Nokea
A home care nurse is teaching meal-planning to a patients son who is caring for his mother during her recovery from hip replacement surgery. Which of the following meals indicates that the son understands the concept of nutrition, based on the U.S. Department of Agricultures MyPlate?
- A. Cheeseburger, carrot sticks, and mushroom soup with whole wheat crackers
- B. Spaghetti and meat sauce with garlic bread and a salad
- C. Chicken and pepper stir fry on a bed of rice
- D. Ham sandwich with tomato on rye bread with peaches and yogurt
Correct Answer: D
Rationale: This menu has a choice from each of the food groups identified in MyPlate: grains, vegetables, fruits, dairy, and protein. The other selections are incomplete choices.
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The nurse is completing a family history for a patient who is admitted for exacerbation of chronic obstructive pulmonary disease (COPD). The nurse should include questions that address which of the following health problems?
- A. Allergies
- B. Alcoholism
- C. Psoriasis
- D. Hypervitaminosis
- E. Obesity
Correct Answer: A,B,E
Rationale: In general, the following conditions are included in a family history: cancer, hypertension, heart disease, diabetes, epilepsy, mental illness, tuberculosis, kidney disease, arthritis, allergies ???¾?±?????²?µ?½?½?¾?¹, alcoholism, and obesity. Psoriasis and hypervitaminosis do not have genetic etiologies.
A school nurse is teaching a 14-year-old girl of normal weight some of the key factors necessary to maintain good nutrition in this stage of her growth and development. What interventions should the nurse most likely prioritize?
- A. Decreasing her calorie intake and encouraging her to maintain her weight to avoid obesity
- B. Increasing her BMI, taking a multivitamin, and discussing body image
- C. Increasing calcium intake, eating a balanced diet, and discussing eating disorders
- D. Obtaining a food diary along with providing close monitoring for anorexia
Correct Answer: C
Rationale: Adolescent girls are considered to be at high risk for nutritional disorders. Increasing calcium intake and promoting a balanced diet will provide the necessary vitamins and minerals. If adolescents are diagnosed with eating disorders early, the recovery chances are increased. The question presents no information that indicates a need for decreasing her calories. There is no apparent need for an increase in BMI. A food diary is used for assessing eating habits, but the question asks for teaching factors related to good nutrition.
In your role as a school nurse, you are performing a sports physical on a healthy adolescent girl who is planning to try out for the volleyball team. When it comes time to listen to the students heart and lungs, what is your best nursing action?
- A. Perform auscultation with the stethoscope placed firmly over her clothing to protect her privacy.
- B. Perform auscultation by holding the diaphragm lightly on her clothing to eliminate the scratchy noise.
- C. Perform auscultation with the diaphragm placed firmly on her skin to minimize extra noise.
- D. Defer the exam because the girl is known to be healthy and chest auscultation may cause her anxiety.
Correct Answer: C
Rationale: Auscultation should always be performed with the diaphragm placed firmly on the skin to minimize extra noise and with the bell lightly placed on the skin to reduce distortion caused by vibration. Placing a stethoscope over clothing limits the conduction of sound. Performing auscultation is an important part of a sports physical and should never be deferred.
The nurse is performing the process of inspection during an assessment. What nursing action should the nurse include during this phase?
- A. Gather as many psychosocial details as possible.
- B. Pay attention to the details while observing.
- C. Write down as many details as possible during the observation.
- D. Do not let the patient know he is being assessed.
Correct Answer: B
Rationale: It is essential to pay attention to the details in observation. Vague, general statements are not a substitute for specific descriptions based on careful observation. It is specific information, not general information, that is being gathered. Writing while observing can be a conflict for the nurse. It is not necessary or appropriate to keep the assessment concealed from the patient.
A 30-year-old man is in the clinic for a yearly physical. He states, I found out that two of my uncles had heart attacks when they were young. This alerts the nurse to complete a genetic-specific assessment. What component should the nurse include in this assessment?
- A. A complete health history, including genogram along with any history of cholesterol testing or screening and a complete physical exam
- B. A limited health history along with a complete physical assessment with an emphasis on genetic abnormalities
- C. A limited health history and focused physical exam followed by safety-related education
- D. A family history focused on the paternal family with focused physical exam and genetic profile
Correct Answer: A
Rationale: A genetic-specific exam in this case would include a complete health history, genogram, a history of cholesterol testing or screening, and a complete physical exam. A broad examination is warranted and safety education is not directly relevant.