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A nurse is preparing a community health program for adults at risk for cardiovascular disease. Which of the following should the nurse include as a modifiable risk factor?
- A. Family history of cardiac disease.
- B. Increasing age.
- C. Diagnosis of diabetes mellitus.
- D. Cigarette smoking.
Correct Answer: D
Rationale: The correct answer is D: Cigarette smoking. Smoking is a modifiable risk factor for cardiovascular disease as individuals can quit smoking to reduce their risk. Family history (A) and increasing age (B) are non-modifiable risk factors. Diabetes (C) is a risk factor but not modifiable in this context. Other choices not provided.
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A community health nurse is developing a pamphlet about breast self-examination (BSE) for a local health fair. Which of the following instructions should the nurse include?
- A. Using the palm of the hand, feel for lumps using a circular motion.
- B. Expect some breast dimpling or discharge with age.
- C. Breasts can be examined in the shower with soapy hands.
- D. For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation.
Correct Answer: C
Rationale: The correct answer is C: Breasts can be examined in the shower with soapy hands. This instruction is important because warm water and soap help to make the examination more comfortable and easier to detect any abnormalities. By examining the breasts in the shower, the individual can incorporate BSE into their routine without it feeling like a separate task. This method also allows for better coverage and thorough examination of the entire breast tissue.
Choice A is incorrect because using the palm of the hand in a circular motion may not be as effective in detecting lumps compared to using the fingertips. Choice B is incorrect as breast dimpling or discharge are not normal signs of aging, and should be reported to a healthcare provider. Choice D is incorrect as performing BSE at specific times in the menstrual cycle is not necessary.
A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child’s appendix is perforated?
- A. Sudden decrease in abdominal pain.
- B. Absence of Rovsing’s sign.
- C. Low-grade fever.
- D. Rigid abdomen.
Correct Answer: A
Rationale: The correct answer is A: Sudden decrease in abdominal pain. A sudden decrease in abdominal pain can indicate a perforated appendix due to the release of pressure and inflammation. This sudden relief occurs when the appendix ruptures, causing the abdominal pain to subside temporarily. This is a critical sign that the appendix has perforated and requires immediate medical attention. The other choices are incorrect because: B: Absence of Rovsing’s sign is not specific to a perforated appendix. C: Low-grade fever is commonly seen in uncomplicated appendicitis and may not necessarily indicate perforation. D: A rigid abdomen is a sign of peritonitis, which can occur with a perforated appendix, but it is not as specific as the sudden decrease in pain.
A nurse is caring for a client who has delusional behavior and states, 'I can’t go to group therapy today. I am expecting a high-level official to visit me.' The nurse responds, 'I understand, but it is time for group therapy and we expect everyone to attend. Let’s walk over together.' For which of the following reasons is the nurse’s response considered therapeutic?
- A. It clearly articulates the expectations of the client.
- B. It demonstrates empathy towards the client.
- C. It sets limits on the client’s manipulative behavior.
- D. It uses reflection when talking with the client.
Correct Answer: B
Rationale: The correct answer is B: It demonstrates empathy towards the client. By acknowledging the client's feelings and showing understanding, the nurse is building a therapeutic relationship based on empathy. This approach helps the client feel heard and validated, fostering trust and cooperation. The other choices are incorrect because: A) while the response does articulate expectations, it does not address the client's emotions or perspective; C) while setting limits is important, the response does not directly address manipulative behavior; D) reflection involves paraphrasing or summarizing the client's thoughts, which is not evident in the nurse's response.
A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction?
- A. Generalized urticaria.
- B. Distended jugular veins.
- C. Blood pressure 184/92 mm Hg.
- D. Bilateral flank pain.
Correct Answer: A
Rationale: The correct answer is A: Generalized urticaria. This finding indicates an allergic transfusion reaction because urticaria, or hives, is a common symptom of an allergic response. The release of histamine during the reaction causes itching and skin rash. Distended jugular veins (B) are more indicative of fluid overload or heart failure. Blood pressure of 184/92 mm Hg (C) is elevated but not specific to an allergic reaction. Bilateral flank pain (D) may suggest kidney issues or musculoskeletal problems, not necessarily related to an allergic reaction.
A nurse is preparing a client who is postoperative following a below-the-knee amputation for a leg prosthesis fitting. Which of the following actions should the nurse take?
- A. Wrap the stump with an elastic bandage in a figure-eight configuration.
- B. Remove the elastic bandage and re-wrap the stump once per day.
- C. Perform passive range of motion exercises once daily.
- D. Secure the elastic bandage to the lowest joint.
Correct Answer: A
Rationale: The correct answer is A: Wrap the stump with an elastic bandage in a figure-eight configuration. This action helps reduce swelling, provide support, and shape the stump for prosthesis fitting. Wrapping in a figure-eight pattern ensures even compression and prevents constriction. Choice B is incorrect as frequent re-wrapping can disrupt wound healing. Choice C is unnecessary and may cause discomfort. Choice D is incorrect as securing the bandage at the lowest joint can lead to constriction and hinder circulation.