Nokea
A client becomes upset when the physician diagnoses diabetes mellitus as the cause of current signs and symptoms. The client tells the nurse, “This must be a mistake. No one in my family has ever had diabetes.” Based on this statement, the nurse suspects the client is using which coping mechanism?
- A. Denial
- B. Anger
- C. Withdrawal
- D. Resolution
Correct Answer: A
Rationale: The correct answer is A: Denial. The client's refusal to accept the diagnosis of diabetes mellitus, stating that no one in their family has had it, indicates denial as a coping mechanism. Denial is a defense mechanism where individuals refuse to acknowledge unpleasant realities. In this case, the client is rejecting the diagnosis to avoid facing the reality of having a chronic condition. The other choices (B: Anger, C: Withdrawal, D: Resolution) do not fit the client's response in this scenario. Anger involves expressing frustration or hostility, withdrawal is avoiding the situation, and resolution is accepting and dealing with the issue.
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A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribes mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How mitomycin does exert its cytotoxic effects?
- A. It inhibits deoxyribonucleic acid (DNA) synthesis
- B. It’s cell cycle-phase specific
- C. It inhibits ribonucleic acid (RNA) synthesis
- D. It inhibits protein synthesis
Correct Answer: A
Rationale: The correct answer is A: It inhibits deoxyribonucleic acid (DNA) synthesis. Mitomycin works by cross-linking DNA, leading to inhibition of DNA synthesis and ultimately causing cell death. This mechanism of action makes it effective against rapidly dividing cancer cells.
B: It’s cell cycle-phase specific - This is incorrect because mitomycin is not specific to a particular phase of the cell cycle.
C: It inhibits ribonucleic acid (RNA) synthesis - This is incorrect as mitomycin primarily targets DNA synthesis, not RNA synthesis.
D: It inhibits protein synthesis - This is incorrect as mitomycin's main mechanism of action is through DNA cross-linking, not protein synthesis inhibition.
Which of the following actions should the nurse take to maintain patient safety when ambulating a patient for the first time postoperatively?
- A. Use one person to assist patient.
- B. Use two people to assist patient.
- C. Encourage patient to “dangle” self 1 hour before ambulation.
- D. Give narcotic 15 minutes before ambulation.
Correct Answer: B
Rationale: The correct answer is B: Use two people to assist the patient. This is the safest option as it provides optimal support and stability for the patient during their first postoperative ambulation. Two people can help prevent falls, ensure proper body mechanics, and offer immediate assistance if needed. Using one person (choice A) may not provide enough support. Encouraging the patient to "dangle" (choice C) may increase the risk of orthostatic hypotension. Giving a narcotic before ambulation (choice D) can impair the patient's balance and coordination, increasing the risk of falls.
The clinical manifestations of Parkinson’s disease (bradykinesia rigidity and tremors) is directly related to a decreased level of:
- A. Acetylcholine
- B. Serotonin
- C. Dopamine
- D. Phenylalanine
Correct Answer: C
Rationale: Rationale: Parkinson's disease is characterized by dopamine deficiency in the brain, leading to motor symptoms like bradykinesia, rigidity, and tremors. Dopamine is crucial for controlling movement. Acetylcholine (A) is not directly related to Parkinson's symptoms. Serotonin (B) is involved in mood regulation, not movement control. Phenylalanine (D) is an amino acid and not directly related to Parkinson's pathology. Therefore, the correct answer is C.
A nurse is using the problem-oriented approach to data collection. Which action will the nurse take first?
- A. Complete the questions in chronological order.
- B. Focus on the patient’s presenting situation.
- C. Make accurate interpretations of the data.
- D. Conduct an observational overview.
Correct Answer: B
Rationale: The correct answer is B - Focus on the patient's presenting situation. This is because in the problem-oriented approach, the nurse must first gather data related to the patient's current issue or concern. This initial focus helps in identifying the primary problem, setting priorities, and developing a care plan.
Now, let's analyze the other choices:
A: Completing questions in chronological order may not be necessary or relevant to addressing the patient's immediate issue.
C: Making accurate interpretations of the data comes after data collection, so it is not the first step.
D: Conducting an observational overview is important but should come after focusing on the patient's presenting situation to gather specific and relevant data.
An adult is on a clear liquid diet. Which food item can be offered/
- A. Milk
- B. Orange juice
- C. Jello
- D. Ice cream
Correct Answer: C
Rationale: The correct answer is C: Jello. A clear liquid diet includes transparent liquids that do not contain any solid particles, providing easily digestible nutrients. Jello meets these criteria as it is a clear, gelatin-based dessert that melts into a liquid form at room temperature.
Rationale:
1. Jello is a clear liquid that does not contain solid particles, making it suitable for a clear liquid diet.
2. Milk (A) and ice cream (D) are not considered clear liquids as they contain fats and proteins, which are not allowed on a clear liquid diet.
3. Orange juice (B) contains pulp and fibers, making it unsuitable for a clear liquid diet.
Summary:
Jello is the correct choice because it meets the criteria of being a clear liquid without solid particles. Milk, orange juice, and ice cream are not appropriate choices for a clear liquid diet due to their composition.