A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention?
- A. Hypertension
- B. Peripheral edema
- C. Tachycardia and other dysrhythmias
- D. Increased blood urea nitrogen (BUN)
Correct Answer: D
Rationale: Chronic urinary retention can lead to an elevated blood urea nitrogen (BUN) level due to impaired kidney function. When urine is not effectively eliminated from the body, waste products, including urea, accumulate in the bloodstream. This can result in an increase in BUN levels, indicating potential kidney dysfunction in the setting of chronic urinary retention. Hypertension (Choice A), peripheral edema (Choice B), and tachycardia and other dysrhythmias (Choice C) are not specifically associated with chronic urinary retention but may be related to other conditions or comorbidities.
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A patient has informed the home health nurse that she has recently noticed distortions when she looks at the Amsler grid that she has mounted on her refrigerator. What is the nurses most appropriate action?
- A. Reassure the patient that this is an age-related change in vision.
- B. Arrange for the patient to have her visual acuity assessed.
- C. Arrange for the patient to be assessed for macular degeneration.
- D. Facilitate tonometry testing.
Correct Answer: C
Rationale: The most appropriate action for the home health nurse to take in this situation where a patient reports distortions when looking at an Amsler grid is to arrange for the patient to be assessed for macular degeneration. Distortions in straight lines on an Amsler grid are a common early symptom of macular degeneration, a progressive eye condition that affects central vision. Macular degeneration is a leading cause of vision loss in older adults, making assessment and early intervention crucial in preserving vision. It is important for the nurse to take the patient's symptoms seriously and facilitate timely evaluation and management to prevent further vision loss. This would involve referring the patient to an ophthalmologist or an eye care specialist for a comprehensive evaluation and appropriate treatment.
A hospitalized patient with impaired vision must get a picture in his or her mind of the hospital room and its contents in order to mobilize independently and safely. What must the nurse monitor in the patients room?
- A. That a commode is always available at the bedside
- B. That all furniture remains in the same position
- C. That visitors do not leave items on the bedside table
- D. That the patients slippers stay under the bed
Correct Answer: B
Rationale: It is crucial for the nurse to monitor that all furniture remains in the same position in the hospitalized patient's room. For a patient with impaired vision who needs to create a mental picture of the room to mobilize independently and safely, any changes in the position of furniture can disrupt this mental map and potentially lead to accidents or falls. By ensuring that all furniture remains unchanged, the nurse supports the patient's ability to navigate the room confidently and without obstacles. This monitoring helps promote the patient's safety and independence during their stay in the hospital.
A nurse is discussing the advantages of a nursingclinical information system. Which advantage should the nurse describe?
- A. Varied clinical databases
- B. Reduced errors of omission
- C. Increased hospital costs
- D. More time to read charts
Correct Answer: B
Rationale: One of the key advantages associated with a nursing clinical information system is the reduction of errors of omission. By using an electronic system that prompts for required data entry and ensures completeness of documentation, nurses are less likely to miss important information, leading to improved patient care and safety. This advantage helps in promoting efficient communication among healthcare providers and contributes to better decision-making processes.
Which of the following individuals would be the most appropriate candidate for immunotherapy?
- A. A patient who had an anaphylactic reaction to an insect sting
- B. A child with allergies to eggs and dairy
- C. A patient who has had a positive tuberculin skin test
- D. A patient with severe allergies to grass and tree pollen
Correct Answer: D
Rationale: Immunotherapy, also known as allergy shots, is a form of treatment that can help reduce symptoms for individuals with severe allergies to substances such as pollen, dust mites, or pet dander. This treatment involves exposing the patient to small, increasing doses of the allergen over time to help the immune system gradually build up a tolerance. Patients with severe allergies to grass and tree pollen would most likely benefit from immunotherapy as it can help reduce their allergy symptoms and improve their quality of life. On the other hand, individuals with anaphylactic reactions to insect stings (Choice A), allergies to eggs and dairy (Choice B), or a positive tuberculin skin test (Choice C) are not typically candidates for immunotherapy as their conditions are not related to the type of allergies that are commonly treated with this method.
The nurse is describing theChooseMyPlateprogramto a patient. Which statement from the patient indicates successful learning?
- A. “I can use this to make healthy lifestyle food choices.”
- B. “I can use this to count specific calories of food.”
- C. “I can use this for my baby girl.”
- D. “I can use this when I am sick.”
Correct Answer: A
Rationale: This statement indicates successful learning because it acknowledges the main purpose of the ChooseMyPlate program, which is to help individuals make healthy food choices for a balanced diet and overall lifestyle. By understanding that ChooseMyPlate can guide them in making healthier food choices rather than just counting calories or using it for specific circumstances like sickness or infant care, the patient demonstrates a good grasp of the program's intended use and benefits.
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