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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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Which information would be important to incorporate when teaching about medications for dementia in a caregiver's support group? Select all that apply.
- A. Antipsychotic medications have been shown to be the most useful category of drugs in reducing behavioral problems in dementias.
- B. Most currently available medications slow the progress of the disease in 20% to 50% of patients but usually do not significantly improve functioning.
- C. None of the currently available medications for dementias provide a cure.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because it accurately conveys important information about medications for dementia to caregivers. It emphasizes that most medications do not significantly improve functioning but may slow disease progression in a subset of patients. This is crucial for setting realistic expectations.
Choice A is incorrect because antipsychotic medications are not the most useful category of drugs for reducing behavioral problems in dementia; they are associated with serious side effects and should be used cautiously.
Choice C is incorrect because it is essential for caregivers to understand that medications do not cure dementia; managing symptoms and slowing progression are the primary goals.
Choice D is incorrect as the correct answer is B, which provides valuable information for caregivers to understand the limitations and benefits of medications for dementia.
A client has been diagnosed with Alzheimer's disease, stage 1. The nurse would expect to help the family plan measures to assist the client with:
- A. Recent memory loss
- B. Catastrophic reactions
- C. Progressive gait disturbances
- D. Perseveration
Correct Answer: A
Rationale: The correct answer is A: Recent memory loss. In stage 1 of Alzheimer's disease, the primary symptom is mild memory loss, particularly with recent events and information. The nurse would help the family plan measures to assist the client by implementing strategies to support memory, such as setting reminders, organizing daily routines, and using memory aids. Choice B, catastrophic reactions, is more commonly associated with later stages of the disease. Choice C, progressive gait disturbances, is not a typical symptom of stage 1 Alzheimer's. Choice D, perseveration, involves the repetition of a particular response or behavior and is not a primary concern in stage 1 Alzheimer's disease.
A nurse is caring for a patient with bulimia nervosa. The nurse should monitor for which of the following complications?
- A. Nutritional deficiency and dehydration.
- B. Respiratory failure and aspiration pneumonia.
- C. Peripheral edema and hyperkalemia.
- D. Mental confusion and decreased blood pressure.
Correct Answer: A
Rationale: The correct answer is A: Nutritional deficiency and dehydration. In bulimia nervosa, recurrent episodes of binge eating followed by purging can lead to electrolyte imbalances, dehydration, and malnutrition. Monitoring for nutritional deficiencies and dehydration is crucial in managing patients with bulimia nervosa.
Explanation for why other choices are incorrect:
B: Respiratory failure and aspiration pneumonia - Although purging behaviors can increase the risk of aspiration pneumonia, it is not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
C: Peripheral edema and hyperkalemia - These complications are not typically associated with bulimia nervosa.
D: Mental confusion and decreased blood pressure - While electrolyte imbalances can lead to mental confusion, these specific complications are not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
In some countries, it is normal to defecate or urinate in public. This makes it clear that judgments of the normality of behavior are
- A. culturally relative
- B. statistical
- C. a matter of subjective discomfort
- D. related to conformity
Correct Answer: A
Rationale: Normality varies by culture, as behaviors acceptable in one society may be abnormal in another.
An advance directive gives legally binding direction for health care interventions when a patient:
- A. has a new diagnosis of cancer
- B. is diagnosed with Parkinsons disease
- C. is unable to make decisions for self because of illness
- D. diagnosed with amyotrophic lateral sclerosis is unable to speak
Correct Answer: C
Rationale: Advance directives are invoked when patients are unable to make their own health care decisions. The correct response is the most global answer. A diagnosis of cancer or Parkinsons disease does not mean the patient is unable to make a decision. For a patient with amyotrophic lateral sclerosis, there are other ways to communicate beyond speaking.