Nokea
A 30-year-old woman with a BMI of 36 is being counseled on weight reduction. In what order should interventions be discussed?
- A. 4, 3, 2, 1
- B. 4, 2, 3, 1
- C. 3, 4, 2, 1
- D. 3, 2, 1, 4
Correct Answer: A
Rationale: The nurse should start with a full assessment (lipid profile and blood pressure), followed by education on diet and exercise, then medication, and finally surgery if needed.
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The nurse at a well-baby clinic is assessing a 12-month-old child. At birth, the child weighed 7 lb. 3 oz. During this visit, the child weighs 21 lb. 10 oz. Which of the following conclusions would the nurse make about the child’s weight?
- A. The infant is gaining weight faster than anticipated.
- B. The infant is malnourished.
- C. The infant is at the expected weight for his or her age.
- D. The infant is having a growth spurt.
Correct Answer: C
Rationale: A 12-month-old should have doubled their birth weight by this age, which is consistent with normal growth.
Which of the following is the most common poison ingested by infants?
- A. Houseplants
- B. Lead
- C. Cleaning agents
- D. Aspirin
Correct Answer: D
Rationale: Aspirin is the most commonly ingested poison by infants, followed by houseplants and cleaning agents.
Anthrax
- A. Anthrax is a viral infection
- B. Anthrax causes skin lesions or pneumonia
- C. Anthrax is spread by person-to-person contact
- D. Anthrax is treated by IV penicillin for 30 days
Correct Answer: B
Rationale: Anthrax is caused by bacteria, not a virus, and can cause skin lesions or pneumonia.
An 18-year-old woman asks the nurse not to tell her mother about her STD diagnosis. Which action should the nurse take?
- A. Follow the principle of veracity and tell the mother the diagnosis.
- B. Respect the principle of confidentiality and support the client’s request.
- C. Tell the mother the client has a UTI.
- D. Ignore the mother’s request for information.
Correct Answer: B
Rationale: Confidentiality ensures the client’s privacy, and the client must authorize disclosure to others.
A nurse is caring for a person with the nursing diagnosis of chronic sorrow related to missed opportunities. Which of the following nursing interventions would be appropriate for this person?
- A. Sharing a personal story with the person to demonstrate empathy
- B. Assuring the person that he or she will be able to cope with the illness
- C. Encouraging the person to discuss his or her fears
- D. Contacting a support group representative for the person
Correct Answer: C
Rationale: Encouraging the person to discuss their fears is an appropriate intervention for facilitating grief work.