Nokea
A client has been scheduled for a Schilling test. What instruction will the nurse give the client?
- A. Take nothing mouth fro 12 hours prior to the test
- B. Collect his urine for 12 hours
- C. Administer a fleet enema the evening before the test
- D. Empty his bladder immediately before the test
Correct Answer: B
Rationale: The correct instruction the nurse will give to the client scheduled for a Schilling test is to collect his urine for 12 hours. The Schilling test is a diagnostic test used to assess the body's ability to absorb vitamin B12. The test involves collecting urine samples over a period of 24 hours after the client ingests a small amount of radioactive vitamin B12. By collecting urine for 12 hours, the healthcare provider will be able to analyze the excretion of the vitamin and determine the client's ability to absorb vitamin B12. Instructions such as fasting, enema administration, or emptying the bladder before the test are not typically associated with the Schilling test procedure.
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Which is descriptive of bulimia during adolescence?
- A. Strong sense of control over eating behavior
- B. Feelings of elation after the binge-purge cycle
- C. Profound lack of awareness that the eating pattern is abnormal
- D. Weight that can be normal, slightly above normal, or below normal
Correct Answer: C
Rationale: During adolescence, individuals with bulimia often have a profound lack of awareness that their eating pattern is abnormal. This lack of awareness can be attributed to various factors, such as societal pressures, distorted body image, and the normalization of disordered eating behaviors within their social circle. Adolescents with bulimia may not recognize their behaviors as problematic or may rationalize them as a means of coping with stress or controlling their weight. This lack of insight can make it challenging for them to seek help or receive proper treatment for their condition.
The MOST appropriate advice for a 4-year-old child visiting the outpatient department with excessive crying is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate for child abuse
Correct Answer: B
Rationale: Further history may help differentiate normal behavior from developmental concerns.
If a patient has elevated pulmonary vascular pressures, the nurse understands that the patient is most likely to develop which of the ff. physiological cardiac changes?
- A. Left atrial atrophy
- B. Left ventricular hypertrophy
- C. Right atrial atrophy
- D. Right ventricular hypertrophy
Correct Answer: D
Rationale: Elevated pulmonary vascular pressures can lead to pulmonary hypertension, which causes increased pressure in the right side of the heart. The right ventricle has to work harder to pump blood against the increased resistance in the pulmonary circulation. Over time, this can result in the development of right ventricular hypertrophy as the muscle of the right ventricle thickens in response to the increased workload. This is a compensatory mechanism to try to maintain cardiac output despite the increased pressure in the pulmonary circulation. Left atrial atrophy, left ventricular hypertrophy, and right atrial atrophy are not typically associated with elevated pulmonary vascular pressures.
Dr. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child?
- A. To increase blood pressure
- B. To reduce inflammation
- C. To decrease proteinuria
- D. To prevent infection
Correct Answer: B
Rationale: Corticosteroids are commonly used to reduce inflammation in various conditions, including nephritic syndrome. In nephritic syndrome, there is inflammation in the glomeruli of the kidneys, leading to symptoms such as proteinuria, hematuria, and reduced kidney function. Corticosteroids work by suppressing this inflammatory response, which helps alleviate the symptoms and improve kidney function in patients with nephritic syndrome. Administering corticosteroids to this child aims to reduce the inflammation in the kidneys, thereby improving their condition.
The twelve-year-old boy has fractured his arm because of a fall from his bike. After the injury has been casted, the nurse knows it is most important to perform all of the following assessments on the area distal to the injury except:
- A. capillary refill.
- B. radial and ulnar pulse.
- C. finger movement
- D. skin integrity
Correct Answer: B
Rationale: Assessing the radial and ulnar pulses is crucial in evaluating the circulation of blood to the hand. However, in this scenario of a fractured arm, the injury is distal to the hand (further away from the body). It is more critical to check capillary refill, finger movement, and skin integrity in the area distal to the injury to ensure there is no compromise to the blood flow, nerve function, or skin integrity following the injury. Checking the radial and ulnar pulse would be more relevant if the injury was closer to the wrist area, as it would directly impact these pulses.