Nokea
A client seeks care for hopeless that has lasted for 1 month. To elicit the most appropriate information about this problem, the nurse should ask which question.
- A. "Do you smoke cigarettes, cigars or pipe?"
- B. "Do you eat a lot of red meat?"
- C. "Have you strained your voice recently?"
- D. "Do you eat spicy foods?"
Correct Answer: E
Rationale: The most appropriate question to elicit information about feelings of hopelessness lasting for 1 month would be related to mental health and emotional well-being. Therefore, asking about smoking habits, diet, voice strain, or spicy food consumption are not directly relevant to the client's presenting concern. Instead, asking about the individual's feelings, thoughts, and experiences related to the ongoing feelings of hopelessness would provide essential information for understanding and addressing the client's mental health needs.
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The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
- A. It decreases levels of angiotensin II
- B. It dilates the arterioles and veins
- C. It adjusts the extracellular volume
- D. It decreases cardiac output
Correct Answer: A
Rationale: Enalapril maleate (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. The main action of ACE inhibitors like enalapril is to decrease the levels of angiotensin II in the body. Angiotensin II is a potent vasoconstrictor that plays a role in regulating blood pressure, stimulating aldosterone secretion, and promoting sodium and water retention. By inhibiting the conversion of angiotensin I to angiotensin II, enalapril reduces vasoconstriction and aldosterone secretion, leading to vasodilation, decreased blood pressure, and ultimately decreased levels of angiotensin II. This mechanism allows for the dilation of arterioles and veins, reduction in cardiac afterload, and ultimately decreases the workload of the heart.
What is the care priority for a newborn with bladder exstrophy and a malformed pelvis?
- A. Change the diaper frequently and assess for skin breakdown.
- B. Keep the exposed bladder open in a warm, dry environment.
- C. Offer formula for growth and fluid management.
- D. Cluster care to allow the child uninterrupted sleep and strength for upcoming surgical repair.
Correct Answer: D
Rationale: Minimizing disturbances (clustering care) helps prevent infection and allows the infant to conserve energy before surgical repair.
The physician prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
- A. "Be sure to take glipizide 30 minutes before meals."
- B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly."
- C. "You won't need to check you blood glucose level after you start taking glipizide."
- D. "Take glipizide after a metal to prevent heartburn."
Correct Answer: A
Rationale: A. "Be sure to take glipizide 30 minutes before meals."
Which of the ff. safety instructions should the nurse give a patient who has temporarily dilated pupils?
- A. Keep eyes closed
- B. Wear sunglasses
- C. Do not drive for 8 hours
- D. Avoid caffeinated beverages
Correct Answer: B
Rationale: Dilated pupils can cause increased sensitivity to light, leading to discomfort or visual disturbances. Wearing sunglasses can help protect the eyes from bright light and reduce potential discomfort for the patient. This safety instruction is important to promote the patient's comfort and prevent any potential harm due to light sensitivity.
An infant with gastroschisis is MORE likely than one with an omphalocele to have which of the following conditions?
- A. Congenital heart disease
- B. History of prematurity
- C. Imperforate anus
- D. N/A
Correct Answer: B
Rationale: Infants with gastroschisis are more likely to have a history of prematurity compared to those with omphalocele, though neither condition is strongly associated with congenital heart disease or imperforate anus.