Nokea
A client comes into the community health center upset and crying stating, "I will die of cancer now that I have this disease." And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?
- A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
- B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
- C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
- D. 'You probably have had episodes of sweating, heart pounding, and headaches.'
Correct Answer: A
Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.
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While explaining an illness to a 10-year-old, what should the nurse keep in mind about the cognitive development at this age?
- A. They are able to make simple associations of ideas
- B. They are able to think logically in organizing facts
- C. Interpretation of events originates from their own perspective
- D. Conclusions are based on previous experiences
Correct Answer: B
Rationale: Correct answer: At the age of 10, children are in the stage of concrete operational thought, where they can think logically and organize facts. Choice A is incorrect as simple associations of ideas are more characteristic of earlier developmental stages. Choice C is incorrect as while children at this age are developing perspective-taking skills, their interpretations are not solely limited to their own perspective. Choice D is incorrect as while previous experiences influence their thinking, the ability to think logically and organize facts is more prominent in this stage of cognitive development.
A community health nurse is planning to implement an outreach program for a community group. Which criteria should the nurse clarify about the program when examining sources for funding?
- A. Focuses on addressing multiple health problems or concerns.
- B. Identifies populations and individuals in need of healthcare services.
- C. Evaluates differences in health services and health status among populations.
- D. Provides healthcare services to community members in local factories, schools, and churches.
Correct Answer: B
Rationale: Identifying populations and individuals in need of healthcare services is essential when seeking funding for an outreach program. This criterion helps demonstrate the relevance and impact of the program on specific groups requiring healthcare services. Choice A is incorrect because while addressing multiple health problems is important, identifying the target population in need of services is more critical for funding considerations. Choice C is incorrect as evaluating variations in health services and status, though valuable, is not directly related to securing funding. Choice D is incorrect as offering services in various community locations is a component of the program's implementation, not a criterion for funding.
Which of the following measures the frequency of new cases of the phenomenon during a given period of time?
- A. prevalence rate
- B. proportionate mortality rate
- C. case fatality rate
- D. incidence rate
Correct Answer: D
Rationale: The correct answer is D, incidence rate. Incidence rate measures the frequency of new cases of a phenomenon, providing important information about the risk of developing the condition. Prevalence rate (choice A) reflects both old and new cases, proportionate mortality rate (choice B) is the proportion of deaths due to a specific cause, and case fatality rate (choice C) measures the proportion of deaths among confirmed cases, not just new cases.
You attended a home delivery with the Rural Health midwife. The newborn is premature. Which of the following should be included in premature infant care at home?
- A. establishing and maintaining good respiration
- B. proper management of feeding
- C. minimum handling of the baby
- D. regulation of body temperature
Correct Answer: D
Rationale: Corrected Rationale: Regulation of body temperature is crucial for the survival of a premature infant. Premature infants have difficulty regulating their body temperature, making it essential to keep them warm. While establishing and maintaining good respiration and proper feeding management are important aspects of infant care, they are not as critical as regulating body temperature for premature infants. Additionally, while minimizing handling to reduce stress can be beneficial, it is not as vital as temperature regulation for premature infants.
A client with chronic renal failure is receiving erythropoietin (Epogen). The nurse should monitor the client for which of the following side effects?
- A. Hypertension
- B. Hypoglycemia
- C. Hyperkalemia
- D. Hypocalcemia
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Erythropoietin can lead to hypertension as a side effect due to its stimulation of red blood cell production, which can increase blood viscosity. This can result in elevated blood pressure. Choices B, C, and D are incorrect. Hypoglycemia is not a common side effect of erythropoietin. Hyperkalemia is more commonly associated with renal failure rather than erythropoietin use. Hypocalcemia is not a typical side effect of erythropoietin administration.