Nokea
For which behavior(s) would limit setting be most essential?
- A. A patient clings to the nurse and asks for advice about inconsequential matters.
- B. A woman is flirtatious and provocative toward staff members of the opposite sex.
- C. An elderly man displays hypervigilance and refuses to attend unit activities.
- D. A young woman urges a suspicious patient to hit anyone who stares at him.
Correct Answer: D
Rationale: The correct answer is D because it involves a behavior that is potentially harmful and puts others at risk. Setting limits is essential to prevent violence and protect both the patient and others. A: Clinging behavior is not inherently harmful. B: Flirtatious behavior, while inappropriate, does not pose a direct threat. C: Hypervigilance and refusal to attend activities may indicate underlying issues but do not require immediate limit setting for safety.
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A priority measure to teach a client who purges is:
- A. that purging endangers one's health.
- B. that individuals who are overweight can be well-adjusted.
- C. to seek out a trusted person when feeling the need to purge.
- D. to use laxatives rather than vomiting as a way to eliminate food.
Correct Answer: C
Rationale: Rationale: Choice C is correct because seeking out a trusted person when feeling the need to purge can help the client establish a supportive and healthy coping mechanism. It encourages open communication, emotional support, and accountability. This approach addresses the underlying issues contributing to the purging behavior, fostering long-term positive change. Choices A, B, and D are incorrect as they do not directly address the need for seeking support and establishing healthier coping strategies.
An infant develops jaundice 6 hours after birth. Which one of the following is the most likely diagnosis?
- A. Haemolytic disease of the newborn.
- B. Umbilical sepsis.
- C. Physiological jaundice.
- D. Atresia of the bile ducts.
Correct Answer: A
Rationale: Jaundice within 24 hours of birth is pathological, often due to haemolytic disease of the newborn (A), such as Rh incompatibility causing rapid red cell breakdown. Physiological jaundice (C) typically appears after 24 hours, while umbilical sepsis (B), bile duct atresia (D), and neonatal hepatitis (E) are less likely to cause such early onset.
A nurse and social worker co-lead a reminiscence group for eight elite-old adults. Which activity is appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in todays newspaper
Correct Answer: B
Rationale: Elite-old adults (100+ years) were young during World War II. Singing a song from that era (B) aligns with reminiscence therapy by sharing relevant past memories. Other options (A, C, D) are less tied to their life experiences.
Hearing voices that are not really there would be called a(n)
- A. hallucination
- B. delusion
- C. auditory regression
- D. depressive psychosis
Correct Answer: A
Rationale: Hallucinations involve perceiving stimuli (e.g., voices) that aren't present, unlike delusions (beliefs).
According to the map showing deaths resulting from poor air quality worldwide, which regions of the world have the poorest air quality?
- A. Brazil
- B. China
- C. Canada
- D. Australia
Correct Answer: B
Rationale: China has some of the poorest air quality globally due to industrial pollution and urbanization, as shown in air quality death maps.