Explanation

Discoloration of skin after death is liver (livor) mortis (also known as postmortem hypostasis).

It occurs due to the settling of blood in the lower parts of the body.

It causing a reddish-purple discoloration.

Explanation

The most comfortable position for a patient with congestive heart failure is High Fowler.

This position helps ease breathing by reducing abdominal pressure on the diaphragm and improving lung expansion.

Explanation

The difficulty in breathing while lying down is called orthopnea.

It is commonly experienced by individuals with heart failure or respiratory conditions and improves when the patient sits up.

Explanation

The World Health Organization (WHO) recommends a series of five Tetanus Toxoid (TT) doses for women of childbearing age as part of the Maternal and Neonatal Tetanus Elimination (MNTE) initiative.

The schedule is:

1. First dose: At the earliest opportunity (e.g., during pregnancy or delivery)
2. Second dose: 4-8 weeks after the first dose
3. Third dose: 6-12 months after the second dose
4. Fourth dose: 1 year after the third dose
5. Fifth dose: 5-10 years after the fourth dose (booster)

Explanation

BCG (Bacillus Calmette-Guérin) is a live attenuated vaccine.

It is used to protect against tuberculosis.

It contains a weakened form of the bacteria.

Explanation

The priority nursing intervention for a client with impaired physical mobility related to pain is administering PRN analgesic medication as ordered by the doctor.

Managing pain effectively is crucial to improving the client's mobility and ability to participate in rehabilitation activities.

Explanation

In this scenario, the risk factor involved is age.

Older adults are at higher risk of falls due to age-related factors such as reduced balance and muscle strength.

Explanation

The area of client teaching and education regarding wound care at home falls under prevention of illness/injury.

Proper wound care education helps prevent complications and promotes healing.

It is crucial for preventing further health issues.

Explanation

For a patient with a colostomy in the first 4 to 6 weeks following surgery, a low-residue diet is indicated.

This diet helps minimize bowel movements and reduce the risk of obstruction by limiting fiber and other residue-forming foods.

Explanation

The patient scheduled for an oral cholecystogram (OCG) should be provided with a fat-free diet on the evening before the test.

A fat-free diet helps to:

• Reduce gallbladder contraction
• Improve visualization of the gallbladder and bile ducts