Nokea
A patient asks the nurse about taking phentermine and topiramate (Qsymia) for weight loss. To avoid side effects
- A. it is important for the nurse to determine whether the patient has a history of
- B. glaucoma.
- C. hypertension.
- D. valvular heart disease.
Correct Answer: A
Rationale: The correct answer is A because it is essential to determine if the patient has a history of certain conditions before prescribing Qsymia. This medication can worsen glaucoma (not just a history of it) making option B incorrect. Option C is incorrect because Qsymia can actually help manage hypertension. Option D is incorrect because while valvular heart disease can be a concern, it is not the primary factor to consider before prescribing this medication.
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Mucosal necrosis is an essential part of:
- A. blind loop syndrome
- B. pseudomembranous enterocolitis
- C. both
- D. neither
Correct Answer: B
Rationale: The correct answer is B: pseudomembranous enterocolitis. Mucosal necrosis is a key characteristic of pseudomembranous enterocolitis, a condition caused by Clostridium difficile infection. The bacteria release toxins that lead to inflammation and damage to the mucosal lining of the intestines, resulting in mucosal necrosis. Blind loop syndrome (choice A) does not specifically involve mucosal necrosis, while pseudomembranous enterocolitis (choice B) does. Choice C is incorrect because only pseudomembranous enterocolitis involves mucosal necrosis. Choice D is incorrect as pseudomembranous enterocolitis does involve mucosal necrosis.
A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?
- A. Epigastric discomfort
- B. Dyspepsia
- C. Constipation
- D. Hematemesis
Correct Answer: D
Rationale: The correct answer is D, Hematemesis. This is the priority finding because it indicates upper gastrointestinal bleeding, which can be life-threatening. The nurse should address this immediately to prevent further complications. Epigastric discomfort (A) and dyspepsia (B) are common symptoms of peptic ulcer disease but do not indicate active bleeding. Constipation (C) is not directly related to peptic ulcer disease and does not pose an immediate threat to the client's health.
The patient experienced a blood transfusion reaction. How should the nurse explain to the patient the cause of the hemolytic jaundice that occurred?
- A. Results from hepatocellular disease
- B. Due to a malaria parasite breaking apart red blood cells (RBCs)
- C. Results from decreased flow of bile through the liver or biliary system
- D. Due to increased breakdown of RBCs that caused elevated serum unconjugated bilirubin
Correct Answer: D
Rationale: The correct answer is D. Hemolytic jaundice in a blood transfusion reaction is due to increased breakdown of red blood cells (RBCs) causing elevated serum unconjugated bilirubin. This occurs when the patient's immune system reacts to the transfused blood, leading to destruction of RBCs. The breakdown of these cells releases hemoglobin, which is metabolized into bilirubin. This unconjugated bilirubin then accumulates in the blood, causing jaundice.
Choice A is incorrect because hepatocellular disease does not directly cause hemolytic jaundice. Choice B is incorrect as malaria parasite breaking apart RBCs leads to hemolysis, not a blood transfusion reaction. Choice C is incorrect as decreased bile flow through the liver or biliary system typically causes obstructive jaundice, not hemolytic jaundice.
In preparing a client for a colonoscopy procedure, which task is most suitable to delegate to the nursing assistant?
- A. Explain the need for clear liquids 1-3 days prior to procedure.
- B. Reinforce NPO status 8 hours prior to procedure.
- C. Administer laxatives 1-3 days prior to procedure.
- D. Administer an enema the night before the procedure.
Correct Answer: B
Rationale: Step 1: Delegation Principle - The task should be within the nursing assistant's scope of practice.
Step 2: NPO reinforcement is a basic instruction that does not require clinical judgment.
Step 3: Nursing assistant can remind the client about NPO status without interpreting medical information.
Step 4: Administering laxatives (C) and enema (D) require clinical judgment and should be done by licensed staff.
Step 5: Explaining the need for clear liquids (A) involves providing medical information, not just a reminder.
Which of these processes occurs in the mouth?
- A. ingestion
- B. mechanical digestion
- C. chemical digestion
- D. all of the above
Correct Answer: D
Rationale: In the mouth, ingestion occurs when food is taken in. Mechanical digestion occurs through chewing and mixing food with saliva. Chemical digestion begins with enzymes in saliva breaking down carbohydrates. Therefore, all processes (ingestion, mechanical digestion, and chemical digestion) occur in the mouth. Other choices are incorrect because they do not encompass all the processes that happen in the mouth.