A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition?
- A. Memory loss as a natural consequence of aging
- B. Difficulty coping with physical and psychological changes
- C. Severe cognitive impairment that occurs rapidly
- D. Loss of cognitive abilities, impairing the ability to perform activities of daily living
Correct Answer: D
Rationale: The correct answer is D. Dementia is characterized by a loss of cognitive abilities that impairs the individual's capacity to perform activities of daily living. Choice A is incorrect because dementia is not simply memory loss related to aging but involves broader cognitive deficits. Choice B is incorrect as it does not capture the comprehensive cognitive decline seen in dementia. Choice C is incorrect as dementia typically progresses gradually rather than rapidly, and it is not solely about severe cognitive impairment but also impacts daily functioning.
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Nurse Sharie is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case?
- A. Flexible role functioning between parents
- B. History of the parent having been abused as a child
- C. Single-parent home situation
- D. Presence of parental mental illness
Correct Answer: B
Rationale: The correct answer is B: 'History of the parent having been abused as a child.' Research shows that a history of being abused as a child is a significant risk factor for child abuse. This cycle of abuse can sometimes continue from one generation to the next. Choices A, C, and D are incorrect. Flexible role functioning between parents, a single-parent home situation, and the presence of parental mental illness are important factors to consider in various contexts but may not specifically indicate a higher likelihood of child abuse in this case.
A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Euthyroid sick syndrome
- D. Subclinical hyperthyroidism
Correct Answer: B
Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B).
Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism.
Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case.
Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.
Which of the following outcome criteria is appropriate for a client with dementia?
- A. The client will return to an established schedule for activities of daily living.
- B. The client will learn new coping mechanisms to handle anxiety.
- C. The client will seek out resources in the community for support.
- D. The client will follow an established schedule for activities of daily living.
Correct Answer: D
Rationale: The correct answer is D. For clients with dementia, following an established schedule for activities of daily living is appropriate as it helps maintain routine and structure, which can be beneficial for their condition. Choice A has been rephrased to align better with the context of dementia care. Choice A is incorrect as expecting a return to a previous level of self-functioning may not be realistic for clients with dementia. Choice B is not the most appropriate outcome criteria as handling anxiety, while important, may not be the primary focus when working with clients with dementia. Choice C, seeking out resources in the community for support, is also important but may not be as directly related to the day-to-day care and management of activities for a client with dementia.
Which of the following disorders is more likely to be associated with blood in the stool?
- A. Gastroesophageal reflux
- B. Crohn's disease
- C. Irritable bowel syndrome
- D. Colon cancer
Correct Answer: D
Rationale: The correct answer is D, Colon cancer. Colon cancer commonly presents with blood in the stool due to bleeding from the tumor. Gastroesophageal reflux (Choice A) is associated with heartburn and regurgitation of stomach contents into the esophagus. Crohn's disease (Choice B) is a type of inflammatory bowel disease that can cause symptoms like abdominal pain, diarrhea, and weight loss, but it does not typically present with blood in the stool as a primary symptom. Irritable bowel syndrome (Choice C) is a functional gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and changes in bowel habits, but it does not usually involve blood in the stool as a prominent feature.
Which pathophysiologic process causes the decreased glomerular filtration rate in a patient with acute glomerulonephritis?
- A. Decreased renal-induced constriction of the renal arteries
- B. Immune complex deposition, increased capillary permeability, and cellular proliferation
- C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
- D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis
Correct Answer: B
Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. In acute glomerulonephritis, immune complexes deposit in the glomerulus, leading to inflammation, increased capillary permeability, and cellular proliferation. These processes collectively reduce the glomerular filtration rate. Choices A, C, and D do not accurately describe the pathophysiologic process in acute glomerulonephritis. Decreased renal-induced constriction of the renal arteries, necrosis of nephrons due to increased kidney interstitial hydrostatic pressure, and scar tissue formation in the proximal convoluted tubule are not the primary mechanisms responsible for the decreased filtration rate in this condition.
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