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A nurse is caring for a patient with a history of stroke. The nurse should monitor the patient for signs of:
- A. Pulmonary embolism.
- B. Atrial fibrillation.
- C. Chronic kidney disease.
- D. Sepsis.
Correct Answer: B
Rationale: The correct answer is B: Atrial fibrillation. Patients with a history of stroke are at an increased risk of atrial fibrillation, a common cause of ischemic stroke. Monitoring for signs of atrial fibrillation such as irregular heartbeat, palpitations, dizziness, and chest discomfort is crucial for early detection and prevention of recurrent strokes. Pulmonary embolism (A), chronic kidney disease (C), and sepsis (D) are not directly associated with a history of stroke and would not be the primary focus of monitoring in this case.
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A patient with a history of diabetes presents with a wound on the foot that is not healing. The nurse would be concerned about the possibility of:
- A. Peripheral vascular disease.
- B. Deep vein thrombosis.
- C. Cellulitis.
- D. Skin cancer.
Correct Answer: A
Rationale: The correct answer is A: Peripheral vascular disease. In a patient with diabetes, poor blood circulation due to damaged blood vessels can lead to delayed wound healing. Peripheral vascular disease is a common complication of diabetes that can result in inadequate blood flow to the extremities, impairing wound healing. Deep vein thrombosis (B) is a blood clot issue, not directly related to poor wound healing. Cellulitis (C) is a bacterial skin infection that can occur in anyone, not just diabetics. Skin cancer (D) is a condition unrelated to the wound healing process in this context.
A nurse is caring for a patient with a history of hypertension. The nurse should educate the patient to avoid which of the following?
- A. Increasing potassium intake.
- B. Consuming more fruits and vegetables.
- C. Limiting sodium intake.
- D. Increasing caffeine consumption.
Correct Answer: D
Rationale: The correct answer is D: Increasing caffeine consumption. Caffeine can potentially raise blood pressure in individuals with hypertension. The rationale is that caffeine is a stimulant that can lead to temporary spikes in blood pressure. This can be harmful for patients with a history of hypertension as it can exacerbate their condition.
A: Increasing potassium intake is generally recommended for individuals with hypertension as it can help lower blood pressure.
B: Consuming more fruits and vegetables is also beneficial for hypertension due to their high fiber and nutrient content.
C: Limiting sodium intake is crucial for managing hypertension as high sodium levels can lead to increased blood pressure.
In summary, increasing caffeine consumption is the correct answer to avoid for patients with hypertension, as it can potentially worsen their condition by raising blood pressure.
A patient has had a cerebrovascular accident (stroke). He is trying very hard to communicate. He seems driven to speak and says, "I buy obie get spirding and take my train.' What is the best way for the nurse to communicate with this patient?
- A. Use speech because he will understand even if the nurse cannot understand him.
- B. Abandon all attempts to communicate with him. His aphasia is irreversible.
- C. Give him a pencil and paper because reading and writing abilities will not be impaired.
- D. Support his efforts to communicate, and use pantomime and gestures to communicate when possible.
Correct Answer: D
Rationale: The correct answer is D because the patient is showing signs of expressive aphasia, where they have difficulty with verbal expression. By supporting his efforts to communicate and using pantomime and gestures, the nurse can help bridge the communication gap and facilitate understanding. This approach acknowledges the patient's drive to communicate and helps him convey his thoughts effectively.
Option A is incorrect because although the patient may understand, the nurse needs to adapt the communication method to support the patient's expressive difficulties. Option B is incorrect as abandoning communication efforts would be detrimental to the patient's well-being and recovery. Option C is incorrect as the patient's ability to read and write may also be impaired due to the stroke, making this method less effective than using gestures and pantomime.
In obtaining a review of systems on a "healthy" 7-year-old girl, the health care provider knows that it would be important to include the:
- A. last glaucoma examination.
- B. frequency of breast self-examination.
- C. date of her last electrocardiogram.
- D. limitations related to her involvement in sports activities.
Correct Answer: D
Rationale: The correct answer is D because obtaining information on the limitations related to the girl's involvement in sports activities is crucial for assessing her overall physical health and well-being. This information helps in understanding any potential risks or issues that may arise from her participation in sports. Choices A, B, and C are incorrect as they are not relevant to a review of systems for a healthy 7-year-old girl. Glaucoma examination, breast self-examination frequency, and electrocardiogram date are not typically part of a routine review of systems for a child of her age and health status.
Which of the following would be included in a total health database for a well person?
- A. Nursing goals for the patient
- B. Anticipated growth and development patterns
- C. A patient's perception of his or her health status
- D. The nurse's perception of disease as related to this patient
Correct Answer: C
Rationale: The correct answer is C: A patient's perception of his or her health status. In a total health database for a well person, it is important to include the patient's own perception of their health status as it provides valuable insights into their overall well-being and can help detect any potential health issues early on. This information is crucial for preventive care and promoting a patient-centered approach to healthcare.
A: Nursing goals for the patient - This information would be relevant for a patient with specific health goals or conditions but not necessarily for a well person.
B: Anticipated growth and development patterns - This information is more relevant for pediatric or adolescent populations rather than for a well adult.
D: The nurse's perception of disease as related to this patient - The nurse's perception is subjective and not as valuable as the patient's own perception in understanding their health status.