Nokea
During which step of the nursing process does the nurse analyze data related to the patient's health status?
- A. Assessment
- B. Implementation
- C. Diagnosis
- D. Evaluation
Correct Answer: A
Rationale: The correct answer is 'Assessment.' During the assessment phase of the nursing process, the nurse collects and analyzes data related to the patient's health status. This involves gathering information through various means such as patient interviews, physical examinations, and reviewing medical records. Choice B, 'Implementation,' refers to the phase where the nurse carries out the planned interventions. Choices C and D, 'Diagnosis' and 'Evaluation,' come after the assessment phase in the nursing process.
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Which food provides a 1-ounce serving of grains for a preschool child?
- A. 1 cup of ready-to-eat cereal flakes
- B. 1â„2 slice of whole wheat bread
- C. 1â„2 of a 6-inch flour tortilla
- D. 1 cup of cooked rice
Correct Answer: A
Rationale: The correct answer is A: 1 cup of ready-to-eat cereal flakes. For a preschool child, 1 cup of ready-to-eat cereal flakes provides a 1-ounce serving of grains, meeting the requirement. Choice B, 1â„2 slice of whole wheat bread, is not the correct answer as it does not constitute a 1-ounce serving of grains. Similarly, choice C, 1â„2 of a 6-inch flour tortilla, does not offer a 1-ounce serving of grains. Choice D, 1 cup of cooked rice, also does not provide a 1-ounce serving of grains for a preschool child, making it an incorrect choice.
In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:
- A. 24 hours
- B. 36 hours
- C. 48 hours
- D. 12 hours
Correct Answer: B
Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.
What is a common symptom of vitamin D deficiency?
- A. Hair loss
- B. Night blindness
- C. Bone pain
- D. Rashes
Correct Answer: C
Rationale: The correct answer is C: Bone pain. Vitamin D deficiency often leads to bone pain and weakness as it plays a crucial role in maintaining bone health by aiding in the absorption of calcium. Hair loss (choice A) is not a common symptom of vitamin D deficiency. Night blindness (choice B) is typically associated with vitamin A deficiency, not vitamin D deficiency. Rashes (choice D) are not a common symptom of vitamin D deficiency.
After cleaning the abrasions and applying antiseptic, the nurse applies a cold compress to the swollen ankle as ordered by the physician. This statement shows that the nurse has a correct understanding of the use of a cold compress:
- A. Cold compress reduces blood viscosity in the affected area
- B. It is safer to apply than a hot compress
- C. Cold compress prevents edema and reduces pain
- D. It eliminates toxic waste products due to vasodilation
Correct Answer: C
Rationale: The correct understanding of using a cold compress includes knowing that it helps prevent edema and reduces pain. Cold application constricts blood vessels, reducing blood flow to the area, which helps decrease swelling and pain. Choices A, B, and D are incorrect because cold compresses do not directly affect blood viscosity, safety compared to hot compresses, or eliminate toxic waste products due to vasodilation. It is essential for nurses to have a clear understanding of the rationale behind interventions to provide effective patient care.
To prevent baby bottle tooth decay, what should the nurse instruct?
- A. Water
- B. Milk
- C. Iron-fortified formula
- D. Unsweetened fruit juice
Correct Answer: A
Rationale: The correct answer is A: Water. Water is the best choice to prevent baby bottle tooth decay as it does not cause tooth decay and is a good option for bedtime bottles. Milk (choice B) and iron-fortified formula (choice C) contain sugars that can contribute to tooth decay. Unsweetened fruit juice (choice D) also contains natural sugars that can be harmful to the baby's teeth.