Nokea
A nurse is caring for a patient with a history of chronic liver disease. The nurse should monitor for which of the following complications?
- A. Anemia.
- B. Jaundice.
- C. Hypertension.
- D. Hypoglycemia.
Correct Answer: B
Rationale: The correct answer is B: Jaundice. In chronic liver disease, impaired liver function leads to the accumulation of bilirubin in the blood, causing jaundice. Jaundice is a common complication seen in patients with liver disease. Anemia (choice A) may occur in liver disease but is not as specific as jaundice. Hypertension (choice C) is not a direct complication of liver disease. Hypoglycemia (choice D) is more commonly associated with pancreatic disorders, not liver disease. Therefore, monitoring for jaundice is crucial in patients with chronic liver disease.
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When providing culturally competent care, nurses must incorporate cultural assessment into their health assessment. Which statement is most appropriate to use when initiating a cultural beliefs assessment with a First Nations elder?
- A. Are you of the Christian faith, or another faith?
- B. Do you want to see a medicine man?
- C. How often do you seek help from medical providers?
- D. What cultural or spiritual beliefs are important to you?
Correct Answer: D
Rationale: The correct answer is D: "What cultural or spiritual beliefs are important to you?" This question allows the nurse to understand the elder's values and beliefs, guiding care. A: Assumes a specific faith. B: Stereotypes the elder. C: Focuses on frequency of medical visits, not beliefs.
A man has come in to the clinic because he is afraid he might have skin cancer. During the skin assessment, the nurse notices several areas of pigmentation that look greasy, dark, and "stuck on' on his skin. Which of the following is the best prediction?
- A. He probably has senile lentigines, which do not become cancerous.
- B. He probably has actinic keratoses, precursors to basal cell carcinoma.
- C. He probably has acrochordons, precursors to squamous cell carcinoma.
- D. He probably has seborrheic keratosis, which do not become cancerous.
Correct Answer: D
Rationale: The correct answer is D: He probably has seborrheic keratosis, which do not become cancerous. Seborrheic keratosis typically appear as greasy, dark, and "stuck on" pigmented growths on the skin, commonly seen in older adults. They are benign and do not progress to skin cancer. This conclusion is based on the characteristics of seborrheic keratosis and the fact that they are not associated with malignancy.
Choice A (senile lentigines) is incorrect because although they are also common in older adults, they are flat and dark spots rather than raised growths. Choice B (actinic keratoses) is incorrect as they are precancerous lesions related to sun exposure, leading to a risk of developing squamous cell carcinoma, not basal cell carcinoma. Choice C (acrochordons) are skin tags and not precursors to squamous cell carcinoma.
A nurse is caring for a patient with pneumonia. The nurse should prioritize which of the following assessments?
- A. Oxygen saturation levels.
- B. Pain levels.
- C. Bowel sounds.
- D. Level of consciousness.
Correct Answer: A
Rationale: The correct answer is A: Oxygen saturation levels. This assessment is crucial in pneumonia to ensure adequate oxygenation. Low oxygen levels can lead to respiratory distress. Pain levels (B) are important but not a priority over oxygenation. Bowel sounds (C) are not directly related to pneumonia. Level of consciousness (D) is also important but not as critical as ensuring proper oxygen levels for a patient with pneumonia. Oxygen saturation levels should be prioritized to prevent complications and ensure the patient's respiratory status is stable.
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.
A nurse is teaching a patient about managing chronic pain. Which of the following strategies should the nurse emphasize?
- A. Increasing activity to improve function.
- B. Using medications only when absolutely necessary.
- C. Implementing physical therapy and exercises.
- D. Using complementary therapies such as meditation and relaxation.
Correct Answer: C
Rationale: The correct answer is C: Implementing physical therapy and exercises. This is crucial for managing chronic pain as it helps improve strength, flexibility, and overall function. Physical therapy can also address underlying issues contributing to pain. Choice A could worsen pain if not done appropriately. Choice B may be necessary but should not be the sole approach. Choice D can be beneficial but may not address the root cause of pain like physical therapy does.