Nokea
A client has an abnormal result on a Papanicolaou test. After admitting that she read her chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide?
- A. Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin
- B. Increase in the number of normal cells in a normal arrangement in a tissue or an organ
- C. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found
- D. Alteration in the size, shape, and organization of differentiated cells
Correct Answer: D
Rationale: Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. It indicates abnormal changes in the cells that can be a precursor to cancer. In the context of a Papanicolaou test, the presence of dysplasia may suggest abnormal cell growth in the cervix, which can potentially develop into cervical cancer if left untreated. It is important for the client to follow up with healthcare providers for further evaluation and management if dysplasia is detected.
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The developmental age of a child who continues to search for a hidden subject has achieved
- A. 7 months
- B. 9 months
- C. 11 months
- D. 13 months
Correct Answer: B
Rationale: Object permanence is typically achieved around 9 months.
Hypernatremia is associated with a:
- A. Serum osmolality of 245mOsm/kg
- B. Urine specific gravity below 1.003
- C. Serum sodium of 150mEq/L
- D. Combination of all of the above
Correct Answer: C
Rationale: Hypernatremia is defined as an elevated serum sodium level above 145mEq/L. In this case, a serum sodium level of 150mEq/L indicates hypernatremia. The other options, serum osmolality of 245mOsm/kg and urine specific gravity below 1.003, are not specific criteria for the diagnosis of hypernatremia. The primary marker used for diagnosing hypernatremia is an elevated serum sodium level.
A highly careful mother of a 10-month-old baby boy complains of inadequate weight gain due to refusal of spoon feeding. The LEAST helpful advice is to
- A. respect infant independence
- B. offer softer diet
- C. use 2 spoons (1 for the child and 1 for the parent)
- D. use finger foods
Correct Answer: B
Rationale: Offering softer food may not address the underlying issue of refusal.
Which is the most appropriate nursing intervention for the newborn who is jittery and twitching and has a high-pitched cry?
- A. Monitor blood pressure closely.
- B. Obtain urine sample to detect glycosuria.
- C. Obtain serum glucose and serum calcium levels.
- D. Administer oral glucose or, if newborn refuses to suck, IV dextrose.
Correct Answer: C
Rationale: The most appropriate nursing intervention for the jittery and twitching newborn with a high-pitched cry is to obtain serum glucose and serum calcium levels (Option C). These symptoms are indicative of possible hypoglycemia or hypocalcemia, which are common issues for newborns. Monitoring glucose and calcium levels will help identify and address any imbalances that may be causing these symptoms. Administering glucose (Option D) may be necessary if hypoglycemia is confirmed, but it should be based on the results of blood tests. Monitoring blood pressure (Option A) and obtaining a urine sample to detect glycosuria (Option B) are not the priority interventions in this scenario compared to assessing serum glucose and calcium levels.
All the following are features of rapid eye movement (REM) EXCEPT
- A. polysomnography
- B. EEG
- C. fibro-optic nasopharngeal examination
- D. CT scan of head and neck
Correct Answer: D
Rationale: CT scan of head and neck is not a feature of REM sleep; it is an imaging study unrelated to the physiological characteristics of REM sleep.