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Austin, age 6 months, has six teeth. How should the nurse interpret this finding?
- A. Normal tooth eruption
- B. Delayed tooth eruption
- C. Unusual and dangerous
- D. Earlier-than-normal tooth eruption
Correct Answer: A
Rationale: The eruption of teeth in infants typically begins around 6 months of age, with the lower central incisors being the first to appear. Having six teeth at 6 months old is within the normal range of tooth eruption for infants. The average time frame for infants to have their first teeth is between 4 to 7 months, so Austin's situation falls within that range. There is no cause for concern or interpretation of the finding as unusual or dangerous in this scenario.
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A client is undergoing a diagnostic work-up for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:
- A. Testosterone therapy during childhood
- B. Early onset of puberty
- C. Sexually transmitted disease
- D. Cryptorchidism
Correct Answer: D
Rationale: Cryptorchidism, also known as undescended testicle, is a known risk factor for testicular cancer. Men who had cryptorchidism, a condition where one or both testicles fail to descend into the scrotum before birth, have a higher risk of developing testicular cancer compared to those without this condition. The abnormal positioning of the testicle outside the scrotum may disrupt normal testicular development and increase the likelihood of malignant transformation. Therefore, clients with a history of cryptorchidism are at increased risk for testicular cancer and warrant close monitoring and follow-up.
A patient has been prescribed bumetanide (Bumex) every morning for control of hypertension. Which of the ff. statements indicates correct knowledge of the treatment regimen?
- A. "I can travel to Florida and sunbathe all day."
- B. "Now I can eat whatever I want, whenever I want."
- C. "I'll take my medication in the morning, every morning."
- D. "I won't need medication once my pressure goes down."
Correct Answer: C
Rationale: The correct statement indicating the patient has a good understanding of the treatment regimen is statement C: "I'll take my medication in the morning, every morning." This statement shows that the patient acknowledges the importance of taking their prescribed bumetanide (Bumex) every morning as directed. Consistency in taking the medication as prescribed is crucial for the effective control of hypertension. Statements A and B are unrelated to the treatment regimen and do not address medication adherence. Statement D reflects a misconception that medication can be stopped once blood pressure decreases, which is inaccurate and potentially harmful.
Which action by the nurse demonstrates use of evidence-based practice (EBP)?
- A. Gathering equipment for a procedure
- B. Documenting changes in a patient's status
- C. Questioning the use of daily central line dressing changes
- D. Clarifying a physician's prescription for morphine
Correct Answer: C
Rationale: Questioning the use of daily central line dressing changes demonstrates the use of evidence-based practice (EBP) by the nurse. In EBP, decisions about patient care should be informed by the best available evidence, clinical expertise, and patient preferences. By questioning the necessity of daily dressing changes for central lines, the nurse is seeking to ensure that the care provided is based on sound evidence and best practices rather than simply following routine procedures. This critical thinking and questioning approach aligns with the principles of evidence-based practice.
Angie is an adolescent who has seizure disorder; which of the following would not be a focus of a teaching program?
- A. Ability to obtain a driver's license
- B. Drug and alcohol abuse
- C. Increased risk of infections
- D. Peer pressure
Correct Answer: A
Rationale: The correct answer is A, ability to obtain a driver's license. This would not be a focus of a teaching program for Angie with a seizure disorder since individuals with uncontrolled seizures are typically not allowed to have a driver's license due to safety concerns. It is important for Angie to understand the risks and consequences of drug and alcohol abuse, the increased risk of infections, and how to handle peer pressure effectively in relation to her condition. These topics are more relevant to managing her health and well-being with a seizure disorder.
Which of the following intravenous solutions is hypotonic?
- A. Normal saline
- B. Ringer's lactate
- C. 0.45% saline
- D. 5% dextrose in normal saline  A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET F
Correct Answer: C
Rationale: A hypotonic solution has a lower concentration of solutes compared to the cells in the body. 0.45% saline is hypotonic because it has a lower concentration of sodium chloride compared to the normal extracellular fluid in the body. When this solution is administered intravenously, water will move into the cells to balance the concentration gradient, potentially causing cellular swelling. A hypotonic solution is used to rehydrate cells in cases of hypernatremia or dehydration with cellular dehydration.