Nokea
Recurrent abdominal pain (RAP) is most often seen in school-age or adolescent children. The nurse should assess closely for what potential problem?
- A. Physical problems
- B. Relational problems
- C. Eating disorders
- D. Emotional problems
Correct Answer: D
Rationale: The correct answer is D: 'Emotional problems.' Recurrent abdominal pain (RAP) in children is frequently associated with emotional factors rather than physical issues, relational problems, or eating disorders. Children may manifest emotional distress through physical symptoms like abdominal pain, making it crucial for nurses to assess for emotional problems as a potential cause.
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A male client with heart failure calls the clinic and reports that he cannot put his shoes on because they are too tight. Which additional information should the nurse obtain?
- A. What time he took his medication?
- B. Has his weight changed in the last several days?
- C. Is he still able to tighten his belt buckle?
- D. How many hours he slept last night?
Correct Answer: B
Rationale: The correct answer is B: 'Has his weight changed in the last several days?' Sudden weight gain can indicate fluid retention, which is a common symptom of worsening heart failure. The inability to put on tight shoes can be due to fluid retention leading to swelling in the feet and ankles. Choices A, C, and D do not directly address the potential fluid retention issue and are less relevant in this scenario.
Which type of lipoprotein is associated with decreasing the risk of atherosclerosis?
- A. High-density lipoprotein (HDL)
- B. Low-density lipoprotein (LDL)
- C. Very low-density lipoprotein (VLDL)
- D. Intermediate-density lipoprotein (IDL)
Correct Answer: A
Rationale: The correct answer is High-density lipoprotein (HDL). HDL is known as 'good' cholesterol because it helps remove cholesterol from the arteries, reducing the risk of atherosclerosis. LDL (choice B) is considered 'bad' cholesterol as it can deposit cholesterol in the arteries, increasing the risk of atherosclerosis. VLDL (choice C) and IDL (choice D) are also associated with increased risk of atherosclerosis rather than decreasing it.
A client who is newly diagnosed with emphysema is being prepared for discharge. Which instruction is best for the nurse to provide the client to assist them with dyspnea self-management?
- A. Allow additional time to complete physical activities to reduce oxygen demand.
- B. Practice inhaling through the nose and exhaling slowly through pursed lips.
- C. Use a humidifier to increase home air quality humidity between 30-50%.
- D. Strengthen abdominal muscles by alternating leg raises during exhalation.
Correct Answer: B
Rationale: The correct answer is B. Instructing the client to practice inhaling through the nose and exhaling slowly through pursed lips can help improve oxygenation and reduce dyspnea. This technique, known as pursed lip breathing, can help regulate breathing patterns and decrease the work of breathing in clients with emphysema. Choice A is incorrect because allowing additional time for physical activities does not directly address dyspnea management. Choice C is incorrect as using a humidifier, although beneficial for respiratory conditions, does not specifically assist with dyspnea self-management. Choice D is also incorrect as strengthening abdominal muscles through leg raises does not directly target dyspnea relief.
The settings on a client's synchronized intermittent mandatory ventilation (SIMV) are respiratory rate 12 breaths/minute, tidal volume at 600 mL, FiO2 35%, and positive end-expiratory pressure (PEEP) 5 cm H2O. Which assessment finding necessitates immediate intervention by the nurse?
- A. Bilateral crackles in the lung bases.
- B. Low-pressure indicator alarm.
- C. Oxygen saturation of 91%.
- D. Respiratory rate of 18 breaths/minute.
Correct Answer: B
Rationale: A low-pressure alarm may indicate a disconnection or leak in the system, which needs immediate intervention. Bilateral crackles in the lung bases may indicate fluid overload but do not require immediate intervention in this case. An oxygen saturation of 91% is concerning but not as urgent as a potential equipment issue. A respiratory rate of 18 breaths/minute is higher than the set rate but may not necessitate immediate intervention unless accompanied by other distress symptoms.
A client with cirrhosis is receiving lactulose. What is the desired effect of this medication?
- A. Decrease blood glucose levels
- B. Reduce serum ammonia levels
- C. Increase platelet count
- D. Lower serum bilirubin levels
Correct Answer: B
Rationale: The correct answer is B: Reduce serum ammonia levels. Lactulose is used to reduce serum ammonia levels in clients with cirrhosis, helping to prevent hepatic encephalopathy. Lactulose works by acidifying the colon, trapping ammonia for excretion. Decreasing blood glucose levels (choice A) is not the primary effect of lactulose. Increasing platelet count (choice C) and lowering serum bilirubin levels (choice D) are not direct effects of lactulose in the management of cirrhosis.