A complication of total parenteral nutrition (TPN) is the development of cholestasis. What is this condition?
- A. an inflammatory process of the extrahepatic bile ducts
- B. an arrest of the normal flow of bile
- C. an inflammation of the gallbladder
- D. the formation of gallstones
Correct Answer: B
Rationale: Cholestasis due to TPN administration is an intrahepatic process that interrupts the normal flow of bile. It is characterized by a reduction or stoppage of bile flow. Choice A, an inflammatory process of the extrahepatic bile ducts, refers to cholangitis, not cholestasis. Choice C, an inflammation of the gallbladder, describes cholecystitis, a different condition. Choice D, the formation of gallstones, is not correct as cholestasis is about the flow of bile, not the formation of gallstones.
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A 6-year-old with cerebral palsy functions at the level of an 18-month-old. Which finding would support that assessment?
- A. She dresses herself
- B. She pulls a toy behind her
- C. She can build a tower of eight blocks
- D. She can copy a horizontal or vertical line
Correct Answer: B
Rationale: The correct answer is 'She pulls a toy behind her.' This behavior is consistent with the developmental stage of an 18-month-old who enjoys push-pull toys. Dressing oneself usually begins around 3 years old, building a tower of eight blocks at approximately 3 years old, and copying a horizontal or vertical line at about 4 years old. Choices A, C, and D are incorrect as they represent skills that are typically observed in older children.
When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:
- A. conversion.
- B. regression
- C. introjection.
- D. rationalization
Correct Answer: B
Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings. Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.
Which of the following factors can impact an individual's ability to give informed consent?
- A. IQ
- B. educational level
- C. pain medications
- D. financial status
Correct Answer: C
Rationale: Pain medications might alter alertness, thought processes, and reactions, potentially impacting an individual's ability to give informed consent. It is recommended to approach a client for consent at least 4 hours after the last dose of pain medicine to minimize any influence. Choices A, B, and D are incorrect. While IQ and educational level may affect how information is presented during the discussion process, they do not directly impact informed-consent decision-making. Financial status is also not a direct factor in an individual's ability to provide informed consent, unlike pain medications which can directly affect cognitive functions and decision-making abilities.
What is the primary goal of family education?
- A. symptom reduction
- B. improved quality of life
- C. increased knowledge about mental illness
- D. improved caregiving skills
Correct Answer: B
Rationale: The primary goal of family education is to improve the quality of life. Family education aims to enhance the overall well-being and functioning of both the individual with the condition and their family members. While increased knowledge about mental illness may be a beneficial outcome, it is not the primary objective of family education. Symptom reduction is more commonly associated with psychoeducation rather than family education. Improving caregiving skills is a component of family education, but the primary focus is on improving the quality of life for everyone involved in the caregiving process.
The ethical principle of keeping professional promises or obligations is:
- A. veracity
- B. autonomy
- C. fidelity
- D. beneficence
Correct Answer: C
Rationale: The correct answer is fidelity. Fidelity is the ethical principle that refers to keeping professional promises or obligations. Veracity, however, relates to truth-telling. Autonomy is about client self-determination and decision-making. Beneficence, on the other hand, involves doing good and is crucial in the provision of nursing care.
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