Nokea
Here in Boston our water comes from
- A. Groundwater
- B. The Charles River
- C. Marlborough
- D. The Quabbin Reservoir
Correct Answer: D
Rationale: Boston's primary water source is the Quabbin Reservoir, which supplies clean water to the metropolitan area.
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A patient with borderline personality disorder has cut her wrists. The physician orders daily dressing changes for the lacerations. The nurse performing this care should:
- A. encourage the patient to vent anger and aggression.
- B. provide care in a matter-of-fact manner
- C. be kindly, sympathetic, and concerned.
- D. offer to listen to the patient's feelings about cutting.
Correct Answer: B
Rationale: The correct answer is B: provide care in a matter-of-fact manner. This approach is important in treating patients with borderline personality disorder as it helps maintain boundaries and consistency, which are crucial for managing their condition. By being matter-of-fact, the nurse can prevent potential manipulation or reinforcement of maladaptive behaviors. Encouraging the patient to vent anger (choice A) may escalate the situation. Being overly sympathetic (choice C) can blur professional boundaries. Offering to listen to feelings (choice D) may reinforce the behavior and not address the underlying issues effectively.
At what age do the synaptic connections in human brain peak?
- A. At birth
- B. End of 3 years
- C. 5 years
- D. 8 years
Correct Answer: B
Rationale: Synaptic connections peak around the end of 3 years (B), a period of rapid synaptogenesis and neural plasticity, followed by pruning. At birth (A), development begins, while 5 (C) and 8 years (D) see continued growth but past the peak, per neurodevelopmental research.
A patient with anorexia nervosa is being treated with refeeding. Which complication should the nurse monitor for during this phase?
- A. Hyperkalemia and hyperglycemia.
- B. Hypophosphatemia and cardiac arrhythmias.
- C. Increased appetite and food cravings.
- D. Dehydration and hypotension.
Correct Answer: B
Rationale: The correct answer is B: Hypophosphatemia and cardiac arrhythmias. During refeeding in anorexia nervosa, there is a risk of rapid shifts in electrolytes, particularly phosphorus, leading to hypophosphatemia which can cause cardiac arrhythmias. This is a critical complication that the nurse should monitor for. Hyperkalemia and hyperglycemia (choice A) are less common in refeeding syndrome. Increased appetite and food cravings (choice C) are expected outcomes of refeeding, not complications. Dehydration and hypotension (choice D) are potential issues but are not specific to refeeding in anorexia nervosa.
A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 g sodium diet, restraint as needed, limit fluids to 1800 mL daily, continue antihypertensive medication, milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should
- A. question the fluid restriction.
- B. question the order for restraint.
- C. transcribe the prescriptions as written.
- D. assess the resident's bowel elimination.
Correct Answer: B
Rationale: The correct answer is B: question the order for restraint. Restraints should only be used as a last resort due to the potential risks and ethical considerations. In this scenario, the prescription of restraint seems unnecessary and should be questioned to ensure the resident's safety and well-being. The other choices are incorrect because questioning the fluid restriction (A) is not necessary as it aligns with the resident's needs, transcribing the prescriptions as written (C) would be inappropriate without considering the necessity of each order, and assessing the resident's bowel elimination (D) is important but not the immediate concern indicated by the order for restraint.
A community health nurse visits an elderly person whose spouse died 6 months ago. Two vodka bottles are in the trash. When the nurse asks about alcohol use, this person says, 'I get lonely and drink a little to help me forget.' Select the nurses most therapeutic intervention.
- A. Assess whether this patient is drinking and driving
- B. Advise the person not to drink alone because the risks for injury increase
- C. Teach the person about risks for alcoholism and suggest other coping strategies
- D. Arrange for the person to attend an Alcoholics Anonymous meeting for older adults
Correct Answer: D
Rationale: This person needs help with alcohol abuse as well as social involvement. An AA meeting for older adults will provide an opportunity for peer bonding as well as strategies for coping with stress without abusing alcohol. The distracters will not be therapeutic in this instance.