Nokea
A 56-year-old man is visiting the doctor for the first time in seven years for treatment for an infected finger. The office nurse wants him to make an appointment for a physical. The nurse knows that he does not understand the importance of a physical when he makes which statement?
- A. I know my blood sugar and weight should be monitored.'
- B. I am healthy. If I wasn't, I'd have some problems.'
- C. I don't smoke and I exercise daily.'
- D. I understand that checking my blood pressure is important.'
Correct Answer: B
Rationale: Assuming health without symptoms dismisses the need for preventive screenings, indicating a lack of understanding of physicals.
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What is the most important consideration when teaching parents how to reduce risks in the home?
- A. Age and knowledge level of the parents
- B. Proximity to emergency services
- C. Number of children in the home
- D. Age of children in the home
Correct Answer: D
Rationale: Age of children in the home. Safety measures must be tailored to the developmental stage of the children.
The nurse anticipates that for a family who practices Chinese medicine the priority therapeutic goal would be to
- A. achieve harmony
- B. maintain a balance of energy
- C. respect life
- D. restore yin and yang
Correct Answer: D
Rationale: For followers of Chinese medicine, health is maintained through balance between the forces of yin and yang.
The nurse is caring for a client with a history of type 2 diabetes who is receiving metformin (Glucophage) 500 mg PO bid. Which of the following laboratory results would be of GREATest concern to the nurse?
- A. Creatinine 2.0 mg/dL.
- B. Hemoglobin A1c 7.0%.
- C. Potassium 4.0 mEq/L.
- D. Fasting glucose 120 mg/dL.
Correct Answer: A
Rationale: A creatinine of 2.0 mg/dL indicates renal impairment, increasing the risk of lactic acidosis with metformin, requiring immediate evaluation. Options B, C, and D are less concerning: A1c 7.0% shows fair control, potassium 4.0 mEq/L is normal, and glucose 120 mg/dL is acceptable.
Which of the following assessment findings would indicate to the nurse the need for more sedation in a client who is withdrawing from alcohol dependence?
- A. Steadily increasing vital signs.
- B. Mild tremors and irritability.
- C. Decreased respirations and disorientation.
- D. Stomach distress and inability to sleep.
Correct Answer: A
Rationale: Steadily increasing vital signs (e.g., heart rate, blood pressure) indicate progression toward delirium tremens, a life-threatening complication of alcohol withdrawal, necessitating additional sedation. Mild tremors, decreased respirations, or gastroinTest inal symptoms are expected or contraindicate more sedation.
The nurse assesses the use of coping mechanisms by an adolescent 1 week after the client had a motor vehicle accident resulting in multiple serious injuries. Which of these characteristics are most likely to be displayed?
- A. Ambivalence, dependence, demanding
- B. Denial, projection, regression
- C. Intellectualization, rationalization, repression
- D. Identification, assimilation, withdrawal
Correct Answer: B
Rationale: Helplessness and hopelessness may contribute to regressive, dependent behavior which often occurs at any age with hospitalization. Denying or minimizing the seriousness of the illness is used to avoid facing the worst situation. Recall that denial is the initial step in the process of working through any loss.