Nokea
Polyhydramnios means amniotic fluid volume more than:
- A. 1000 ml
- B. 1500 ml
- C. 2000 ml
- D. 2500 ml
Correct Answer: C
Rationale: Polyhydramnios is excess amniotic fluid, complicating pregnancy. Normal volume at term is 500-1000 ml. Polyhydramnios is diagnosed above 2000 ml (choice C) via ultrasound (amniotic fluid index >24 cm), often due to fetal anomalies (e.g., esophageal atresia) or maternal diabetes. 1000 ml (choice A) is normal, 1500 ml (choice B) is borderline, and 2500 ml (choice D) exceeds typical thresholds but isn't the standard cutoff. C is correct, per obstetric guidelines. Nurses monitor for preterm labor or distress, supporting maternal-fetal care.
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A client with a new diagnosis of hypothyroidism is being taught about medication management. Which of the following statements should the nurse include in the teaching?
- A. You should take your medication with a high-fiber meal.
- B. You should take your medication on an empty stomach.
- C. You should take your medication with a calcium supplement.
- D. You should take your medication before bedtime.
Correct Answer: B
Rationale: The correct answer is B: 'You should take your medication on an empty stomach.' When educating a client with hypothyroidism, it is essential to advise taking thyroid medication on an empty stomach to enhance absorption and effectiveness. Taking the medication with food, especially high-fiber or with supplements like calcium, can interfere with absorption and reduce its efficacy. Therefore, it is crucial for the client to follow the recommendation of taking the medication on an empty stomach. Choices A, C, and D are incorrect because taking the medication with a high-fiber meal (Choice A) or with a calcium supplement (Choice C) can hinder absorption, and taking it before bedtime (Choice D) does not optimize absorption compared to taking it on an empty stomach.
Skin breaks, abrasion, blister, or shallow crater, edema, and infection are characteristics of
- A. Stage I pressure ulcer
- B. Stage II pressure ulcer
- C. Stage III pressure ulcer
- D. Stage IV pressure ulcer
Correct Answer: B
Rationale: Stage II pressure ulcers involve partial-thickness skin loss, presenting as abrasions, blisters, or shallow craters, often with edema or infection if untreated. Stage I shows non-blanchable redness, Stage III extends to subcutaneous tissue, and Stage IV reaches muscle or bone. Nurses assess these signs to stage ulcers accurately, guiding interventions like pressure relief or wound care, preventing progression and promoting healing in at-risk patients.
During a Romberg test, the nurse asks the patient to assume which position?
- A. Sitting
- B. Standing
- C. Genupectoral
- D. Trendelenburg
Correct Answer: B
Rationale: The Romberg test assesses balance while standing with eyes open and closed.
Which of the following is TRUE about the mechanism of action of the Aortic and Carotid bodies?
- A. If the BP is elevated, the RR increases
- B. If the BP is elevated, the RR decreases
- C. Elevated BP leads to Metabolic alkalosis
- D. Low BP leads to Metabolic acidosis
Correct Answer: B
Rationale: Aortic and carotid bodies, chemoreceptors, slow respiration when BP rises e.g., baroreceptors signal reduced need for O2 delivery. Increased RR (hypoxia), alkalosis (pH), or acidosis (metabolic) misalign. Nurses note this e.g., in hypertension for respiratory adjustments, per cardiovascular interplay.
Which of the following statements best describes a wellness nursing diagnosis for an individual, family, or community?
- A. clinical judgment of transition to a higher level of wellness
- B. nursing judgment that in some area no pathology exists
- C. a judgment that in some area there is more wellness than illness
- D. statement of an area of family strength to use in interventions
Correct Answer: A
Rationale: A wellness nursing diagnosis best describes a clinical judgment of transitioning to a higher wellness level, focusing on enhancing health beyond mere absence of disease. Unlike pathology-based diagnoses, it identifies potential for growth like improving nutrition in a healthy client reflecting nursing's preventive role. Judging no pathology or more wellness than illness is narrower, missing the forward-looking aspect, while family strengths support interventions but aren't the diagnosis. This perspective encourages proactive care, aligning with wellness models to elevate client health.