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In the elderly, administering medication is a great concern for the nurse since these patients are more prone to side effects. The primary cause of this is:
- A. Altered circulation and renal function
- B. Accelerated gastrointestinal system
- C. Enlarged Lymph nodes
- D. Musculoskeletal system weakness
Correct Answer: A
Rationale: The elderly are more likely to have side effects when there is altered metabolism through the kidneys and liver as well as altered circulatory function (A), unlike the other options (B, C, D) which are less relevant.
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Which nursing diagnosis is likely to apply to an individual diagnosed with a serious mental illness who is homeless?
- A. Insomnia
- B. Substance abuse
- C. Chronic low self-esteem
- D. Impaired environmental interpretation syndrome
Correct Answer: C
Rationale: Many individuals with serious mental illness do not live with their families and become homeless. Life on the street or in a shelter has a negative influence on the individuals self-esteem, making this nursing diagnosis one that should be considered. Substance abuse is not an approved NANDA-International diagnosis. Insomnia may be noted in some patients but is not a universal problem. Impaired environmental interpretation syndrome refers to persistent disorientation, which is not seen in a majority of the homeless.
An individual brought by ambulance to the emergency room is accompanied by a roommate. The patient fights against the restraints and shouts incoherently. The roommate reports that the patient was weak and confused on awakening this morning and about 3 hours ago began "rambling and talking crazy."Â A nurse notes that the patient's skin is flushed and dry. The priority nursing action is to:
- A. take the patient's vital signs.
- B. start intravenous fluids.
- C. administer a sedative.
- D. perform a mental status examination.
Correct Answer: A
Rationale: The correct answer is A: take the patient's vital signs. This is the priority action because the patient is exhibiting signs of potential medical emergency, such as altered mental status, flushed and dry skin, and confusion. Vital signs can provide crucial information about the patient's condition and help determine the urgency of the situation. Starting intravenous fluids (B) may be necessary but should be based on the assessment of vital signs first. Administering a sedative (C) is not appropriate without knowing the underlying cause of the symptoms. Performing a mental status examination (D) is important but not the priority in this situation where the patient's physical condition needs immediate attention.
What is the correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors?
- A. Observe for parotid gland enlargement and dehydration.
- B. Assess for fluid retention and leg swelling.
- C. Perform regular weight checks to assess for weight loss.
- D. Evaluate for signs of hyperactivity and poor sleep.
Correct Answer: A
Rationale: The correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors is to observe for parotid gland enlargement and dehydration. Parotid gland enlargement is a common physical manifestation due to repeated vomiting, and dehydration can result from purging behaviors. This assessment is crucial in monitoring the patient's physical health and identifying potential complications. Assessing for fluid retention and leg swelling (Choice B) is more typical in conditions like heart failure. Performing weight checks (Choice C) may not accurately reflect the patient's health status due to fluid shifts. Evaluating for signs of hyperactivity and poor sleep (Choice D) are not directly related to the immediate physical consequences of purging behaviors.
A 19-year-old woman, prescribed a triphasic oral contraceptive for the first time one month ago, complains of frequent spotting. Which one of the following is the most appropriate management?
- A. Increase the dose of oestrogen.
- B. Increase the dose of progestogen.
- C. Advise alternative contraception.
- D. Continue the medication and review in two months.
Correct Answer: D
Rationale: Spotting is common in the first few months of oral contraceptives as the body adjusts. Continuing the medication and reviewing later (D) is standard, rather than immediate dose changes (A, B), switching methods (C, E) without trial.
Which of the following is a common complication of anorexia nervosa?
- A. Hypertension and hyperglycemia.
- B. Cardiovascular instability and electrolyte imbalances.
- C. Insulin resistance and excessive weight gain.
- D. Severe dehydration and frequent urination.
Correct Answer: B
Rationale: The correct answer is B: Cardiovascular instability and electrolyte imbalances. Anorexia nervosa can lead to severe malnutrition, causing cardiovascular issues like low heart rate and blood pressure. Electrolyte imbalances occur due to inadequate nutrient intake. Hypertension and hyperglycemia (choice A) are not common in anorexia. Insulin resistance and weight gain (choice C) are more associated with conditions like obesity. Severe dehydration and frequent urination (choice D) are not typical manifestations of anorexia.