Nokea
A First Nations woman has come to the clinic for diabetes follow-up teaching. During the interview, the nurse notices that the patient never makes eye contact and speaks mostly looking down at the floor. Which of the following statements about this situation is true?
- A. She is nervous and embarrassed.
- B. She has something to hide and is ashamed.
- C. She is showing inconsistent verbal and nonverbal behaviours.
- D. She is showing that she is listening carefully to what the nurse is saying.
Correct Answer: D
Rationale: The correct answer is D because the patient's behavior of not making eye contact and looking down can be a sign of active listening and respect in some cultures, including many First Nations cultures. This behavior may indicate that the patient is focusing on what the nurse is saying and showing attentiveness. Making eye contact may be considered disrespectful or challenging in some cultures, so the lack of eye contact does not necessarily mean the patient has something to hide, is ashamed, or is nervous. Choice A assumes the patient is nervous or embarrassed without evidence. Choice B is an assumption without any basis, and choice C does not consider cultural differences in communication styles.
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The nurse is obtaining the health history of an 87-year-old woman. Which of the following areas of questioning would be most useful at this time?
- A. Obstetrical history
- B. Childhood illnesses
- C. General health for the past 20 years
- D. Current health promotion activities
Correct Answer: D
Rationale: Rationale:
1. Current health promotion activities are important to assess the patient's preventive measures.
2. At 87 years old, focusing on current habits can help identify areas for improvement.
3. Obstetrical history is irrelevant as the patient is postmenopausal.
4. Childhood illnesses are less relevant compared to current health status.
5. General health for the past 20 years may not reflect current health behaviors.
A nurse is teaching a patient with diabetes about insulin administration. Which of the following actions should the nurse emphasize to the patient?
- A. Store insulin at room temperature to prevent crystallization.
- B. Use insulin immediately after drawing it up into the syringe.
- C. Inject insulin into the same spot to avoid tissue damage.
- D. Rotate injection sites to prevent lipodystrophy.
Correct Answer: D
Rationale: The correct answer is D: Rotate injection sites to prevent lipodystrophy. Rotating injection sites helps prevent the development of lipodystrophy, a condition characterized by the loss of fat tissue at the injection site. This is important for maintaining consistent insulin absorption and reducing the risk of injection site complications.
A: Storing insulin at room temperature is generally recommended, but it is not the most critical action for insulin administration.
B: Using insulin immediately after drawing it up is not necessary for all types of insulin and may not be feasible in all situations.
C: Injecting insulin into the same spot can lead to tissue damage and inconsistent insulin absorption, so it should be avoided.
A patient is diagnosed with anemia. The nurse is educating the patient about dietary sources of iron. Which of the following foods is the best source of iron?
- A. Eggs.
- B. Spinach.
- C. Chicken liver.
- D. Oranges.
Correct Answer: C
Rationale: The correct answer is C: Chicken liver. Chicken liver is the best source of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods like spinach or oranges. Eggs do contain iron, but in smaller amounts compared to chicken liver. Oranges, on the other hand, are a source of vitamin C which can enhance iron absorption but do not contain significant amounts of iron themselves.
The nurse is planning to assess new memory with a patient. The best way to do this would be to:
- A. Administer the FACT test.
- B. Ask him to describe his first job to you.
- C. Give him the Four Unrelated Words Test.
- D. Ask him to describe the last TV show he watched before coming to the clinic.
Correct Answer: C
Rationale: The correct answer is C: Give him the Four Unrelated Words Test. This is the best way to assess new memory because it is a standardized test specifically designed to evaluate a patient's ability to form new memories. The test involves presenting the patient with four unrelated words and then asking them to recall those words after a delay. This test is reliable, valid, and widely used in clinical settings to assess new memory formation.
Other choices are incorrect because:
A: Administering the FACT test is not the best way to assess new memory as it is not specifically designed for this purpose.
B: Asking the patient to describe his first job does not directly evaluate new memory formation and may not provide a standardized assessment.
D: Asking the patient to describe the last TV show he watched does not focus on new memory and is not a standardized way to assess memory function.
A nurse is caring for a patient with a history of chronic obstructive pulmonary disease (COPD). The nurse should monitor for which of the following complications?
- A. Pulmonary embolism.
- B. Pneumothorax.
- C. Hypercapnia.
- D. Asthma attack.
Correct Answer: C
Rationale: The correct answer is C, hypercapnia. In COPD, impaired lung function leads to inadequate oxygen exchange, causing increased carbon dioxide levels in the blood (hypercapnia). This can result in respiratory acidosis and further exacerbate respiratory distress. Monitoring for hypercapnia is crucial in COPD management to prevent respiratory failure.
Incorrect choices:
A: Pulmonary embolism - While patients with COPD are at increased risk for blood clots, pulmonary embolism is not a direct complication of COPD.
B: Pneumothorax - Although individuals with COPD may develop pneumothorax due to weakened lung tissue, it is not a common complication.
D: Asthma attack - Asthma and COPD are distinct conditions with different pathophysiology. Asthma attacks are not a typical complication of COPD.