Nokea
Select the tactile sensation that is accurately paired with its description or procedure for testing.
- A. Fine motor coordination: The use of the fingers
- B. Stereognosis: Equal hearing in both ears
- C. Two-point discrimination: The nurse gently pricks the patient's skin
- D. Gross motor function: The use of the lower limbs
Correct Answer: C
Rationale: The correct answer is C: Two-point discrimination: The nurse gently pricks the patient's skin. Two-point discrimination assesses the ability to discern two points touched simultaneously on the skin. Fine motor coordination (Choice A) refers to the precise movements of small muscles, not related to tactile sensation. Stereognosis (Choice B) is the ability to recognize objects by touch, not equal hearing in both ears. Gross motor function (Choice D) involves the coordination of large muscle groups, not specifically related to tactile sensation testing.
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A nurse is caring for a client who has cancer. The client¢â‚¬â„¢s adult child asks the nurse for information about the client¢â‚¬â„¢s treatment plan. Which of the following responses should the nurse make?
- A. I will ask your mother's primary care provider to speak with you
- B. What would you like to know about your mother's treatment?
- C. I cannot provide this information to you without your mother's consent
- D. You will have to speak directly to your mother about her treatment
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately?
- A. Generalized rash over trunk
- B. Increased temperature
- C. Decreased level of consciousness
- D. Report of photophobia
Correct Answer: C
Rationale: The correct answer is C: Decreased level of consciousness. In a client with meningitis, a decreased level of consciousness is a critical finding that should be reported immediately. This could indicate increased intracranial pressure or neurological deterioration, requiring prompt intervention. Choices A, B, and D are important in the assessment of meningitis but are not as immediately concerning as a decreased level of consciousness. A generalized rash over the trunk can be seen in meningococcal meningitis, an increased temperature is expected due to the inflammatory response, and photophobia is a common symptom due to meningeal irritation.
You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is:
- A. 8 to 12 months of age.
- B. 20 to 24 months of age.
- C. 16 to 20 months of age.
- D. 12 to 16 months of age.
Correct Answer: A
Rationale: The correct answer is A: 8 to 12 months of age. Surgical correction for a cleft palate is typically performed around this age to optimize speech development and prevent feeding difficulties. Options B, C, and D suggest later ages for surgery, which may lead to speech and feeding issues due to the delay in correction.
Select the stage of shock that is accurately paired with its characteristic.
- A. The initial stage of shock: Hyperventilation occurs and the blood pH rises.
- B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises.
- C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.
- D. The refractory stage of shock: Potassium ions leak out; sodium ions build up, and metabolic acidosis increases.
Correct Answer: C
Rationale: The progressive stage of shock is accurately described as the stage where histamine is released, leading to fluid and proteins leaking into surrounding tissues and the blood thickening. In this stage, the body's compensatory mechanisms are overwhelmed, resulting in a cascade of events that worsen the shock state. Choice A is incorrect as hyperventilation and a rise in blood pH are more characteristic of the compensatory stage. Choice B is incorrect as hypoxia and a rise in lactic acid are more typical of the progressive stage. Choice D is incorrect as the described electrolyte imbalances and metabolic acidosis are more aligned with the refractory stage of shock.
In developing a disaster management plan for a hospital, which resource should be the highest priority to have available in response to a bioterrorism event?
- A. A mental health specialist on the response team
- B. A sufficient supply of PPE
- C. A system for tracking client information
- D. A network for communication between staff members and families
Correct Answer: B
Rationale: During a bioterrorism event, the highest priority resource to have available is a sufficient supply of personal protective equipment (PPE). PPE is crucial in protecting healthcare workers and other responders from exposure to biological agents. While mental health support, client information tracking systems, and communication networks are important components of disaster management, in the context of a bioterrorism event, ensuring the safety of staff through adequate PPE takes precedence over other resources.