Nokea
Nurse Carlos teaches a community adult class about the common symptoms of tuberculosis. Which of the following should Nurse Carlos include?
- A. weight loss
- B. dyspnea on exertion
- C. increased appetite
- D. mental status changes
Correct Answer: A
Rationale: The correct answer is A: weight loss. Weight loss is a common symptom of tuberculosis due to the impact of the infection on the body's metabolism and appetite. This symptom is important to recognize as it can be an early indicator of the disease. Dyspnea on exertion (B) is not a common symptom of tuberculosis, as it typically affects the lungs rather than causing difficulty breathing. Increased appetite (C) is not a typical symptom, as TB usually leads to decreased appetite and weight loss. Mental status changes (D) are not directly associated with tuberculosis and are more commonly seen in other conditions affecting the brain. Therefore, weight loss is the most relevant symptom to include in the teaching material for identifying possible cases of tuberculosis.
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When a neurologist asks a patient to smile, which cranial nerve is being tested?
- A. CN II
- B. CN X
- C. CN VII
- D. CN XI
Correct Answer: C
Rationale: Step-by-step rationale:
1. The cranial nerve responsible for facial expression is CN VII, the facial nerve.
2. When a neurologist asks a patient to smile, they are testing the function of CN VII.
3. CN II (optic nerve) is responsible for vision, not facial expression.
4. CN X (vagus nerve) is responsible for various functions like heart rate and digestion, not facial expression.
5. CN XI (accessory nerve) is responsible for shoulder movement, not facial expression.
Summary:
Testing a patient's ability to smile involves assessing the function of CN VII, the facial nerve. Choices A, B, and D are incorrect as they are associated with different functions and not responsible for controlling facial muscles.
Following hypophysectomy, patients require extensive teaching regarding this major alteration in their lifestyle
- A. Abnormal distribution of body hair
- B. Lifetime dependency on hormone replacement
- C. The need to drink many fluids to replace those lost
- D. The need to undergo repeat surgical procedures
Correct Answer: B
Rationale: The correct answer is B (Lifetime dependency on hormone replacement) because after hypophysectomy (removal of the pituitary gland), patients will no longer produce essential hormones like growth hormone, thyroid-stimulating hormone, etc. Therefore, they will require lifelong hormone replacement therapy to maintain normal bodily functions.
A: Abnormal distribution of body hair is not directly related to hypophysectomy.
C: While fluid intake may be important post-surgery, it is not the primary focus of teaching.
D: There is typically no need for repeat surgical procedures after a hypophysectomy, as it is a one-time surgery to address specific issues.
In summary, choice B is correct as it directly addresses the long-term implications of the surgery on hormone production and the need for replacement therapy, while the other choices are not directly relevant to the post-operative care of hypophysectomy patients.
Which points should a nurse includes in the discharge teaching plan for a client after cardiac surgery?
- A. Avoid showers and take tub bath until all incisions are healed
- B. Notify the physician if a painless lump is felt at the top of the chest incision
- C. Continue to wear support hose or elastic stockings during the night and remove them during the day
- D. Sexual relations typically can be resumed in 2-4 weeks depending on tolerance for activity
Correct Answer: B
Rationale: The correct answer is B because it addresses the importance of notifying the physician about a painless lump at the top of the chest incision, which could indicate a serious complication like a seroma or hematoma. This is crucial for early detection and intervention.
A is incorrect because showers are generally allowed after cardiac surgery as long as the incisions are kept clean and dry.
C is incorrect because support hose or elastic stockings are typically recommended to be worn during the day and removed at night to prevent swelling and promote circulation.
D is incorrect because resuming sexual relations after cardiac surgery should be based on individual recovery and should be discussed with the healthcare provider, rather than a standard timeframe.
The nurse interprets this as?
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Metabolic alkalosis
Correct Answer: C
Rationale: The nurse interprets this as respiratory alkalosis because the patient is likely experiencing hyperventilation, leading to a decrease in CO2 levels and respiratory alkalosis. This is indicated by an increase in pH and a decrease in PaCO2 on arterial blood gas analysis. Metabolic acidosis (choice B) is characterized by low pH and low bicarbonate levels, not seen in this scenario. Respiratory acidosis (choice A) is characterized by high PaCO2 levels and low pH, which is not the case here. Metabolic alkalosis (choice D) is characterized by high pH and high bicarbonate levels, which is not consistent with the patient's presentation.
. Which of the following laboratory test results would suggest to the nurse that a client has a corticotrophin- secreting pituitary adenoma?
- A. High corticotropin and low cortisol levels
- B. high corticotropin and high cortisol levels
- C. Low corticotropin and high cortisol levels
- D. Low corticotropin and low cortisol levels
Correct Answer: B
Rationale: Step-by-step rationale:
1. Corticotropin-secreting pituitary adenoma leads to excess adrenocorticotropic hormone (ACTH) production.
2. High corticotropin levels would be expected due to the adenoma's overproduction.
3. The high cortisol levels occur as a result of increased ACTH stimulating cortisol release from the adrenal glands.
4. Therefore, choice B (high corticotropin and high cortisol levels) is the correct answer.
Summary:
- Choice A is incorrect because low cortisol levels would not be expected in a client with a corticotrophin-secreting pituitary adenoma.
- Choice C is incorrect because low corticotropin levels would not align with the excessive ACTH production from the adenoma.
- Choice D is incorrect as both low corticotropin and low cortisol levels would not be consistent with the pathophysiology of a corticotrophin-secreting pituitary adenoma.