Nokea
A 48-year-old woman is seen in the outpatient clinic for complaints of irregular menses.
- A. What is the most probable cause of irregular menses in a 48-year-old woman with a history of regular periods?
- B. Emotional trauma and stress.
- C. The onset of menopause.
- D. The presence of uterine fibroids.
- E. A possible tubal pregnancy.
Correct Answer: B
Rationale: Irregular menses in a 48-year-old woman is most likely due to menopause, as ovarian function declines between ages 45- Stress lacks supporting data, fibroids cause excessive bleeding, and tubal pregnancy typically presents with missed periods and pain.
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A client on suicide precautions is verbalizing other options besides suicide, appears to be responding to antidepressant medication, is sleeping and eating better, and has indicated a willingness to interact more with family members.
Based on this data, which of the following nursing actions is MOST appropriate?
- A. Recommend that the physician decrease the client's medication dosage.
- B. Recommend that the treatment team reevaluate the client's treatment plan.
- C. Give the client privileges to walk around the hospital by himself.
- D. Ask the family to begin planning for the client's discharge.
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) may reverse the client's progress (2) correct-data suggests that client is beginning to benefit from treatment; entire treatment team should share data and make a decision about the suicide precautions so that restrictions are changed gradually based on a full-data picture (3) may be the team's decision, but not until a thorough review of the case is completed (4) premature
An 8 year-old client is admitted to the hospital for surgery. The child's parent reports the allergies listed below. Which of these allergies should all health care personnel be aware of?
- A. Shellfish
- B. Molds
- C. Balloons
- D. Perfumed soap
Correct Answer: C
Rationale: Allergy to balloons indicates a latex allergy. All personnel in contact with the child will need to be aware of this condition and use non-latex gloves.
An adult male developed diabetes insipidus following a craniotomy.
Which of the following statements, if made by the client, would indicate that further teaching is needed?
- A. I should keep a daily record of my fluid intake and how much I go to the bathroom.
- B. I should call my doctor if I seem thirsty a lot and my urine specific gravity is less than 1.005.
- C. I should weigh myself every day and drink less fluid if I gain more than 5 lb over a week.
- D. I will need to take the nose spray medication for the rest of my life.
Correct Answer: C
Rationale: Strategy: 'Further teaching' indicates an incorrect response. (1) disorder or water metabolism caused by deficiency of ADH (antidiuretic hormone) by pituitary gland, symptoms are increased urinary output (4-30 L/24 h), dilute urine with specific gravity less than 1.005 (2) normal specific gravity 1.003-1.030 (3) correct-weight gain should be reported to physician, may need medication adjusted (4) desmopressin (DDAVP) nasally or SQ required for remainder of life
The triage nurse for a women's health center receives a phone call from each of the following women.
Which woman should be directed to come to the health care facility IMMEDIATELY?
- A. A multipara woman who is four weeks pregnant and reporting unilateral, dull abdominal pain.
- B. A primipara woman who is seven weeks pregnant and reporting an increase in whitish vaginal secretions.
- C. A primigravida woman who is five weeks gestation and is having vaginal spotting and some cramping.
- D. A multigravida woman who is six weeks pregnant and reporting frank, red vaginal bleeding with moderate cramps.
Correct Answer: A
Rationale: Strategy: Determine the least stable client. (1) correct-needs to be evaluated for an ectopic pregnancy (2) expect during first trimester of pregnancy (3) symptomatic of threatened abortion; instruct to decrease activity (4) symptoms of spontaneous abortion; instruct client to save and count pads
The recent increase in the reported cases of active tuberculosis (TB) in the United States is attributed to which factor?
- A. The increased homeless population in major cities
- B. The rise in reported cases of positive HIV infections
- C. The migration patterns of people from foreign countries
- D. The aging of the population located in group homes
Correct Answer: B
Rationale: The rise in reported cases of positive HIV infections. Between 1985 and 2002 there has been a significant increase in the reported cases of TB. The increase was most evident in cities with a high incidence of positive HIV infection. Positive HIV infection currently is the greatest known risk factor for reactivating latent TB infections.