Correct Answer: A,D

Rationale: Using a urine filter ensures the recovery of passed stones for laboratory analysis, assisting in identifying stone composition and tailoring prevention strategies. Calcium intake is essential for bone health and reducing oxalate absorption. Avoiding calcium increases oxalate availability, worsening stone formation. Diuretic fluids like coffee promote dehydration and concentration of urine, increasing the risk of stone recurrence. Diuretics should be prescribed for specific stone types. Maintaining hydration prevents urine concentration and the supersaturation of stone-forming crystals, which are primary risk factors for nephrolithiasis.

Correct Answer: A

Rationale: Using a Foley catheter can help prevent skin breakdown caused by prolonged contact with urine in incontinent patients, especially if they are confused or non-ambulatory and unable to use other urinary devices. Maintaining intact skin is crucial to avoiding infections and pressure injuries, making a Foley catheter a suitable intervention in specific cases when prescribed. Foley catheters are not inherently inappropriate but must be prescribed judiciously due to risks like urinary tract infections. While alternative methods may be preferable, this intervention is justified for incontinent, immobile patients with compromised mental status to protect skin integrity. It aligns with clinical guidelines and patient-specific needs.

Correct Answer: D

Rationale: Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort. Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms. Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD. Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.

Correct Answer: D

Rationale: Administering dextrose IVP is inappropriate for hyperglycemia. It elevates blood sugar further, risking complications like hyperosmolar hyperglycemic state. It is used to treat severe hypoglycemia instead. Glucagon stimulates glycogen breakdown into glucose, increasing blood sugar. It is contraindicated in hyperglycemia, as it would aggravate elevated glucose levels. It is a treatment for severe hypoglycemia. Holding insulin allows hyperglycemia to persist, increasing risks of complications like ketoacidosis. Insulin administration is essential to reduce the glucose level safely. Rapid-acting insulin like Humalog reduces hyperglycemia efficiently, bringing preprandial blood glucose closer to the target range of 70-130 mg/dL. Administering 4 units is a reasonable corrective dose based on the blood glucose of 243 mg/dL.

Correct Answer: B

Rationale: Checking plantar and dorsiflexion assesses neurological status requiring nursing expertise and cannot be delegated to UAP. Log rolling every 2 hours maintains spinal alignment post-laminectomy, a straightforward, standardized task suitable for experienced UAP. PCA assessment involves evaluating pain control methods, which require critical nursing judgments and is not appropriate to delegate. Determining readiness to ambulate involves comprehensive assessment skills, evaluating multiple factors like pain, strength, and hemodynamic stability, beyond UAP's scope of practice.