nurses like Nurse Keena must exercise caution and use appropriate infection control measures to prevent transmission of communicable diseases through these vehicles.

Correct Answer: D

Rationale: It is important for the nurse to acknowledge the patient's preference and respect their choice. By responding with "So then you would prefer to speak with your doctor?" the nurse is showing understanding and willingness to accommodate the patient's request. This response helps to maintain a positive and respectful interaction with the patient.

Correct Answer: B

Rationale: In order to understand and interpret a message accurately, it is essential to consider the context in which it was delivered. Context provides the necessary background information, setting, and circumstances that give meaning and relevance to the message being communicated. Without context, it can be challenging to fully grasp the intention and significance of the communication. While the other options (process, phrases and sentences, thoughts and feelings) play roles in communication, it is the context that ultimately helps to give meaning and context to the message being conveyed.

Correct Answer: A

Rationale: Selective IgA deficiency is a primary immunodeficiency disorder characterized by low or absent levels of immunoglobulin A (IgA) in the blood. Since IgA plays a crucial role in mucosal immunity and defense against pathogens at mucosal surfaces, individuals with this deficiency are more susceptible to recurrent bacterial infections, particularly of the respiratory and gastrointestinal tracts. In contrast, severe combined immunodeficiency (SCID) is a more severe immunodeficiency disorder affecting T and B lymphocytes, chronic granulomatous disease (CGD) is a disorder of phagocytes, and autoimmune hemolytic anemia is an autoimmune disease involving red blood cells, none of which are directly associated with selective IgA deficiency.