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NEW QUESTION # 14
The stool analysis on a nine-month-old infant showed occult blood. The child is otherwise healthy.
Which of the following questions the nurse should include when taking health history?
- A. How often do you give chocolate to the infant?
- B. Do you add leafy vegetables to the infant's food?
- C. When did you include chicken in the infant's diet?
- D. Have you introduced cow-milk to the infant?
Answer: D
Explanation:
Occult blood in the stool of a nine-month-old infant can be a sign of gastrointestinal irritation or bleeding. One common cause of occult blood in infants is an intolerance to cow's milk protein. Therefore, it is crucial to ask if cow's milk has been introduced to the infant's diet. This helps identify a potential cause of the symptoms and guides further management. While diet and other factors are also important, cow's milk introduction is a primary consideration for occult blood in this age group.
NEW QUESTION # 15
An 11-year-old child with beta-thalassemia major is admitted for blood transfusion. The child underwent splenectomy last month.
Which of the following is a PRIORITY nursing intervention?
- A. Maintain adequate hydration
- B. Promote high-fat intake
- C. Prevent infections
- D. Encourage frequent voiding
Answer: C
Explanation:
* Beta-Thalassemia Major and Splenectomy:
* Patients with beta-thalassemia major often require frequent blood transfusions.
* Splenectomy increases the risk of infections due to loss of the spleen's immune function.
* Priority Nursing Interventions:
* Prevent Infections:The highest priority post-splenectomy due to the increased risk of sepsis and other infections.
* High-Fat Intake, Frequent Voiding, Hydration:Important but secondary to infection prevention.
References:
* Centers for Disease Control and Prevention (CDC) guidelines on post-splenectomy care
* National Institutes of Health (NIH) on Thalassemia Management
NEW QUESTION # 16
Which of the following characteristics of older adults would be expected in today's society?
- A. Chronic conditions result in some limitations in ADL
- B. Most older adults live independently or in home care centers
- C. Married people have higher mortality rate than unmarried people at all ages
- D. There is steady increase in percentage of workers in the labor force
Answer: A
Explanation:
* Chronic Conditions and ADLs:
* Older adults are more likely to suffer from chronic conditions such as arthritis, hypertension, heart disease, and diabetes. These conditions can lead to some limitations in Activities of Daily Living (ADLs), which include tasks like bathing, dressing, eating, and walking.
* According to the Centers for Disease Control and Prevention (CDC), chronic diseases are the leading cause of death and disability in the United States, and they significantly impact the quality of life of older adults.
* Living Arrangements:
* While many older adults do live independently or in home care settings, a significant number also live with chronic conditions that impact their ADLs, hence answer B is less accurate compared to A.
* As per the Administration for Community Living (ACL), the majority of older adults do live independently; however, chronic conditions still play a significant role in their daily lives.
* Labor Force Participation:
* There is an increase in the percentage of older adults in the labor force, but this is not a primary characteristic affecting most older adults today.
* Marital Status and Mortality:
* Studies have shown that married individuals often have a lower mortality rate compared to unmarried individuals, making option D incorrect.
References:
* Centers for Disease Control and Prevention (CDC)
* Administration for Community Living (ACL)
NEW QUESTION # 17
A woman presents to the clinic with signs and symptoms of menopause. The doctor advised to start hormonal replacement therapy. The woman enquired about the adverse effects of this therapy.
Which of the following is an adverse effects of the hormonal replacement therapy?
- A. Osteoporosis
- B. Atherosclerosis
- C. Cerebrovascular accident
- D. Endometrial cancer
Answer: D
Explanation:
Hormone replacement therapy (HRT) can have several adverse effects. One significant risk associated with HRT, especially if estrogen is given without progesterone to women with an intact uterus, is the increased risk of endometrial cancer. Estrogen stimulates the lining of the uterus, and without the balancing effect of progesterone, this can lead to endometrial hyperplasia and potentially cancer. Other risks include breast cancer, blood clots, and stroke, but endometrial cancer is a specific concern with unopposed estrogen therapy.
NEW QUESTION # 18
A couple attends infertility clinic to review the investigation results. The laboratory results show that the man has aspermia. He asked the nurse about the meaning of aspermia.
The nurse replied that: "the aspermia means
- A. sperms count is lower than 20 million/milliliter"
- B. absence of sperms"
- C. prematurity of sperms"
- D. abnormalities of the sperms'"
Answer: B
Explanation:
* Aspermia Definition:
* Aspermia is a medical term used to describe the complete absence of semen, which includes the absence of sperms.
* This condition can result from various factors such as hormonal imbalances, obstruction of the reproductive tract, or surgeries like vasectomy.
* Differentiation from Other Terms:
* Prematurity of Sperms:Refers to sperm cells that are not fully mature.
* Abnormalities of Sperms:Indicates that the sperm present have structural or functional defects.
* Low Sperm Count (Oligospermia):Describes a condition where the sperm count is lower than the normal threshold (20 million/milliliter).
References:
* Mayo Clinic
* American Society for Reproductive Medicine (ASRM)
NEW QUESTION # 19
A nurse caring for a 52-year-old patient who is scheduled for cardiac surgery understands that this patient would be experiencing which of the following type of stressors?
- A. Physical
- B. Physiological
- C. Psychological
- D. Social
Answer: C
Explanation:
* Types of Stressors in Preoperative Patients:
* Social:Related to interactions with family, friends, and community.
* Physical:Directly affecting the body, such as pain or physical disability.
* Physiological:Body's physical response to stress.
* Psychological:Mental and emotional response to stressors, including anxiety, fear, and worry about the surgery and its outcomes.
* Stressors for Cardiac Surgery Patients:
* Psychological:Patients scheduled for cardiac surgery often experience significant psychological stress due to fear of the procedure, potential complications, and concerns about recovery.
References:
* American Psychological Association (APA) on Stress and Surgery
* Mayo Clinic on Preoperative Anxiety and Stress Management
NEW QUESTION # 20
The nurse assesses a patient with Chronic Renal Failure notes crackles in the lung bases, elevated blood pressure, and weight gain of 1 kg in one day.
Based on these finding, which of the following nursing diagnoses is the MOST appropriate for this patient?
- A. Ineffective tissue perfusion related to interrupted arterial blood flow
- B. Excess fluid volume related to the kidney's inability to maintain fluid balance
- C. Imbalance nutrition more than body requirements related to dietary excess
- D. Increased cardiac output related to fluid overload
Answer: B
Explanation:
The patient's symptoms-crackles in the lung bases, elevated blood pressure, and rapid weight gain-are indicative of fluid overload, which is a common issue in chronic renal failure due to the kidneys' inability to excrete excess fluid.
* Increased Cardiac Output Related to Fluid Overload: Increased cardiac output would not typically result from fluid overload; rather, fluid overload can lead to decreased cardiac output due to strain on the heart.
* Ineffective Tissue Perfusion Related to Interrupted Arterial Blood Flow: This diagnosis does not directly correlate with the symptoms of fluid overload observed in this patient.
* Imbalanced Nutrition More Than Body Requirements Related to Dietary Excess: This diagnosis is not relevant to the observed symptoms, which are more clearly related to fluid retention rather than dietary intake.
* Excess Fluid Volume Related to the Kidney's Inability to Maintain Fluid Balance: This is the most appropriate nursing diagnosis as it directly addresses the kidney's failure to regulate fluid balance, leading to the observed clinical signs.
References:
* National Kidney Foundation: Clinical Practice Guidelines for Chronic Kidney Disease
* Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
NEW QUESTION # 21
A researcher is conducting a study on population with similar age group to determine the exposure and observe who get infected by specific disease over a period of time.
Which of the following type of studies is BEST describe the scenario?
- A. Ecologic
- B. Case-control
- C. Experimental
- D. Cohort
Answer: D
Explanation:
A cohort study involves following a group of people who share a common characteristic or experience within a defined period to determine how certain exposures affect outcomes over time. In this scenario, the researcher is following a population of a similar age group over time to observe the incidence of a specific disease. This longitudinal approach helps to identify the relationship between exposure and the development of the disease, making it a cohort study.
NEW QUESTION # 22
A seven-year-old boy had tonsillectomy few hours ago. The mother asks the nurse about the type of food to be given when he awakes.
The nurse replies as the following:
- A. Carbonated beverao.es
- B. Fruits cut into pieces
- C. Crushed ice
- D. Citrus juice
Answer: C
Explanation:
* Post-Tonsillectomy Care:
* After a tonsillectomy, the focus is on minimizing discomfort, preventing bleeding, and promoting healing.
* Food and Drink Recommendations:
* Citrus Juice and Carbonated Beverages:These can irritate the throat and should be avoided.
* Fruits Cut into Pieces:Solid foods can be difficult to swallow and may cause discomfort.
* Crushed Ice:Helps to soothe the throat, reduce swelling, and provide hydration without causing irritation.
References:
* American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)
* Mayo Clinic guidelines on tonsillectomy aftercare
NEW QUESTION # 23
The nurse understands that one of the following cases is anticipated to receive opioids for extended periods of time:
- A. A client with progressive cancer
- B. A client with migraine headache
- C. A client with phantom limb pain
- D. A client with muscular atrophy
Answer: A
Explanation:
* Opioid Use for Chronic Pain:
* Opioids are often prescribed for severe, persistent pain conditions where other treatments have failed or are inappropriate.
* Conditions Requiring Long-term Opioids:
* Muscular Atrophy and Phantom Limb Pain:Can be managed with other medications and therapies.
* Progressive Cancer:Often involves severe pain, making long-term opioid use necessary to manage pain and improve quality of life.
* Migraine Headache:Typically treated with specific migraine medications and not long-term opioids.
References:
* American Cancer Society on Pain Management
* World Health Organization (WHO) guidelines on Cancer Pain Relief
NEW QUESTION # 24
A nurse understands that patient with blood transfusion reaction is at risk to develop which of the following types of jaundice?
- A. Obstructive
- B. Hepatocellular
- C. Chronic
- D. Hemolytic
Answer: D
Explanation:
A blood transfusion reaction can lead to hemolytic jaundice. This type of jaundice occurs when there is an excessive breakdown of red blood cells, leading to an increase in bilirubin production. Hemolytic reactions during a blood transfusion cause the destruction of the transfused red bloodcells, releasing large amounts of hemoglobin into the bloodstream, which is then converted to bilirubin, resulting in jaundice.
NEW QUESTION # 25
48-year-old male has an appointment at the primary health care setting for the screening program. The nurse recognizes that this patient had breakfast.
Which of the following is the BEST nurse's response?
- A. "No worries, let's take your history, and the appropriate assessment"
- B. "You are not eligible for this screening program"
- C. "It is better we take the history now and come later for the blood test"
- D. "Go home and come tomorrow fasting for at least 8-10 hours"
Answer: C
Explanation:
* Screening Programs and Fasting Requirements:
* Certain screening tests, like fasting blood glucose or lipid profiles, require fasting for accurate results.
* Nurse's Response:
* Not Eligible:Incorrect as the patient can still participate in parts of the screening.
* Come Tomorrow:Not the most efficient use of the patient's time.
* No Worries:Incorrect as fasting is important for some tests.
* Take History Now, Blood Test Later:The best response as it makes efficient use of the current visit for history taking and schedules the blood test for another time when fasting can be ensured.
References:
* American Diabetes Association (ADA) guidelines
* U.S. Preventive Services Task Force (USPSTF) guidelines
NEW QUESTION # 26
A nurse is caring for a patient with retinal detachment who is posted for retinopexy surgery.
The INITIAL nursing intervention in order to maintain pressure for reattaching the sensory retina:
- A. Instruct the patient to avoid lying on the surgical side
- B. Keep the patient in prone position
- C. Provide eye patch with intact dressing
- D. Follow aseptic technique when cleaning the eye
Answer: C
Explanation:
* Retinal Detachment and Retinopexy:
* Retinal detachment is a serious condition where the retina peels away from its underlying layer.
Retinopexy surgery is performed to reattach the retina.
* Initial Nursing Interventions:
* Eye patch and dressing:Helps maintain pressure on the retina and prevent movement that could disrupt the reattachment process.
* Prone position and avoiding lying on surgical side:These are not specific standard initial interventions.
* Aseptic technique:Important but not the primary initial intervention for maintaining retinal attachment pressure.
References:
* American Academy of Ophthalmology (AAO) guidelines on Retinal Detachment
* Mayo Clinic guidelines on Retinopexy Surgery
NEW QUESTION # 27
A nurse plans to provide morning care for a bedridden client.
What is the priority action that the nurse should consider before starting?
- A. Ensure that the bed is locked
- B. Remove the bed sheets
- C. Remove the pillows
- D. Ensure that the client is at the side of the bed
Answer: A
Explanation:
* Safety in Bedridden Patient Care:
* Ensuring patient safety is paramount before beginning any care activities.
* Priority Actions:
* Bed Locked:Prevents bed movement which could cause patient falls.
* Pillows and Bed Sheets:Secondary actions related to patient comfort and hygiene.
* Client Position:Important but ensuring bed stability is the first step for safety.
References:
* Joint Commission guidelines on patient safety
* Fundamentals of Nursing textbooks
NEW QUESTION # 28
Which of the following tests is conducted to detect the hypokinetic and a kinetic wall motion of the heart and check the ejection fraction?
- A. Electrocardiogram
- B. Angiography
- C. Echocardiogram
- D. Stress test
Answer: B
Explanation:
An echocardiogram is a diagnostic test used to detect hypokinetic (reduced movement) and akinetic (no movement) wall motion of the heart and to assess the ejection fraction, which measures the percentage of blood leaving the heart each time it contracts. This test uses ultrasound waves to create images of the heart's structure and function. An electrocardiogram (ECG) records the electrical activity of the heart, angiography visualizes blood vessels, and a stress test evaluates the heart's response to physical exertion.
NEW QUESTION # 29
A nurse visited a postpartum mother who delivered a baby boy 3 days ago. During assessment, the nurse suspects that the mother is having postpartum depression.
Which behavior suggests the condition in the mother?
- A. Difficulty to breastfeed the baby
- B. Weakness to care for the baby
- C. Euthymia
- D. Eating too little
Answer: B
Explanation:
* Postpartum Depression Symptoms:
* Postpartum depression can manifest in various ways, affecting the mother's ability to care for herself and her baby.
* Behavioral Indicators:
* Euthymia:Indicates normal mood, not a sign of depression.
* Eating Too Little:Can be a symptom but not as specific to postpartum depression.
* Weakness to Care for the Baby:A significant indicator, as it shows the mother's lack of energy, interest, or capability to perform daily tasks related to baby care.
* Difficulty Breastfeeding:Could be due to various reasons and not solely indicative of depression.
References:
* American Psychological Association (APA) on Postpartum Depression
* Mayo Clinic guidelines on Postpartum Depression
NEW QUESTION # 30
A nurse is examining a 24-month-old child with hydrocephalus for the development of later signs of hydrocephalus.
Which of the following signs the nurse would find?
- A. Bulging fontanels
- B. Dilated scalp veins
- C. Frontal bossing
- D. Separated sutures
Answer: C
Explanation:
In a 24-month-old child with hydrocephalus, later signs of the condition include frontal bossing, which is the prominent, protruding forehead caused by the enlargement of the frontal bone. This is a characteristic feature of chronic hydrocephalus. Bulging fontanels, separated sutures, and dilated scalp veins are typically earlier signs of hydrocephalus seen in younger infants before the cranial sutures close. As the child ages, frontal bossing becomes more apparent due to prolonged intracranial pressure.
NEW QUESTION # 31
A head nurse of an intensive care unit wants to ensure that the staff are performing Basic Life Support (BLS) based on latest American Heart Association's guidelines.
What will be the head nurse's BEST action?
- A. Review the BLS policy periodically
- B. Monitor the staff performing BLS during the actual scene
- C. Send staff to renew BLS certification every three years
- D. Perform regular mocks on BLS in the unit
Answer: D
Explanation:
Ensuring that staff perform Basic Life Support (BLS) according to the latest American Heart Association (AHA) guidelines involves several strategies, but performing regular mock drills is the best approach.
* Reviewing the BLS Policy Periodically: While this is important, it alone does not ensure that staff are up-to-date or proficient in BLS techniques.
* Performing Regular Mocks on BLS in the Unit: Regular mock drills provide hands-on practice and allow staff to apply the latest guidelines in a simulated environment. This helps in retaining skills and identifying any gaps in knowledge or performance.
* Sending Staff to Renew BLS Certification Every Three Years: Certification renewal is necessary, but practical skills can degrade over time if not regularly practiced.
* Monitoring the Staff Performing BLS During the Actual Scene: This is reactive rather than proactive and does not provide an opportunity for practice and improvement without the pressure of a real-life situation.
References:
* American Heart Association (AHA): Guidelines for CPR and ECC
* National Institutes of Health (NIH): Effective Training Strategies in Healthcare
NEW QUESTION # 32
A group of nurses conducted a community-based diabetes self-management program. The program includes blood glucose self-monitoring and self-administering insulin injection.
Which of the following would be the BEST method the nurse would implement?
- A. Teach back method
- B. Focus group method
- C. Group discussion method
- D. Audiovisual method
Answer: A
Explanation:
* Diabetes Self-Management Education:
* Effective education methods are essential to ensure patients understand and can manage their condition independently.
* Educational Methods:
* Audiovisual Method:Good for initial learning but not the best for confirming understanding.
* Teach Back Method:The most effective method where the patient repeats back the information, ensuring they understand and can perform tasks correctly.
* Focus Group and Group Discussion:Useful for sharing experiences but less effective for individual skill assessment.
References:
* American Diabetes Association (ADA) on Diabetes Education
* Centers for Disease Control and Prevention (CDC) on Health Literacy
NEW QUESTION # 33
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