Nokea
Examination of a newborn in the birth room reveals bilateral cataracts. Which disease process in the maternal history would likely cause this abnormality?
- A. Rubella
- B. Cytomegalovirus (CMV)
- C. Syphilis
- D. HIV
Correct Answer: A
Rationale: The correct answer is A: Rubella. Rubella infection during pregnancy can lead to congenital rubella syndrome, which includes bilateral cataracts as a characteristic feature. Rubella virus can cross the placenta and affect the developing fetus. Cytomegalovirus (CMV) can also cause congenital cataracts, but rubella is more commonly associated with this abnormality. Syphilis can cause other congenital abnormalities but not bilateral cataracts. HIV does not typically lead to bilateral cataracts in newborns.
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A smiling patient angrily states, “I will notcough and deep breathe.” How will the nurse interpret this finding?
- A. The patient’s denotative meaning is wrong.
- B. The patient’s personal space was violated.
- C. The patient’s affect is inappropriate.
- D. The patient’s vocabulary is poor.
Correct Answer: C
Rationale: The correct answer is C because the patient's affect, which refers to their emotional expression, is inappropriate. The patient is smiling while expressing anger, which is a contradiction. This inconsistency indicates a possible underlying issue such as emotional distress or confusion. Choice A is incorrect because the issue is not about the patient's understanding of the term "cough and deep breathe." Choice B is incorrect as there is no mention of personal space violation. Choice D is incorrect as the issue is not related to the patient's vocabulary but rather their emotional expression.
A gerontologic nurse is advocating for diagnostic testing of an 81-year-old patient who is experiencing personality changes. The nurse is aware of what factor that is known to affect the diagnosis and treatment of brain tumors in older adults?
- A. The effects of brain tumors are often attributed to the cognitive effects of aging.
- B. Brain tumors in older adults do not normally produce focal effects.
- C. Older adults typically have numerous benign brain tumors by the eighth decade of life.
- D. Brain tumors cannot normally be treated in patient over age
Correct Answer: A
Rationale: The correct answer is A because the cognitive effects of aging can mimic symptoms of brain tumors in older adults, leading to misdiagnosis or delayed diagnosis. Aging can also affect the presentation, progression, and treatment outcomes of brain tumors. Option B is incorrect as brain tumors in older adults can indeed produce focal effects. Option C is incorrect as not all older adults have numerous benign brain tumors, and this is not a factor affecting the diagnosis and treatment of brain tumors in this case. Option D is incorrect as age alone does not preclude treatment for brain tumors.
A nurse is providing an educational event to a local mens group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group?
- A. Native Americans
- B. Caucasian Americans
- C. African Americans
- D. Asian Americans
Correct Answer: C
Rationale: The correct answer is C: African Americans. African American men have the highest incidence rate of prostate cancer among all ethnic groups. This is due to genetic and environmental factors, as well as disparities in access to healthcare. Native Americans (A), Caucasian Americans (B), and Asian Americans (D) have lower rates of prostate cancer compared to African Americans. It is important to educate the local men's group about this increased risk in African Americans to promote awareness and early detection.
When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?
- A. Late childbearing
- B. Human papillomavirus (HPV)
- C. Postmenopausal bleeding
- D. Tobacco use
Correct Answer: B
Rationale: The correct answer is B: Human papillomavirus (HPV). HPV is the most important risk factor for cervical cancer as it is responsible for almost all cases. Step 1: HPV infection can lead to changes in cervical cells, increasing the risk of cancer. Step 2: Early detection and vaccination against HPV can prevent cervical cancer. Step 3: Other factors like late childbearing, postmenopausal bleeding, and tobacco use may be associated with increased risk but are not as directly linked to cervical cancer development.
A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patients nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: The correct answer is B: TPN administered via a peripherally inserted central catheter. TPN provides comprehensive nutrition intravenously, bypassing the GI tract, which is important for patients unable to tolerate oral intake. A peripherally inserted central catheter allows for long-term TPN administration.
A: Administration of parenteral feeds via a peripheral IV is not ideal for long-term nutrition as it may not provide complete nutrition.
C: Insertion of an NG tube may not be feasible due to the tumor location and the patient's inability to tolerate oral intake.
D: Maintaining NPO status and IV hydration alone may lead to malnutrition over time as it does not provide adequate nutrition.