Nokea
A nurse is working with an older adult who is at risk for malnutrition. Which of the following interventions is the most appropriate?
- A. Administer high-calorie supplements.
- B. Encourage intake of a variety of foods rich in vitamins and minerals.
- C. Restrict caloric intake to prevent weight gain.
- D. Focus on protein supplements exclusively.
Correct Answer: B
Rationale: A balanced diet with a variety of foods helps ensure adequate nutrition, including vitamins and minerals, in older adults.
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During a physical examination, a patient presents with swollen lymph nodes. How should you adjust your palpation technique based on the findings?
- A. Increase the pressure to assess for tenderness
- B. Use a firmer grip to ensure you can feel the nodes
- C. Continue using soft finger pads but apply a more vigorous motion
- D. Maintain the light circular motion but focus on the areas of swelling
Correct Answer: A
Rationale: Increased pressure helps assess tenderness and the degree of swelling or possible infection in swollen lymph nodes.
An 80-year-old man is being evaluated for recent episodes of incontinence and confusion. His family states that he is usually independent with no altered mental issues but has become forgetful within the last 2 weeks. Which medication is most likely associated with these symptoms?
- A. Cimetidine (Tagamet)
- B. Warfarin (Coumadin)
- C. Ramipril (Altace)
- D. Vitamin B12
Correct Answer: A
Rationale: Cimetidine can cause confusion and altered mental status in the elderly.
Which cranial nerves are responsible for eye movement?
- A. CN II, III, IV
- B. CN III, IV, VI
- C. CN II, IV, VI
- D. CN III, IV, VII
Correct Answer: B
Rationale: Cranial nerves III, IV, and VI control eye movements.
Snellen chart evaluation indicated that the patient vision is 20/30. What is the proper description of this result?
- A. At 20 feet, this patient can see what a person with normal vision can see at 30 feet
- B. At 30 feet, this patient can see what a person with normal vision can see at 20 feet
- C. At 20 feet, this patient can see what few people can see at 30 feet
- D. This patient has sight abilities that are worse than a patient with 20/40 vision
Correct Answer: A
Rationale: 20/30 means that at 20 feet, the patient can see what someone with normal vision sees at 30 feet.
When assessing a patient's condition, which of the following scenarios would be considered critical trauma?
- A. An elderly woman has fallen and has broken her collarbone.
- B. A 32-year-old man has cut his hand with a kitchen knife.
- C. A child has sustained a fracture of his femur.
- D. A teenager has fallen from a height of greater than 20 feet.
Correct Answer: D
Rationale: A fall from a height greater than 20 feet is considered critical trauma.