Correct Answer: A

Rationale: Administering albuterol via nebulizer is the first action to take during an acute asthma attack, as it rapidly relaxes bronchial smooth muscles, relieving bronchospasm and improving airflow.
Choice B is incorrect because a supine position can worsen breathing; a semi-Fowler's or upright position is preferred to facilitate lung expansion.
Choice C is incorrect because obtaining a peak expiratory flow rate is useful for monitoring but is not the priority during an acute attack.
Choice D is incorrect because administering oxygen is secondary to bronchodilator therapy unless the client has severe hypoxia (e.g., oxygen saturation <90%).

Correct Answer: C

Rationale:
Choice A is wrong because placing a yellow bracelet on a client who is at risk for falls is not malpractice, but rather a safety measure. A yellow bracelet indicates that the client needs assistance with mobility and should not be left alone. This is a common practice in many health care facilities to prevent falls and injuries.
Choice B is wrong because leaving a nasogastric tube clamped after administering oral medication is not malpractice, but rather a mistake. A nasogastric tube is a tube that goes through the nose and into the stomach to deliver nutrition or medication. It should be unclamped after giving oral medication to allow the medication to enter the stomach and prevent reflux or aspiration. However, this error does not rise to the level of malpractice unless it causes harm to the patient, such as vomiting, choking, or infection. This is because potassium is a medication that can cause cardiac arrest if given too quickly or in high doses. A nurse who administers potassium via IV bolus is not providing the standard of care that a similarly trained nurse would have offered under the same circumstances. This could result in harm or death to the patient.
Choice D is wrong because documenting communication with a provider in the progress notes of the client's medical record is not malpractice, but rather a good practice.

Correct Answer: A

Rationale: Crepitus (grating or crunching sound) with joint movement is a common finding in osteoarthritis due to cartilage degeneration and bone-on-bone contact.
Choice B is incorrect because osteoarthritis typically causes asymmetrical joint swelling, unlike rheumatoid arthritis, which is symmetrical.
Choice C is incorrect because morning stiffness in osteoarthritis is brief (less than 30 minutes), unlike rheumatoid arthritis, where it lasts longer (e.g., 2 hours).
Choice D is incorrect because fever is not a feature of osteoarthritis unless there is an infection or another condition.

Correct Answer: A

Rationale: Increasing fluid intake to 2 to 3 liters daily helps prevent uric acid crystal formation in the kidneys and promotes excretion, reducing gout flare-ups while taking allopurinol.
Choice B is incorrect because high-purine meals (e.g., red meat, shellfish) should be avoided, as they increase uric acid levels, counteracting allopurinol's effect.
Choice C is incorrect because allopurinol takes weeks to reduce uric acid levels and does not provide immediate joint pain relief; acute attacks require other treatments like NSAIDs.
Choice D is incorrect because, while ice may help during an acute gout attack, it is not directly related to allopurinol use and is not the priority instruction.

Correct Answer: B

Rationale: Checking the client's blood glucose level is the first action to take, as shakiness and sweating suggest hypoglycemia (blood glucose typically <70 mg/dL) in a client with type 1 diabetes, and the glucose level will guide treatment (e.g., administering 15 g of fast-acting carbohydrates).
Choice A is wrong because administering insulin would worsen hypoglycemia; insulin is used to lower blood glucose, not treat low levels.
Choice C is wrong because a high-protein snack is not appropriate for treating hypoglycemia; fast-acting carbohydrates (e.g., juice, glucose tabs) are needed first to rapidly raise blood glucose.
Choice D is wrong because encouraging rest does not address the urgent need to correct hypoglycemia, which can progress to confusion, seizures, or unconsciousness if untreated.