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A patient who has been diagnosed with vasospastic disorder (Raynaud's disease) complains of cold and stiffness in the fingers. Which of the following descriptions is most likely to fit the patient?
- A. An adolescent male
- B. An elderly woman
- C. A young woman
- D. An elderly man
Correct Answer: C
Rationale: The correct answer is 'A young woman.' Raynaud's disease is most common in young women and is often associated with rheumatologic disorders like lupus and rheumatoid arthritis. This disorder involves vasospasm of the arteries, leading to reduced blood flow to the fingers and toes. Typically, Raynaud's affects the fingers, and in some cases, it can affect the toes. Only rarely does it involve other body parts such as the nose, ears, nipples, and lips. Choices B, C, and D are less likely as Raynaud's disease predominantly affects young women, although it can occur in other demographic groups as well.
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While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child's developmental needs?
- A. "I want to protect my child from any falls."?
- B. "I will set limits on exploring the house."?
- C. "I understand the need to use those new skills."?
- D. "I intend to keep control over our child."?
Correct Answer: C
Rationale: The correct answer is: "I understand the need to use those new skills."? This response indicates that the mother recognizes the importance of allowing the toddler to practice and develop new skills, supporting autonomy and exploration. Setting limits, protecting from falls, and intending to keep control go against the toddler's developmental needs. Toddlers at this stage require opportunities to explore, practice new skills, and gain independence to foster healthy development.
You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key item should NOT be included in the teaching plan?
- A. Avoid foods that contain tyramine, such as alcohol and aged cheese.
- B. Avoid drugs such as Tagamet, nitroglycerin, and Nifedipine.
- C. Continue taking estrogen as prescribed by your physician.
- D. A potential side effect of medications is rebound headache.
Correct Answer: C
Rationale: The correct answer is C: Continue taking estrogen as prescribed by your physician. Medications such as estrogen supplements may actually trigger a migraine headache attack. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy, and menopause, seem to trigger headaches in many women. Choices A and B are important to include in the teaching plan for a patient with migraines as avoiding foods containing tyramine and certain drugs can help prevent migraine triggers. Choice D is also relevant as it is essential for the patient to be aware of potential side effects of medications, including rebound headaches.
A client is admitted to a nursing unit with a remittent fever. Which statement best describes this pattern of fever?
- A. A fever that spikes and then lowers without returning to normal
- B. A fever that lasts 2 days followed by normal temperature for 2 days, followed by fever again
- C. A fever that lasts 2 days followed by normal temperature for 12 hours, followed by fever again
- D. A persistent fever that has lasted over 24 hours
Correct Answer: A
Rationale: A remittent fever is characterized by temperature fluctuations where the fever spikes and then lowers but does not return to normal temperature. Option A best describes this pattern of fever. Option B describes a pattern of fever known as a biphasic fever, where the fever alternates between days of fever and normal temperature. Option C describes a pattern of fever that is more indicative of an intermittent fever, where the fever lasts for a specific duration followed by an interval of normal temperature. Option D does not accurately describe a remittent fever, as it suggests a persistent fever that has lasted over 24 hours, which is not specific to the remittent pattern.
A nursing student is teaching a patient and family about epilepsy prior to the patient's discharge. For which statement should you intervene?
- A. "You should avoid consumption of all forms of alcohol."?
- B. "Wear your medical alert bracelet at all times."?
- C. "Protect your loved one's airway during a seizure."?
- D. "It's important to consult with your physician before taking over-the-counter medications."?
Correct Answer: D
Rationale: The correct answer is, "It's important to consult with your physician before taking over-the-counter medications."? Patients with epilepsy should not take over-the-counter medications without medical advice due to potential interactions with antiepileptic drugs or triggering seizures. Choices A, B, and C are all appropriate statements for a patient with epilepsy, focusing on alcohol avoidance, wearing a medical alert bracelet, and airway protection during a seizure, respectively. Choice D is incorrect because patients with epilepsy need to be cautious about medications due to possible interactions or adverse effects, so consulting with a physician is crucial before taking over-the-counter medications.
The client has a long leg cast. During discharge teaching about appropriate exercises for the affected extremity, the nurse should recommend:
- A. Isometric
- B. Range of motion
- C. Aerobic
- D. Isotonic
Correct Answer: D
Rationale: The nurse should recommend isometric exercises for the muscles of the casted extremity. Isometric exercises involve contracting and relaxing muscles without moving the affected part. This type of exercise helps maintain muscle strength without moving the joint, which is important for clients with immobilized extremities. Range of motion exercises involve moving the joint through its full range of motion, which may not be suitable for a client with a long leg cast. Aerobic exercises focus on increasing cardiovascular endurance and may not be appropriate for a client with a casted extremity. Isotonic exercises involve muscle contractions with movement, which may not be safe for the affected extremity in a cast.