Nokea
A cognitive assessment of Belle indicated that according to Piaget's theory she was functioning at the concrete operational stage. Which of these behaviors would the nurse observe in Belle?
- A. Thinks logically and sees possibilities.
- B. Understands only her own viewpoint.
- C. Feels her own reasoning should agree with the reasoning of others.
- D. Makes and tests hypothesis
Correct Answer: A
Rationale: At the concrete operational stage according to Piaget's theory, children typically demonstrate logical thinking abilities and are able to understand and work with concrete objects and events. They can also grasp concepts such as conservation and classification. These children are able to think logically about concrete events but may still struggle with abstract and hypothetical situations. Therefore, Belle, functioning at the concrete operational stage, would exhibit behaviors such as thinking logically and being able to see possibilities, as described in option A.
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A patient presents with a rash characterized by erythematous papules and vesicles arranged in a linear distribution. Which of the following conditions is most likely responsible for this presentation?
- A. Psoriasis
- B. Contact dermatitis
- C. Scabies
- D. Atopic dermatitis
Correct Answer: C
Rationale: Scabies is a contagious skin infestation caused by the Sarcoptes scabiei mite. The classic presentation of scabies includes a rash characterized by erythematous papules and vesicles that are arranged in a linear or burrow-like distribution. These linear tracks are often seen in areas such as the interdigital spaces, wrists, elbows, axillae, belt line, and genitalia. It is commonly associated with intense itching, especially at night. Unlike psoriasis, which presents with silvery scales and well-defined borders, or contact dermatitis, which results from exposure to a specific allergen or irritant, scabies is caused by a parasitic mite infestation. Atopic dermatitis, on the other hand, is a chronic inflammatory skin condition characterized by pruritic eczematous lesions, but it typically does not manifest with a linear distribution of lesions like scabies.
Which of the following is the cause of Somogyi effect, which occurs during sleep in patients with diabetes mellitus?
- A. too much globulin
- B. too much albumin
- C. increase insulin in the body
- D. limited insulin in the body
Correct Answer: D
Rationale: The Somogyi effect, also known as rebound hyperglycemia, is a phenomenon observed in patients with diabetes mellitus during sleep. It is characterized by a low blood sugar level (hypoglycemia) followed by high blood sugar (hyperglycemia) in the morning. This occurs due to limited insulin in the body during the night, leading to high blood sugar levels in the morning as a response to the hypoglycemia episode. Too much globulin or albumin are not directly associated with the Somogyi effect. Increasing insulin in the body would rather help prevent the hypoglycemia episode that triggers the rebound hyperglycemia in the Somogyi effect.
A woman in active labor is receiving intravenous fentanyl for pain relief. What fetal assessment finding indicates potential neonatal opioid withdrawal syndrome (NOWS)?
- A. Hypertonicity
- B. Bradycardia
- C. Hypoglycemia
- D. Respiratory depression
Correct Answer: A
Rationale: Neonatal Opioid Withdrawal Syndrome (NOWS), previously known as Neonatal Abstinence Syndrome (NAS), can occur when a newborn is exposed to opioids in utero. Opioid exposure in utero can lead to physical dependence in the fetus, and when the drug is no longer available after birth, withdrawal symptoms can occur.
A postpartum client who delivered preterm expresses concern about breastfeeding her premature infant. What nursing intervention should be prioritized to support successful breastfeeding in this situation?
- A. Providing education on strategies for initiating and maintaining milk supply
- B. Recommending the use of supplemental formula feedings to ensure adequate nutrition
- C. Encouraging the client to postpone breastfeeding until the infant reaches full term
- D. Referring the client to a lactation consultant for specialized support
Correct Answer: A
Rationale: Providing education on strategies for initiating and maintaining milk supply should be prioritized to support successful breastfeeding in this situation. Preterm infants can benefit significantly from breast milk due to its unique composition that supports their growth and development. Educating the client on techniques such as pumping to establish and maintain milk supply, proper latching techniques, and understanding the benefits of breastfeeding for preterm infants can help alleviate her concerns and increase her confidence in breastfeeding her premature infant. Additionally, promoting skin-to-skin contact and frequent feedings can also help stimulate milk production and foster bonding between the mother and infant. Encouraging and supporting the client with evidence-based information will be crucial in promoting successful breastfeeding outcomes for the preterm infant.
A patient presents with acute knee pain and swelling following a twisting injury during sports activity. Physical examination reveals joint effusion and tenderness along the joint line. Which structure is most likely injured in this scenario?
- A. Anterior cruciate ligament (ACL)
- B. Medial collateral ligament (MCL)
- C. Meniscus
- D. Patellar tendon
Correct Answer: C
Rationale: The scenario described is suggestive of a meniscus injury. A twisting injury during sports activity leading to acute knee pain and swelling, accompanied by joint effusion and tenderness along the joint line, is commonly associated with meniscus tears. The meniscus is a C-shaped cartilage structure located between the femur and tibia in the knee joint, providing cushioning and stability. The symptoms of a meniscus tear typically include pain, swelling, joint line tenderness, and sometimes mechanical symptoms like locking or clicking. Treatment may involve rest, physical therapy, or in some cases, surgery to repair or remove the torn meniscus.