Nokea
A client has been taking a decongestant for allergic rhinitis. During a follow-up visit, which of the following suggests that the decongestant has been effective?
- A. Increased salivation
- B. Reduced sneezing
- C. Increased tearing
- D. Headache
Correct Answer: B
Rationale: The correct answer is B: Reduced sneezing. Decongestants work by constricting blood vessels in the nasal passages, reducing swelling and congestion, which in turn can lead to a decrease in sneezing. Increased salivation (choice A) is not a typical effect of decongestants. Increased tearing (choice C) is more commonly associated with allergies or irritants. Headache (choice D) can be a side effect of decongestants due to their impact on blood vessels, but it does not necessarily indicate effectiveness in treating allergic rhinitis.
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Mr. Reyes is extremely confused. The nurse provide new information slowly and in small amounts because;
- A. Confusion or delirium can be a defense against further stress
- B. Destruction of brain cells has occurred, interrupting mental activity
- C. Teaching based on information progressing from the simple to the complex
- D. A minimum of information should be given, since he is unaware of surrounding
Correct Answer: A
Rationale: The correct answer is A. When someone is extremely confused, providing new information slowly and in small amounts can help prevent overwhelming stress and further confusion. This approach allows the individual to process information more effectively and reduces the risk of escalating confusion or delirium as a defense mechanism. Choices B, C, and D are incorrect because destruction of brain cells, teaching progression, and giving minimal information are not directly related to managing confusion in this scenario.
Three days after admission Ms. CC continued to have frequent stools. Her oral intake of both fluids and solids are poor. Her physician ordered parenteral hyperalimentation. Hyperalimentation solutions are:
- A. Hypotonic solutions used primarily to increase osmotic pressure of blood plasma
- B. Hypertonic solutions used primarily for hydration when hemoconcentration is present
- C. Alkalizing solutions used to treat metabolic acidosis thus reducing cellular sweating
- D. Hyperosmolar solutions used primarily to reverse negative nitrogen balance
Correct Answer: D
Rationale: The correct answer is D: Hyperosmolar solutions used primarily to reverse negative nitrogen balance.
Rationale:
1. Hyperalimentation solutions are designed to provide essential nutrients intravenously.
2. Hyperosmolar solutions have a higher osmolarity compared to body fluids, providing concentrated nutrition.
3. Negative nitrogen balance occurs when the body breaks down more protein than it synthesizes, requiring additional protein intake.
4. Hyperosmolar solutions can provide adequate protein and nutrients to reverse negative nitrogen balance.
Summary:
A: Hypotonic solutions do not increase osmotic pressure, but rather decrease it.
B: Hypertonic solutions are not primarily used for hydration in this context.
C: Alkalizing solutions are not the primary purpose of hyperalimentation and do not directly address cellular sweating.
The nurse teaches a client with newly diagnosed hypothyroidism about the need for thyroid hormone replacement therapy to restore normal thyroid function. Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy?
- A. Methimazole (Tapazole)
- B. Livothyronine (Cytomel)
- C. Thyroid USP dessicated (Thyroid USP
- D. Levothyroxine (Synthroid) Enseals)
Correct Answer: D
Rationale: Step 1: Levothyroxine (Synthroid) is the synthetic form of the thyroid hormone T4, the main hormone produced by the thyroid gland.
Step 2: Levothyroxine is the preferred agent for thyroid hormone replacement therapy in hypothyroidism due to its stable and consistent potency.
Step 3: Levothyroxine is well-absorbed by the body and has a long half-life, allowing for once-daily dosing.
Step 4: Other choices are incorrect because Methimazole is used to treat hyperthyroidism, Livothyronine is a form of T3 hormone not commonly used for replacement therapy, and Thyroid USP dessicated is derived from animal thyroid glands and has inconsistent hormone content.
Summary: Levothyroxine (Synthroid) is the preferred choice for thyroid hormone replacement therapy due to its synthetic nature, stable potency, good absorption, and long half-life. Other options are not
Which of the following would the nurse identify as an abnormal finding?
- A. Red blood cells (RBCs): 4.9million/ul
- B. Hematocrit: 45%
- C. Platelets: 115,000/ul
- D. None of the above
Correct Answer: C
Rationale: The nurse would identify platelets at 115,000/ul as an abnormal finding because it is below the normal range of 150,000-450,000/ul. Low platelet count can lead to increased bleeding risk. RBC count and hematocrit levels are within normal ranges, making them normal findings. Option D is incorrect as platelets are abnormal.
A patient with a spinal cord injury is seeking to enhance urinary elimination abilities by learning self- catheterization versus assisted catheterization by home health nurses and family members. The nurse adds Readiness for enhanced urinary elimination in the care plan. Which type of diagnosis did the nurse write?
- A. Risk
- B. Problem focused
- C. Health promotion
- D. Collaborative problem
Correct Answer: C
Rationale: The correct answer is C: Health promotion. The nurse wrote a diagnosis related to enhancing the patient's urinary elimination abilities through self-catheterization, which focuses on promoting the patient's health and well-being. The Readiness for enhanced urinary elimination diagnosis indicates the patient's motivation and readiness to improve their urinary elimination abilities, aligning with the concept of health promotion. This type of diagnosis acknowledges the patient's potential for growth and improvement in their health status.
Incorrect choices:
A: Risk - This choice would be more appropriate if the diagnosis focused on potential complications or adverse events related to the patient's urinary elimination abilities.
B: Problem focused - This choice would be suitable if the diagnosis identified an existing issue or problem with the patient's urinary elimination abilities that needed to be addressed.
D: Collaborative problem - This choice would be relevant if the diagnosis required collaboration between healthcare providers to manage the patient's urinary elimination abilities effectively.