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A nurse is caring for a patient with a history of alcohol abuse. The nurse should be aware that this patient is at increased risk for which of the following complications?
- A. Chronic liver disease.
- B. Chronic kidney disease.
- C. Pulmonary embolism.
- D. Stroke.
Correct Answer: A
Rationale: The correct answer is A: Chronic liver disease. Patients with a history of alcohol abuse are at increased risk for chronic liver disease due to the toxic effects of alcohol on the liver. Alcohol can lead to fatty liver, alcoholic hepatitis, cirrhosis, and liver cancer. The liver plays a crucial role in metabolizing alcohol, and excessive alcohol consumption can overwhelm the liver's ability to detoxify the body. Chronic kidney disease (B), pulmonary embolism (C), and stroke (D) are not directly associated with alcohol abuse. Kidney disease is more commonly linked to conditions like diabetes and hypertension, pulmonary embolism is often related to blood clotting disorders, and stroke can be caused by factors such as hypertension and atherosclerosis.
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The nurse is conducting an interview with a woman who has recently learned that she is pregnant and has come to the clinic to begin prenatal care. The woman states that she and her husband are excited about the pregnancy but have a few questions. She looks nervously at her hands during the interview and sighs audibly. Which of the following statements does the nurse know is most accurate, considering the concept of communication?
Correct Answer: B
Rationale: The correct answer is B because the woman's nonverbal cues (looking nervously at her hands, sighing audibly) indicate potential anxiety or stress. The nurse should acknowledge these cues and explore her feelings further to provide appropriate support. Option A is incorrect as it does not address the woman's nonverbal cues. Option C is incorrect as it assumes the woman is not genuinely excited about the pregnancy. Option D is incorrect as it overlooks the woman's nonverbal cues and does not address her potential emotional needs.
A nurse is teaching a patient with diabetes about insulin administration. Which of the following statements by the patient indicates proper understanding?
- A. I will inject insulin into my arm to ensure faster absorption.
- B. I will rotate injection sites to avoid tissue damage.
- C. I should inject insulin only when my blood glucose is elevated.
- D. I should inject insulin into the same spot every time to ensure consistency.
Correct Answer: B
Rationale: The correct answer is B: I will rotate injection sites to avoid tissue damage. This statement indicates proper understanding because rotating injection sites helps prevent tissue damage and ensures consistent absorption. Injecting into the same spot every time can lead to lipohypertrophy. Injecting insulin only when blood glucose is elevated is incorrect as insulin is needed regularly. Injecting into the arm for faster absorption is also incorrect, as it can lead to unpredictable absorption rates. Rotation of sites is crucial for optimal insulin absorption and to prevent complications.
Which statement is correct regarding the development of one's culture?
- A. Culture is genetically determined on the basis of racial background.
- B. Culture is rooted in several distinctive and specific social elements.
- C. Culture is a nonspecific phenomenon and is adaptive, but unnecessary.
- D. Culture is biologically determined on the basis of physical characteristics.
Correct Answer: B
Rationale: The correct answer is B because culture is indeed rooted in specific social elements such as language, customs, traditions, beliefs, and values. These elements are passed down through generations within a particular society or group. Choice A is incorrect because culture is not genetically determined, but rather learned and acquired through socialization. Choice C is incorrect as culture plays a crucial role in shaping identities, behaviors, and interactions within a society. Choice D is incorrect as culture is not biologically determined, but rather socially constructed.
A nurse is caring for a patient with diabetes. The nurse should monitor for which of the following complications?
- A. Hypoglycemia.
- B. Hyperkalemia.
- C. Hypotension.
- D. Hyperglycemia.
Correct Answer: D
Rationale: The correct answer is D: Hyperglycemia. In diabetes, hyperglycemia occurs when blood sugar levels are too high. This can lead to various complications such as diabetic ketoacidosis or hyperosmolar hyperglycemic state. Monitoring for hyperglycemia is crucial to prevent these serious complications.
A: Hypoglycemia is low blood sugar and can also occur in diabetes, but it is not the primary complication to monitor for in this case.
B: Hyperkalemia is high potassium levels and is not a common complication of diabetes unless there are other underlying issues.
C: Hypotension is low blood pressure, which can be a complication of diabetes but is not as directly related to glucose management as hyperglycemia.
In summary, monitoring for hyperglycemia is essential in diabetes care to prevent serious complications associated with high blood sugar levels.
The nurse is preparing to assess a hospitalized patient who is experiencing significant shortness of breath. How should the nurse proceed with the assessment?
- A. Examine only the body areas related to the problem for which the patient is hospitalized, and then do a complete assessment after the problem has been resolved.
- B. Perform a mini-database by examining the body areas directly related to the problem for which the patient is hospitalized.
- C. Consider this a normal finding, and proceed with the abdominal assessment.
- D. Examine the entire body to determine if the problem is linked to something else.
Correct Answer: A
Rationale: The correct answer is A because when a patient is experiencing significant shortness of breath, the nurse should initially focus on assessing the areas directly related to the presenting problem to address the immediate issue. This approach allows for prompt intervention and treatment of the patient's acute condition. Once the patient's respiratory distress is managed, the nurse can then proceed with a complete assessment to identify any underlying or additional health issues. This stepwise approach ensures that the patient's urgent needs are met first before conducting a comprehensive assessment.
Choices B, C, and D are incorrect because:
B: Performing a mini-database by only examining body areas directly related to the problem may not provide a comprehensive understanding of the patient's condition and could overlook other potential health issues.
C: Dismissing significant shortness of breath as a normal finding and proceeding with an abdominal assessment is inappropriate and could delay necessary interventions for the respiratory distress.
D: Examining the entire body to determine if the problem is linked to something else is inefficient and