A 28 year-old male has a diagnosis of AIDS. The patient has had a two year history of AIDS. The most likely cognitive deficits include which of the following?
- A. Disorientation
- B. Sensory changes
- C. Inability to produce sound
- D. Hearing deficits
Correct Answer: A
Rationale: Cognitive changes may include confusion and disorientation.
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A client with urinary tract calculi needs to avoid which of the following foods?
- A. lettuce
- B. cheese
- C. apples
- D. broccoli
Correct Answer: B
Rationale: The client with urinary tract calculi needs to avoid cheese, which has high calcium content. The other foods do not.
When planning intervention for a client during a crisis, which of the following outcomes is most appropriate?
- A. The client should explore deep psychological problems.
- B. The client should express positive feelings about event.
- C. The client should identify needs that are threatened by the event.
- D. The client should use constructive coping mechanisms.
Correct Answer: D
Rationale: The primary goal of crisis intervention is to relieve the symptoms of anxiety and foster constructive coping. Previous psychological issues might recur during crisis, but the focus is on short-term resolution of the current problem. At the end, the nurse credits a client for positive changes and helps him or her understand what was learned. This allows the client to use the learned coping mechanisms when new problems arise.
If a client is suffering from thyroid storm, the PN can expect to find on assessment:
- A. tachycardia and hyperthermia.
- B. bradycardia and hypothermia.
- C. a large goiter.
- D. a calm, quiet client.
Correct Answer: A
Rationale: In thyroid storm, excessive thyroxine causes increased metabolic rate, leading to tachycardia, hyperthermia, and other signs of hyperthyroidism such as atrial fibrillation.
A client who recently lost 50 pounds just received news that she is pregnant. A possible nursing diagnosis is:
- A. Actual Chronic Low Self-Esteem (related to obesity).
- B. Potential Chronic Low Self-Esteem (related to obesity).
- C. Actual Situational Low Self-Esteem (related to fear of weight regain and pregnancy).
- D. Potential Situational Low Self-Esteem (related to fear of weight regain and pregnancy).
Correct Answer: D
Rationale: If there are indications of a body image disturbance, the nursing care plan should include body disturbances, related to a functional or physical problem. The disturbance might be an anticipated one - that is, weight gain and pregnancy. Stressors can include a change in physical appearance, sexuality concerns, or an unrealistic ideal self.
A family member of a client with a diagnosis of Schizophrenia asks about the prognosis. The nurse's response is based on the knowledge that schizophrenia:
- A. affects women more often than men.
- B. is usually diagnosed between the ages of 15 and 45.
- C. is a chronic, deteriorating disease with periods of remission.
- D. is diagnosed later in women due to a protective hormone effect.
Correct Answer: C
Rationale: Although all of the choices are true about schizophrenia, only Choice 3 answers the question asked.