Nokea
A nurse who provides care in a campus medical clinic is performing an assessment of a 21-year-old student who has presented for care. After assessment, the nurse determines that the patient has a BMI of 45. What does this indicate?
- A. The patient is a normal weight.
- B. The patient is extremely obese.
- C. The patient is overweight.
- D. The patient is mildly obese.
Correct Answer: B
Rationale: Individuals who have a BMI between 25 and 29.9 are considered overweight. Obesity is defined as a BMI of greater than 30 (WHO, 2011). A BMI of 45 would indicate extreme obesity.
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The segment Kreutzer of the population who has a BMI lower than 24 has been found to be at increased risk for poor nutritional status and its resultant problems. What else is a low BMI associated with in the community-dwelling elderly population?
- A. High risk of diabetes
- B. Increased incidence of falls
- C. Higher mortality rate
- D. Low risk of chronic disease.
Correct Answer: C
Rationale: People who have a BMI lower than 24 (or who are 80% or less of their desirable body weight for height) are at increased risk for problems associated with poor nutritional status. In addition, a low BMI is associated with a higher mortality rate among hospitalized patients and community-dwelling elderly. Low BMI is not directly linked to an increased risk for falls or diabetes. Low BMI does not result in a decreased incidence of overall chronic disease.
During a comprehensive health assessment, which of the following structures can the nurse best assess by palpation?
- A. Intestines
- B. Gall bladder
- C. Thyroid gland
- D. Pancreas
Correct Answer: C
Rationale: Many structures of the body, although not visible, may be assessed through the techniques of light and deep palpation. Examples include the superficial blood vessels, lymph nodes, thyroid gland, organs of the abdomen, pelvis, and rectum. The intestines, muscles, and pancreas cannot be assessed through palpation.
You are admitting an elderly woman who is accompanied by her husband. The husband wants to know where the information you are obtaining is going to be kept and you follow up by describing the system of electronic health records. The husband states, I sure am not comfortable with that. It is too easy for someone to break into computer records these days. What is your best response?
- A. The Institute of Medicine has called for the implementation of the computerized health record so all hospitals are doing it.
- B. Weve been doing this for several years with good success, so I can assure you that our records are very safe.
- C. This hospital is as concerned as you are about keeping our patients records private. So we take special precautions to make sure no one can break into our patients medical records.
- D. Your wifes records will be safe, because only people who work in the hospital have the credentials to access them.
Correct Answer: C
Rationale: Nurses must be sensitive to the needs of the older adults and others who may not be comfortable with computer technology. Special precautions are indeed taken. Not every hospital employee has access and referencing the IOM may not provide reassurance.
The nurse is completing a family history for a patient who is admitted for exacerbation of chronic obstructive pulmonary disease (COPD). The nurse should include questions that address which of the following health problems?
- A. Allergies
- B. Alcoholism
- C. Psoriasis
- D. Hypervitaminosis
- E. Obesity
Correct Answer: A,B,E
Rationale: In general, the following conditions are included in a family history: cancer, hypertension, heart disease, diabetes, epilepsy, mental illness, tuberculosis, kidney disease, arthritis, allergies ???¾?±?????²?µ?½?½?¾?¹, alcoholism, and obesity. Psoriasis and hypervitaminosis do not have genetic etiologies.
A nurse on a medical unit is conducting a spiritual assessment of a patient who is newly admitted. In the course of this assessment, the patient indicates that she does not eat meat. Which of the following is the most likely significance of this patients statement?
- A. The patient does not understand the principles of nutrition.
- B. This is an aspect of the patients religious practice.
- C. This constitutes a nursing diagnosis of Risk for Imbalanced Nutrition.
- D. This is an example of the patients coping strategies.
Correct Answer: B
Rationale: Because this datum was obtained during a spiritual assessment, it could be that this is an aspect of the patients religious practice. It is indeed a personal choice, but this is not the primary significance of the statement. This practice may not be related to health-seeking if it is in fact a religious practice. This does not necessarily constitute a risk for malnutrition or a misunderstanding of nutrition.