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A nurse is teaching a patient with chronic kidney disease (CKD) about dietary modifications. Which of the following statements by the patient indicates proper understanding?
- A. I should limit my sodium intake and increase my potassium intake.
- B. I should avoid eating foods high in potassium.
- C. I can eat as much protein as I want.
- D. I should drink fluids freely without restriction.
Correct Answer: B
Rationale: Rationale:
B is correct because patients with CKD often have difficulty excreting potassium, so limiting high potassium foods is crucial to prevent hyperkalemia. A is incorrect because increasing potassium intake is not recommended. C is incorrect as excessive protein intake can worsen kidney function. D is incorrect because CKD patients typically have fluid restrictions to prevent fluid overload and electrolyte imbalances.
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Which of the following statements best describes the Montreal Cognitive Assessment (MoCA) examination?
- A. Scores below 30 indicate cognitive impairment.
- B. It is a good tool to evaluate mood and thought processes.
- C. It is a good tool to detect delirium and dementia and to differentiate these from psychiatric mental illness.
- D. It is useful for an initial evaluation of mental health. Additional tools are needed to evaluate changes in cognition over time.
Correct Answer: C
Rationale: The correct answer is C because the Montreal Cognitive Assessment (MoCA) is specifically designed to detect delirium and dementia and differentiate these conditions from psychiatric mental illness. It assesses various cognitive domains such as memory, attention, language, and visuospatial abilities. Scores below the normal range on the MoCA can indicate cognitive impairment related to delirium or dementia.
Choice A is incorrect because a score below 30 on the MoCA does not necessarily indicate cognitive impairment; it depends on the individual's baseline and education level.
Choice B is incorrect because the MoCA primarily focuses on cognitive function rather than mood and thought processes.
Choice D is incorrect because while the MoCA can be used for initial evaluation of cognitive function, it is not sufficient for evaluating changes over time. Additional tools and assessments are needed for longitudinal monitoring of cognitive changes.
A nurse is assessing a patient's hydration status. Which of the following findings would suggest dehydration?
- A. Increased urine output
- B. Decreased heart rate
- C. Dry mucous membranes
- D. Increased blood pressure
Correct Answer: C
Rationale: The correct answer is C: Dry mucous membranes. Dry mucous membranes are a common sign of dehydration as the body lacks adequate fluid. When a person is dehydrated, there is a decrease in saliva production, leading to dryness in the mouth and throat. This can be easily observed during a physical examination by looking at the patient's lips, tongue, and inside of the mouth. On the other hand, increased urine output (choice A) is a sign of adequate hydration, decreased heart rate (choice B) can be a normal response to dehydration but is not a consistent indicator, and increased blood pressure (choice D) is not typically associated with dehydration. Therefore, dry mucous membranes are the most reliable finding to suggest dehydration in a patient.
The nurse has just started an assessment of the newborn child of a woman of Vietnamese origin. Considering the mother's cultural background, which of the following statements about this examination is true? The mother:
- A. Will be offended if the infant's fontanelles are examined.
- B. Will be offended if the infant's diaper area is touched during the examination.
- C. Would prefer to have the results of the examination communicated directly to her husband.
- D. Would prefer to receive written report about her child's growth and development, rather than a verbal one.
Correct Answer: A
Rationale: The correct answer is A because in Vietnamese culture, touching or examining the fontanelles (soft spots on a baby's head) is considered disrespectful and potentially harmful. This is due to the belief that the fontanelles are fragile and touching them can impact the baby's health. It is crucial for the nurse to respect and be sensitive to the cultural beliefs and practices of the mother to establish trust and provide culturally competent care.
Choice B is incorrect because there is no specific cultural taboo in Vietnamese culture about touching the infant's diaper area during examination. Choice C is incorrect as assuming that the husband should be the primary communicator of medical information goes against the principle of patient autonomy. Choice D is incorrect as there is no indication that Vietnamese mothers prefer written reports over verbal communication regarding their child's growth and development.
A nurse is teaching a patient with hypertension about lifestyle modifications. Which of the following dietary changes should the nurse emphasize?
- A. Increase intake of foods high in sodium.
- B. Decrease intake of saturated fats.
- C. Increase intake of processed foods.
- D. Decrease intake of fiber.
Correct Answer: B
Rationale: The correct answer is B: Decrease intake of saturated fats. Saturated fats can raise cholesterol levels, leading to increased risk of heart disease and hypertension. Decreasing intake of saturated fats can help lower blood pressure.
Incorrect choices:
A: Increasing intake of foods high in sodium can worsen hypertension by increasing blood pressure.
C: Increasing intake of processed foods often leads to higher sodium and saturated fat intake, worsening hypertension.
D: Decreasing intake of fiber is not ideal as fiber helps in maintaining a healthy weight and managing blood pressure.
A nurse is assessing a patient who is experiencing shortness of breath and a cough that produces thick, green sputum. Which of the following conditions should the nurse be most concerned about?
- A. Asthma.
- B. Bronchitis.
- C. Pneumonia.
- D. Pulmonary embolism.
Correct Answer: C
Rationale: The correct answer is C: Pneumonia. The patient's symptoms of shortness of breath and cough with thick, green sputum suggest an acute infection in the lungs. Pneumonia is characterized by inflammation and infection of the lung tissue, leading to symptoms such as productive cough, shortness of breath, and sputum production. It is a serious condition that requires prompt treatment with antibiotics.
A: Asthma typically presents with wheezing, chest tightness, and shortness of breath triggered by certain stimuli, but not usually with thick, green sputum.
B: Bronchitis is inflammation of the bronchial tubes, characterized by cough with clear or slightly discolored sputum, not typically thick and green.
D: Pulmonary embolism is a blockage in the arteries of the lungs, causing sudden shortness of breath and chest pain, but not usually associated with green sputum production.