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In an individual with Sjogren's syndrome, nursing care should focus on:
- A. Moisture replacement
- B. Nutritional supplementation
- C. Electrolyte balance
- D. Arrhythmia management
Correct Answer: A
Rationale: Sjogren's syndrome is an autoimmune disorder characterized by dryness of the eyes and mouth due to the destruction of moisture-producing glands. Nursing care for individuals with Sjogren's syndrome should focus on addressing the symptoms related to dryness. Moisture replacement is key in managing dry eyes and dry mouth, which can improve the patient's comfort and quality of life. Strategies for moisture replacement may include the use of artificial tears, saliva substitutes, and humidifiers to maintain adequate hydration and alleviate dryness. Nutritional supplementation, electrolyte balance, and arrhythmia management are not typically the primary focus of nursing care in individuals with Sjogren's syndrome.
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Which screening test for colorectal cancer should the nurse recommend?
- A. Carcinoembryonic antigen (CEA) test
- B. Annual digital examination after age 50
- C. Barium enema after age 50
- D. Proctosigmoidoscopy after age 50
Correct Answer: D
Rationale: The nurse should recommend a proctosigmoidoscopy for colorectal cancer screening in individuals over the age of 50. This procedure allows for the visualization of the lower part of the colon and rectum, which are common sites for precancerous and cancerous lesions to develop. Proctosigmoidoscopy can help identify abnormalities early on, allowing for prompt intervention and treatment. This screening method helps in detecting colorectal cancer or pre-cancerous polyps at an early stage when they are more easily treatable. Regular screening is essential for early detection and prevention of colorectal cancer. Other screening tests such as carcinoembryonic antigen (CEA) test, annual digital examination, and barium enema are not recommended as primary screening methods for colorectal cancer.
A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?
- A. Hyperkalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hypochloremia
Correct Answer: A
Rationale: The client is experiencing muscle weakness and numbness in his legs, which are symptoms commonly associated with hyperkalemia (high potassium levels). The potassium level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Hyperkalemia can lead to muscle weakness, numbness, and potentially more severe complications like cardiac arrhythmias.
A nurse is counseling parents of a child beginning to show signs of being overweight. The nurse accurately relates which body mass index (BMI)-for-age percentile indicates a risk for being overweight?
- A. 10th percentile
- B. 9th percentile
- C. 85th percentile
- D. 95th percentile
Correct Answer: D
Rationale: The body mass index (BMI)-for-age percentile indicating a risk for being overweight is the 95th percentile. This means that if a child's BMI falls at or above the 95th percentile for their age group, they are classified as overweight. This percentile is used as a cutoff point to identify children at risk of being overweight and to guide intervention strategies such as lifestyle changes, increased physical activity, and dietary modifications. Parents should work with healthcare providers to address their child's weight status and implement appropriate measures to promote a healthy lifestyle.
Discharge care planning has begun for a seriously injured patient who is Asian. The patient's parents have refused routine home health visits. The pediatric nurse understands the family may:
- A. believe that health outcomes are predetermined.
- B. feel health is a personal responsibility and maintenance of family reputation is paramount.
- C. regard health as a family responsibility, seeking outside aid only when resources are exhausted.
- D. none of the above.
Correct Answer: C
Rationale: In some cultures, families may prefer to handle health matters internally, viewing outside assistance as a last resort.
A client asks nurse Carlos the rationale for giving multi-drug treatment for tuberculosis. Which is an appropriate response?
- A. multiple drugs allow reduced levels of drugs to be given
- B. multiple drugs reduce undesirable drug side-effect
- C. multiple drugs potentiate the action fo the drugs
- D. multiple drugs reduce development of resistant strains of the bacteria
Correct Answer: D
Rationale: Giving multiple drugs for the treatment of tuberculosis is essential because it helps reduce the development of resistant strains of the bacteria. Tuberculosis is caused by Mycobacterium tuberculosis, which has the potential to develop resistance to single drug therapy through genetic mutations. The use of multiple drugs in combination therapy prevents the bacteria from developing resistance since they work through different mechanisms of action, making it harder for the bacteria to adapt and survive. This approach is known as Directly Observed Treatment, Short-course (DOTS), and it is an effective strategy recommended by the World Health Organization to combat the rising issue of drug-resistant tuberculosis.