Nokea
A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?
- A. I hope I can adjust to using crutches while I am recovering.
- B. I am worried about taking care of my toddler at home.
- C. I just don't think I can handle looking at my leg.
- D. I am not sure how I will pay for all the therapy I will need.
Correct Answer: A
Rationale: The client's statement about adjusting to using crutches while recovering suggests a potential need for occupational therapy referral. Occupational therapists assist individuals in regaining independence in activities of daily living, including mobility aids and adaptations. Choices B, C, and D are more indicative of emotional or financial concerns and may require referrals to other healthcare professionals like counselors or financial advisors, rather than occupational therapists.
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You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?
- A. Obtunded
- B. A persistent vegetative state
- C. Locked-in syndrome
- D. Brain death
Correct Answer: B
Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because:
A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning.
C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking.
D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.
Which of the following differentiates ulcerative colitis from Crohn's disease?
- A. Crohn's disease primarily affects the left colon and rectum, while ulcerative colitis most often affects the right colon and distal ileum.
- B. Crohn's disease presents with shallow ulcerations, whereas ulcerative colitis presents with a cobblestone appearance of the mucosal lining.
- C. The extent of involvement is noncontiguous and segmented with Crohn's disease, whereas it is contiguous and diffuse with ulcerative colitis.
- D. Crohn's disease has primarily mucosal involvement, whereas it is transmural with ulcerative colitis.
Correct Answer: C
Rationale: The correct answer is C. Crohn's disease is characterized by noncontiguous, segmented involvement, meaning it can affect different areas with healthy tissue in between, while ulcerative colitis involves continuous areas of inflammation. Choices A, B, and D are incorrect because Crohn's disease can affect any part of the digestive tract from mouth to anus, can present with shallow ulcerations or deep fissures, and is transmural, meaning it affects the entire thickness of the bowel wall. On the other hand, ulcerative colitis typically affects the colon and rectum, presents with a continuous pattern of inflammation, and primarily involves the mucosal lining of the colon.
Which statement about adjuvant medications is true and accurate?
- A. Licensed practical nurses can administer adjuvant medications.
- B. Adjuvant medications are schedule 2 narcotics.
- C. Adjuvant medications are schedule 1 narcotics.
- D. Adjuvant medications can be purchased over the counter.
Correct Answer: D
Rationale: The correct answer is D because adjuvant medications are often available over the counter without a prescription. Choices A, B, and C are incorrect. Choice A is incorrect because licensed practical nurses can administer adjuvant medications depending on their scope of practice. Choices B and C are incorrect because adjuvant medications are not classified as schedule 1 or schedule 2 narcotics.
Which of the following is a key benefit of interprofessional collaboration in healthcare?
- A. Increased professional isolation
- B. Improved patient outcomes
- C. Reduced need for communication
- D. Longer treatment times
Correct Answer: B
Rationale: Improved patient outcomes are a key benefit of interprofessional collaboration in healthcare. Collaboration among healthcare professionals leads to better coordination of care, reduced medical errors, and improved overall patient satisfaction. The other choices are incorrect because interprofessional collaboration aims to decrease professional isolation, enhance communication among team members, and streamline treatment processes to reduce time spent on patient care.
A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?
- A. The 50-year-old client who does not engage in any physical exercise
- B. The 56-year-old client who drinks three glasses of wine daily
- C. The 42-year-old client who is 50 pounds overweight
- D. The 38-year-old client who smokes one pack of cigarettes daily
Correct Answer: C
Rationale: The 42-year-old client who is 50 pounds overweight is at the highest risk for developing diabetes. Excess weight is a significant risk factor for diabetes as it can lead to insulin resistance and metabolic abnormalities. Choices A, B, and D are also risk factors for diabetes, but being overweight has a stronger association with the development of the condition compared to lack of exercise, excessive alcohol consumption, or smoking.