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NEW QUESTION # 44
The nurse manager is conducting an annual disaster drill.
Based on the disaster triage, which of the following types of injuries would have LESS priority to receive care?
- A. Unconscious victim with signs of internal bleeding
- B. Conscious victim with superficial cuts
- C. Conscious victim with fracture femur
- D. Unconscious victim with openskull fracture and brain matter showing
Answer: D
Explanation:
* Disaster Triage Principles:
* In disaster scenarios, triage prioritizes patients based on the severity of their injuries and the likelihood of survival.
* The goal is to provide the greatest good for the greatest number of people.
* Triage Categories:
* Immediate (Red):Life-threatening injuries requiring immediate intervention.
* Delayed (Yellow):Serious injuries needing treatment but not immediately life-threatening.
* Minor (Green):Minor injuries that can wait for treatment.
* Expectant (Black):Injuries are so severe that survival is unlikely, even with treatment.
* Case Analysis:
* Conscious with Femur Fracture:Delayed category, serious but not immediately life-threatening.
* Conscious with Superficial Cuts:Minor category, least priority but still above expectant.
* Unconscious with Internal Bleeding:Immediate category, needs urgent intervention.
* Unconscious with Open Skull Fracture and Brain Matter Showing:Expectant category, very low chance of survival, thus least priority.
References:
* American College of Emergency Physicians (ACEP)
* World Health Organization (WHO) on Mass Casualty Management Systems
NEW QUESTION # 45
Which of the following characteristics of older adults would be expected in today's society?
- A. Most older adults live independently or in home care centers
- B. Chronic conditions result in some limitations in ADL
- 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: B
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 # 46
A client with major depressive disorder is placed on phenelzine 15 mg BID. The nurse discussed with the client the dietary restrictions to follow while taking this medication.
Which of the following instructions MUST be included in teaching?
- A. Avoid milk, peanuts, and tomatoes
- B. Avoid parmesan cheese, beef liver, raisins
- C. Avoid garlic, fish, and egg yolks
- D. Avoid black beans, garlic and pears
Answer: B
Explanation:
Phenelzine is a monoamine oxidase inhibitor (MAOI) used to treat major depressive disorder. Patients taking MAOIs must avoid foods high in tyramine to prevent hypertensive crises. Parmesan cheese, beef liver, and raisins are high in tyramine and should be avoided. Garlic, fish, egg yolks, milk, peanuts, tomatoes, black beans, and pears do not typically contain high levels of tyramine and are generally safe to consume while taking MAOIs. The dietary restrictions are crucial to preventing dangerous interactions and maintaining patient safety.
NEW QUESTION # 47
A nurse must be aware that keeping an aggressive patient in a seclusion or restraint requires an order from the doctor.
The renewal of such order for a patient aged 19 years old must be done:
- A. Every 7 hours
- B. Every 1 hour
- C. Every 2 hours
- D. Every 4 hours
Answer: D
Explanation:
When a patient aged 19 years old is placed in seclusion or restraint, the renewal of the order must be done every 4 hours. This requirement is based on the guidelines provided by the Joint Commission and the Centers for Medicare & Medicaid Services (CMS), which regulate the use of seclusion and restraints in healthcare settings.
* Initial Order: The use of seclusion or restraint must be ordered by a licensed independent practitioner (LIP), such as a physician.
* Time Limits: For adults aged 18 and older, the order must be renewed every 4 hours.
* Renewal Process: This renewal must involve an assessment of the patient's condition and the need for continued seclusion or restraint.
* Documentation: The rationale for using seclusion or restraint and the patient's response to the intervention must be documented thoroughly in the patient's medical record.
References:
* The Joint Commission: Standards for Behavioral Health Care
* Centers for Medicare & Medicaid Services (CMS): Conditions of Participation for Hospitals, 42 CFR
482.13(e)
NEW QUESTION # 48
A patient with a history angina pectoris brought by to the Emergency Department complaining of severe chest pain. The patient informs the nurse that he did not take nitroglycerine tablet.
Which of the following assessment findings must concern the nurses MOST before administering nitroglycerine?
- A. Heart rate of 90 bpm
- B. Blood pressure of 80/60 mmHg
- C. Blood pressure of 190/110 mmHg
- D. Blood sugar of 12 mmol/L
Answer: B
Explanation:
* Patient History: The patient has angina pectoris, which means they have episodes of chest pain due to reduced blood flow to the heart muscle. Nitroglycerin is a common medication used to relieve this pain by dilating blood vessels.
* Nitroglycerin Mechanism: Nitroglycerin works by relaxing and widening blood vessels, which decreases the workload on the heart and increases blood flow to the heart muscle. This process typically lowers blood pressure.
* Assessment Concerns:
* Heart rate of 90 bpm: This is within the normal range and does not typically contraindicate the use of nitroglycerin.
* Blood sugar of 12 mmol/L: Elevated blood sugar is concerning but not directly affected by nitroglycerin administration.
* Blood pressure of 190/110 mmHg: This is high and nitroglycerin can help reduce it. High blood pressure is often treated with nitroglycerin.
* Blood pressure of 80/60 mmHg: This is hypotension (low blood pressure). Since nitroglycerin lowers blood pressure further, administering it to a patient withalready low blood pressure can lead to severe hypotension, which is life-threatening.
Conclusion: The most concerning finding is the low blood pressure (80/60 mmHg) because administering nitroglycerin in this situation can further lower the blood pressure to dangerous levels.References:
NCLEX-RN review guides, pharmacology textbooks, clinical guidelines on the management of angina pectoris and nitroglycerin use.
NEW QUESTION # 49
The nurse understands that caring for a woman with gestational diabetic complications is exhibited as an example of.
- A. Health restoration
- B. Health promotion
- C. Health maintenance
- D. Health rehabilitation
Answer: A
Explanation:
Caring for a woman with gestational diabetes complications falls under health restoration. Health restoration involves actions taken to return a patient to their previous state of health or to manage chronic conditions. This includes managing and treating complications to improve health outcomes. Health promotion focuses on preventing health problems through lifestyle changes, health maintenance involves ongoing monitoring and prevention of deterioration, and health rehabilitation focuses on helping patients recover functionality after severe illness or injury.
NEW QUESTION # 50
A seven-year-old boy with autism is admitted with a leg fracture. The child has been following up in the rehabilitation center for speech and occupational therapies for the past two years.
How should the nurse address the child's speech and social needs during hospitalization?
- A. Review the child's therapy plan from the rehabilitation center
- B. Refer the child to the in-hospital speech and occupational therapy department
- C. Modify the child's daily routines
- D. Develop an occupational and speech care plan
Answer: A
Explanation:
When a child with autism is hospitalized, it is essential to maintain consistency and continuity in their care.
Reviewing the child's therapy plan from the rehabilitation center ensures that the hospital staff can continue to address the child's speech and social needs in a manner that aligns with his established routines and therapy goals. Modifying daily routines or developing a new care plan without prior review may cause unnecessary stress or disruption. Referring the child to in-hospital therapy departments can be beneficial, but it should be done in conjunction with the existing plan to ensure continuity and effectiveness.
NEW QUESTION # 51
A nurse understands that patient with blood transfusion reaction is at risk to develop which of the following types of jaundice?
- A. Obstructive
- B. Hemolytic
- C. Hepatocellular
- D. Chronic
Answer: B
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 # 52
A 50-year-old multi-para woman complains of a soft bulge of tissue in her vagina. It is uncomfortable to her and is protruding through her vaginal orifice. The woman expresses her anxiety regarding her situation.
What is the IMMEDIATE action of the nurse?
- A. Educates the woman about her diet
- B. Teaches the woman about Kegel exercises
- C. Reassures the woman about her condition
- D. Refers the woman to the doctor
Answer: D
Explanation:
* Soft Bulge in Vagina:
* This symptom could indicate a pelvic organ prolapse, such as a uterine or bladder prolapse, which requires medical evaluation and treatment.
* Immediate Action:
* Referral to Doctor:Immediate referral is necessary for proper diagnosis and to plan appropriate treatment.
* Diet and Reassurance:These are important but secondary actions after the initial medical assessment.
* Kegel Exercises:While beneficial for pelvic floor strengthening, they are not the immediate action in response to a significant prolapse.
References:
* American College of Obstetricians and Gynecologists (ACOG)
* Mayo Clinic Guidelines on Pelvic Organ Prolapse
NEW QUESTION # 53
The nurse cares for a 60-year-old patient who is post renal transplant and on Sandimmune (Cyclosporine).
While assessing the patient the nurse observed signs of septic shock.
Which of the following is a risk factor that predisposes the patient for septic shock?
- A. Immunosuppression
- B. Multiple surgeries
- C. Age
- D. History of medication sensitivity
Answer: A
Explanation:
* Post Renal Transplant Care:
* Patients who undergo renal transplants are prescribed immunosuppressive medications like Cyclosporine (Sandimmune) to prevent organ rejection.
* Risk Factors for Septic Shock:
* Age:Older adults have a higher risk of infections, but age alone is not the primary factor for septic shock in this context.
* Multiple Surgeries:Increase the risk of infection but not as significant as immunosuppression.
* Immunosuppression:The primary risk factor as it weakens the immune system, making the patient highly susceptible to infections leading to septic shock.
* History of Medication Sensitivity:Important but less relevant to septic shock risk.
References:
* National Institutes of Health (NIH) on post-transplant care
* Mayo Clinic on Septic Shock
NEW QUESTION # 54
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. Promote high-fat intake
- B. Encourage frequent voiding
- C. Maintain adequate hydration
- D. Prevent infections
Answer: D
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 # 55
Which of the following nursing role within the policy development core functions of public health could help to reduce the risk of obesity associated with a build environment?
- A. Support the implementation of taxes on sugary beverages
- B. Connect the community to available resources to lose weight
- C. Educate the community about the health consequences of obesity
- D. Encourage the community to walk instead of using transportation
Answer: A
Explanation:
Within the policy development core functions of public health, supporting the implementation of taxes on sugary beverages is a direct approach to reducing the risk of obesity. This policy measure is designed to decrease the consumption of sugary drinks, which are a significant contributor to obesity. By advocating for such policies, nurses can help create an environment that promotes healthier choices and reduces obesity rates.
Connecting the community to resources, encouraging walking, and educating about obesity are important but fall more under the roles of community education and resource facilitation rather than policy development.
NEW QUESTION # 56
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. "It is better we take the history now and come later for the blood test"
- B. "You are not eligible for this screening program"
- C. "No worries, let's take your history, and the appropriate assessment"
- D. "Go home and come tomorrow fasting for at least 8-10 hours"
Answer: A
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 # 57
A nursing instructor provides a session to a group of nursing students about the importance of anion gap in an acid base imbalance.
Which of the following statements if made by the nursing student would indicate the understanding of the teaching?
- A. Anion gap of > 12 indicates metabolic acidosis
- B. Anion gap of < 8 indicates metabolic alkalosis
- C. Anion gap is calculated to decide the dose of soda bicarbonate
- D. The normal anion gap value is 6-8 mEq/L
Answer: A
Explanation:
* Understanding Anion Gap:
* The anion gap is a calculated value based on the concentrations of cations (positively charged ions) and anions (negatively charged ions) in the blood, used to identify the causes of metabolic acidosis.
* Normal and Abnormal Values:
* Normal Anion Gap:Typically ranges from 8-12 mEq/L, though some sources consider 6-12 mEq/L as normal.
* High Anion Gap (> 12):Indicates metabolic acidosis, often due to conditions like ketoacidosis, lactic acidosis, or ingestion of toxins.
* Low Anion Gap (< 8):Not typically associated with metabolic alkalosis; other conditions like hypoalbuminemia may cause it.
* Clinical Relevance:
* Anion gap helps clinicians determine the underlying cause of acid-base imbalances and guide appropriate treatment.
References:
* American Association for Clinical Chemistry (AACC)
* Mayo Clinic on Anion Gap
NEW QUESTION # 58
A nursing instructor teaching a group of nursing students about the recommended diet for a patient with a myocardial infarction.
Which of the following points will be included in the teaching?
- A. Low intake of dark chocolate
D Low protein and high carbohydrates - B. High intake of red meat
- C. Low fat and cholesterol
Answer: C
Explanation:
When teaching nursing students about the recommended diet for a patient with a myocardial infarction, it's crucial to emphasize a diet low in fat and cholesterol. This helps in reducing the risk of further cardiovascular complications.
* Low Fat and Cholesterol: Foods low in saturated fat and cholesterol are recommended to prevent the build-up of plaque in the arteries and reduce the risk of another heart attack.
* Avoiding Red Meat: High intake of red meat is discouraged because it is often high in saturated fat and cholesterol.
* Dark Chocolate Intake: While some dark chocolate in moderation can have health benefits due to its antioxidant properties, the emphasis should be on a balanced diet.
* Protein and Carbohydrates: Protein is essential for recovery, but the focus should be on lean sources.
Carbohydrates should come from whole grains and other healthy sources rather than simple sugars.
References:
* American Heart Association (AHA): Dietary Recommendations for Cardiovascular Health
* National Institutes of Health (NIH): Heart-Healthy Eating
NEW QUESTION # 59
A nurse plans to provide morning care for a bedridden client.
What is the priority action that the nurse should consider before starting?
- A. Remove the bed sheets
- B. Ensure that the client is at the side of the bed
- C. Ensure that the bed is locked
- D. Remove the pillows
Answer: C
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 # 60
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. Group discussion method
- B. Focus group method
- C. Audiovisual method
- D. Teach back method
Answer: D
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 # 61
A nurse is seeking best evidence to educate the parents on the use of olive oil for skin care of newborns.
Which of the following is the BEST evidence to consider?
- A. Studies that assessed parent's perception on the use of olive oil
- B. Studies that explored the experience of using olive oil
- C. Studies that considered pediatrician opinion on using olive oil
- D. Studies that compared the use of olive oil versus manufactured baby oils
Answer: D
Explanation:
The best evidence for educating parents on the use of olive oil for newborn skin care would come from studies that directly compare the use of olive oil to other commonly used baby oils.
* Studies that Explored the Experience of Using Olive Oil: These may provide qualitative insights but are not the strongest form of evidence for making recommendations.
* Studies that Considered Pediatrician Opinion on Using Olive Oil: Expert opinion can be valuable but is less robust compared to direct comparative studies.
* Studies that Assessed Parent's Perception on the Use of Olive Oil: These provide subjective insights and are not as strong as objective comparisons of effectiveness and safety.
* Studies that Compared the Use of Olive Oil Versus Manufactured Baby Oils: Comparative studies provide direct evidence on the effectiveness and safety of olive oil compared to other products, making them the most reliable source of evidence for making an informed recommendation.
References:
* Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice
* Cochrane Database of Systematic Reviews: Skincare Interventions for Infants
NEW QUESTION # 62
While caring for a patient with leg ulcers, the nurse expects the patient to receive which of the following medical managements?
- A. Positive pressure therapy
- B. Decompression therapy
- C. Hyperbaric oxygenation
- D. Anticoagulant therapy
Answer: C
Explanation:
* Leg Ulcers Management:
* Leg ulcers, especially chronic ones, require specific treatments to promote healing and prevent infection.
* Medical Management Options:
* Anticoagulant therapy:Typically used for conditions like deep vein thrombosis, not directly for leg ulcers.
* Decompression therapy and Positive pressure therapy:Not standard treatments for leg ulcers.
* Hyperbaric Oxygenation:This treatment involves breathing pure oxygen in a pressurized environment. It increases oxygen delivery to tissues, promotes healing, reduces inflammation, and fights infection, making it an effective treatment for chronic leg ulcers.
References:
* Wound Healing Society guidelines on leg ulcer treatment
* National Institutes of Health (NIH) on Hyperbaric Oxygen Therapy
NEW QUESTION # 63
The destruction of the alveoli walls is defined as:
- A. Bronchiolitis
- B. Asthma
- C. Bronchitis
- D. Emphysema
Answer: D
Explanation:
* Definition of Emphysema:
* Emphysema is a chronic lung condition characterized by the destruction of the alveoli (air sacs) walls. This leads to reduced surface area for gas exchange and difficulty in breathing.
* It is a major component of Chronic Obstructive Pulmonary Disease (COPD).
* Differentiation from Other Conditions:
* Asthma:A condition where the airways become inflamed and narrowed.
* Bronchitis:Inflammation of the bronchial tubes, often resulting in cough and mucus production.
* Bronchiolitis:Inflammation of the small airways (bronchioles), commonly seen in children.
References:
* American Lung Association (ALA)
* National Heart, Lung, and Blood Institute (NHLBI)
NEW QUESTION # 64
A nurse is preparing to give health education for a client on hemodialysis.
What instruction the nurse will include in the teaching plan regarding dietary restriction?
- A. Fluid intake is restricted to 2000 ml/day
- B. Protein intake is restricted to 1.2-1.3 g/kg
- C. Potassium intake is restricted to 3-4 g/kg
- D. Sodium intake is restricted to 4-5 g/kg
Answer: B
Explanation:
For clients on hemodialysis, protein intake is usually restricted to 1.2-1.3 g/kg of body weight to prevent the accumulation of waste products while still providing enough protein to maintain muscle mass and overall health. Sodium intake, fluid intake, and potassium intake are also important to monitor, but the specific restrictions for sodium and potassium vary based on individual needs and lab results. Fluid intake is typically individualized and may be more restrictive than 2000 ml/day.
NEW QUESTION # 65
During the planning phase, a healthcare organization states its purposes and fundamental aims to achieve in the long term.
This defines which of the following organizational concept?
- A. Values
- B. Vision
- C. Mission
- D. Strategy
Answer: C
Explanation:
During the planning phase, a healthcare organization defines its mission, which states its purpose and fundamental aims to achieve in the long term. The mission statement outlines the organization's core purpose, target population, and primary objectives. It provides direction and guides decision-makingand strategic planning. Vision, on the other hand, describes what the organization aspires to become in the future. Strategy refers to the specific actions and plans to achieve the mission and vision, while values are the principles and beliefs that guide the organization's behavior.
NEW QUESTION # 66
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. Citrus juice
- C. Fruits cut into pieces
- D. Crushed ice
Answer: D
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 # 67
A nurse is assigned to care for a client diagnosed with brain cancer who is undergone radiation therapy. On assessment, the nurse notes cachexia.
Which of the following nursing measures would take FIRST for this client?
- A. Encourage frequent oral hygiene
- B. Encourage high protein and high calorie diet
- C. Encourage small cold meals
- D. Encourage daily physical activity
Answer: B
Explanation:
For a client with brain cancer undergoing radiation therapy and exhibiting cachexia, the first nursing measure should be to encourage a high protein and high-calorie diet.
* High Protein and High Calorie Diet: Cachexia is a severe form of malnutrition often seen in cancer patients, characterized by weight loss, muscle wasting, and decreasedquality of life. Ensuring adequate nutrition is crucial to improve strength, immune function, and overall well-being.
* Frequent Oral Hygiene: This is important, especially if the patient has oral side effects from radiation, but it does not address the primary issue of malnutrition.
* Daily Physical Activity: Beneficial for maintaining muscle mass and overall health but should be secondary to addressing severe nutritional deficits.
* Small Cold Meals: These may be more palatable if the patient has nausea but should also be high in calories and protein to combat cachexia.
References:
* American Cancer Society: Managing Cancer Cachexia
* Oncology Nursing Society (ONS): Nutrition and Cancer Care
NEW QUESTION # 68
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