Nokea
You would not find which of the following assessments in a patient with severe anemia?
- A. Pallor
- B. Fatigue
- C. Cold sensitivity
- D. Dyspnea only on exertion
Correct Answer: C
Rationale: Severe anemia is associated with a reduced number of red blood cells, leading to decreased oxygen delivery to the body's tissues. Therefore, symptoms commonly seen in patients with severe anemia include pallor (pale skin), fatigue (due to decreased energy levels), and dyspnea (shortness of breath) especially on exertion (due to the heart working harder to compensate for the reduced oxygen-carrying capacity of the blood). Cold sensitivity is not a typical symptom of anemia and is not directly related to the reduced oxygen-carrying capacity of the blood.
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Which virus causes genital warts?
- A. Cytomegalovirus
- B. Human papillomavirus
- C. Herpes simplex virus type II
- D. Human immunodeficiency virus
Correct Answer: B
Rationale: Genital warts are caused by the human papillomavirus (HPV). HPV is a common sexually transmitted infection (STI) that can infect the genital areas of both men and women. There are many different strains of HPV, some of which can cause genital warts. These warts may appear as small bumps or clusters in the genital or anal area. It's important to note that not all HPV strains cause genital warts, and some can lead to more serious conditions such as cervical cancer. Getting vaccinated against HPV and practicing safe sex can help reduce the risk of HPV infection and its associated complications.
The nurse should include which of the following in preprocedure teaching for a patient scheduled for carotid angiography?
- A. "You will be put to sleep before the needle Is inserted."
- B. "The test will take several hours."
- C. "You may fee! a burning sensation when the dye is injected."
- D. "There will be no complications."
Correct Answer: C
Rationale: It is important for the nurse to include in preprocedure teaching for a patient scheduled for carotid angiography the information that the patient may feel a burning sensation when the dye is injected. This information helps prepare the patient for a common sensation during the procedure, reducing anxiety and promoting patient understanding and cooperation. Providing this education enhances the patient's overall experience and enables them to better cope with the procedure. The other options are not accurate or complete in providing necessary preprocedure information for the patient.
What size of suction catheter would Wilma use for James, who is 6 feet 5 inches in height and weighing approximately 145 lbs?
- A. Fr. 5
- B. Fr. 12
- C. Fr. 10
- D. Fr. 18
Correct Answer: C
Rationale: The correct size of a suction catheter is usually determined by the patient's weight, rather than height. For James, who weighs approximately 145 lbs, a Fr. 10 suction catheter would be suitable. Suction catheter sizes typically range from Fr. 5 (smaller) to Fr. 18 (larger), with Fr. 10 being a common size for an adult patient of James' weight. Using a catheter that is too small may not effectively clear secretions, while one that is too big may cause discomfort or damage to the airways.
What is the best initial action for the nurse to take?
- A. Try to have the client breathe slower or
- B. Give O2 via nasal cannula into the paper bag
- C. Administer sodium bicarbonate
- D. Monitor the client's fluid balance
Correct Answer: A
Rationale: The best initial action for the nurse to take when a client is experiencing hyperventilation is to try to have the client breathe slower. This is because hyperventilation is often caused by rapid, shallow breathing and slowing down the breathing pattern can help restore normal gas exchange and alleviate symptoms. Providing oxygen via a nasal cannula or administering sodium bicarbonate would not directly address the underlying issue of hyperventilation. Monitoring fluid balance is important for overall assessment but not the priority when dealing with acute respiratory distress due to hyperventilation.
In terms of gross motor development, which should the nurse expect a 5-month-old infant to do? (Select all that apply.)
- A. Roll from abdomen to back.
- B. Put feet in mouth when supine.
- C. Roll from back to abdomen.
- D. Sit erect without support.
Correct Answer: A
Rationale: At 5 months old, an infant would typically be able to roll from abdomen to back (Choice A). This is an important gross motor skill that develops during this stage. Additionally, putting their feet in their mouth when lying on their back (Choice B) is also a common movement seen at this age. Both these actions demonstrate the increasing strength and coordination of the infant's muscles as they develop and explore their physical abilities. Rolling from back to abdomen (Choice C) and sitting erect without support (Choice D) typically develop later, around 6-7 months and 8-9 months, respectively. Moving from prone to sitting position (Choice E) and adjusting posture to reach an object (Choice F) are usually mastered around 8-9 months as well.