Nokea
A client tells the nurse that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
- A. Urine glucose level
- B. Serum fructosamine level
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct Answer: D
Rationale: Checking the glycosylated hemoglobin (HbA1c) level is the most appropriate way to determine the effectiveness of the client's efforts to control type 2 diabetes mellitus over the past few months. HbA1c provides an average of the blood glucose levels over the past 2-3 months, reflecting how well the client has been managing their diabetes. This test is not affected by recent food intake or physical activity, making it a reliable indicator of long-term glucose control. Unlike fasting blood glucose levels or urine glucose levels, which can fluctuate throughout the day, HbA1c gives a more comprehensive view of glucose control and helps guide treatment decisions.
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is type of hydrocephalus which there no obstructive to pass CSF but malformation of arachnoid villi :
- A. non communicating hydrocephalus
- B. communicating hydrocephalus
- C. obstructive hydrocephalus
- D. non of the above
Correct Answer: B
Rationale: Communicating hydrocephalus is a type of hydrocephalus where there is no obstruction to the passage of cerebrospinal fluid (CSF), but rather a malfunction or malformation of the arachnoid villi, which are responsible for the reabsorption of CSF. In communicating hydrocephalus, the flow of CSF within the ventricular system is disrupted, leading to an accumulation of fluid and resulting in increased intracranial pressure.
A 40 year-old female nurse had a fecal impaction and was admitted to the hospital. The physician orders an oil retention enema followed by a cleansing enema. What is the rationale for administering the oiul enema first?
- A. lubricate the walls of the intestinal tract
- B. soften the fecal mass and lubricate the walls of the rectum and colon
- C. reduce bacterial content of the fecal mass
- D. coat the walls of the intestines to prevent irritation by the hardened fecal mass
Correct Answer: B
Rationale: The rationale for administering the oil retention enema first in this case is to help soften the fecal mass and lubricate the walls of the rectum and colon. This will make it easier for the impacted stool to be passed, reducing the risk of injury or discomfort during the procedure. The oil enema acts as a lubricant, making it easier for the hardened fecal mass to be expelled from the body without causing damage to the intestinal walls. Additionally, the oil enema helps to soften the fecal mass, further aiding in its removal.
Bennett was rushed to the emergency department with possible increased intracranial pressure (ICP); which of the following is an early clinical manifestation of increased ICP in older children? (Select all that apply.)
- A. Macewen's sign
- B. Setting sun sign
- C. Papilledema
- D. Diplopia
Correct Answer: C
Rationale: Papilledema is a common early clinical manifestation of increased intracranial pressure (ICP) in older children. Papilledema is defined as optic disc swelling due to increased ICP transmitted to the optic nerve sheath. This can be visualized during a fundoscopic examination. It is important to identify papilledema promptly as it may signify increased ICP, which requires urgent evaluation and management to prevent potential complications. While other signs like Macewen's sign, Setting sun sign, and Diplopia can also indicate increased ICP, papilledema is a more specific sign seen in older children.
Four-year-old Brian appears to be upset by hospitalization. Which is an appropriate intervention?
- A. Let him know it is all right to cry.
- B. Give him time to gain control of himself.
- C. Show him how other children are cooperating.
- D. Tell him what a big boy he is to be so quiet.
Correct Answer: A
Rationale: Option A, "Let him know it is all right to cry," is the most appropriate intervention for a four-year-old like Brian who appears to be upset by hospitalization. Acknowledging and validating his emotions, including the possibility of crying, is important for his emotional well-being. By letting Brian know it is okay to express his feelings, he can feel supported and understood during a potentially difficult time. It is crucial for children to feel that their emotions are valid and accepted, promoting their emotional resilience and coping skills. This approach fosters trust and comfort, helping Brian navigate his emotions in a healthy way.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations exhibited are so bizarre that the diagnosis is fairly easy.
- B. Manifestations affect every aspect of the child's life but are most obvious in the classroom.
- C. Learning disabilities associated with ADHD eventually disappear when adulthood is reached.
- D. Diagnosis of ADHD requires that all manifestations of the disorder be present.
Correct Answer: B
Rationale: Option B is descriptive of attention deficit hyperactivity disorder (ADHD). Manifestations of ADHD can significantly impact the child's life, but are most noticeable in the classroom setting. Children with ADHD may struggle with paying attention, staying organized, controlling impulsive behavior, and following instructions in the school environment. While symptoms can also affect other areas of life, such as social interactions and familial relationships, they are typically most prominently displayed in the structured school setting, making it easier to recognize and diagnose the disorder.