Nokea
Several children a day are seen in the emergency department for treatment of illnesses and injuries. The situation that would create a high index of suspicion of child abuse is a child who:
- A. Has repeated middle ear infections.
- B. Complains of abdominal cramps and upset stomach.
- C. Has perineal bruises and urinary tract infections.
- D. Displays reduced functioning at school.
Correct Answer: C
Rationale: The correct answer is C because perineal bruises and urinary tract infections are physical signs that are highly suspicious for child abuse, particularly sexual abuse. Perineal bruises are not commonly seen in children due to accidental injuries, and urinary tract infections in young children are rare and may indicate sexual abuse. Repeated middle ear infections (choice A) and complaints of abdominal cramps and upset stomach (choice B) are common childhood illnesses that do not necessarily indicate child abuse. Displaying reduced functioning at school (choice D) may suggest various issues such as learning disabilities or emotional distress, but is not specific to child abuse.
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What is the key component of treatment for a patient with anorexia nervosa?
- A. Encouraging rapid weight gain and exercise.
- B. Establishing a structured meal plan and emotional support.
- C. Restricting food intake to avoid further weight gain.
- D. Promoting independence and avoidance of therapy.
Correct Answer: B
Rationale: The correct answer is B because establishing a structured meal plan helps regulate eating behaviors and promotes nutrition restoration, while emotional support addresses underlying psychological issues. Rapid weight gain and exercise (A) can be harmful due to medical complications. Restricting food intake (C) worsens the condition. Promoting independence and avoiding therapy (D) hinder recovery by neglecting the importance of professional help.
A man with hypospadias tells the nurse, 'Intercourse with my new bride is painful.' Which term applies to the patient's complaint?
- A. Dyspareunia
- B. Erectile dysfunction
- C. Premature ejaculation
- D. Genito-pelvic pain/penetration disorder
Correct Answer: D
Rationale: The correct answer is D: Genito-pelvic pain/penetration disorder. This term is applicable because it specifically refers to pain experienced during intercourse, which aligns with the patient's complaint. Hypospadias can lead to difficulties in penetration and subsequent pain during intercourse.
Choice A: Dyspareunia refers to persistent or recurrent pain during sexual intercourse, which is a broader term than what the patient is experiencing.
Choice B: Erectile dysfunction is the inability to achieve or maintain an erection, which is not directly related to the patient's complaint of pain during intercourse.
Choice C: Premature ejaculation is the early release of semen during sexual activity, which is unrelated to the pain experienced by the patient during intercourse.
Which of the following statements by a patient with anorexia nervosa indicates a need for further education?
- A. I want to gain weight, but only if I can stay under 120 pounds.
- B. I understand that my body weight is dangerously low.
- C. I know that food is the enemy and I need to avoid it at all costs.
- D. I am willing to work with my healthcare team to improve my nutrition.
Correct Answer: C
Rationale: The correct answer is C because it indicates a misunderstanding of anorexia nervosa. Patients with anorexia often see food as the enemy, which is a distorted perception. Understanding that food is necessary for nourishment and health is crucial in recovery. Choice A shows an unhealthy weight goal, choice B shows awareness of low weight, and choice D shows willingness to work with the healthcare team, all of which are positive signs.
What is the primary nursing concern for a patient with anorexia nervosa during the early stages of treatment?
- A. Ensuring rapid weight gain to restore health.
- B. Addressing the patient's psychological issues related to body image.
- C. Maintaining nutritional intake to prevent further weight loss.
- D. Promoting self-esteem and body image satisfaction.
Correct Answer: C
Rationale: The primary nursing concern for a patient with anorexia nervosa in the early stages of treatment is maintaining nutritional intake to prevent further weight loss. This is crucial as malnutrition can lead to serious health complications. Ensuring adequate nutrition supports physical health and provides a foundation for addressing psychological issues in later stages of treatment. Rapid weight gain (A) can be harmful and lead to refeeding syndrome. Addressing psychological issues (B) and promoting self-esteem (D) are important but secondary concerns once nutritional stability is achieved.
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.