Nokea
Someone who has received a recent tattoo should be screened for:
- A. tuberculosis.
- B. herpes.
- C. hepatitis.
- D. syphilis.
Correct Answer: C
Rationale: Tattooing puts a client at risk for blood-borne hepatitis B or C if strict sterile procedures are not followed. Tuberculosis is an airborne pathogen, while herpes and syphilis are spread directly (such as through sexual contact).
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In the United States, several definitions of death are currently being used. The definition that uses apnea testing and pupillary responses to light is termed:
- A. whole brain death.
- B. heart-lung death.
- C. circulatory death.
- D. higher brain death.
Correct Answer: A
Rationale: The correct answer is 'whole brain death.' Most protocols for determining whole brain death require two separate clinical examinations, including the induction of painful stimuli, pupillary responses to light, oculovestibular testing, and apnea testing. This comprehensive approach ensures that all functions of the brain, including the brainstem, are evaluated to confirm the absence of brain function. Choices B and D are incorrect as they do not reflect the specific tests required for determining whole brain death. Choice C, 'circulatory death,' does not involve the evaluation of brain function and is not a current definition of death in the United States.
Which of the following isoenzymes is elevated in a client who has had a myocardial infarction?
- A. CPK-BB
- B. CPK-MM
- C. CPK-MB
- D. CPK-MI
Correct Answer: C
Rationale: CPK-MB is elevated in clients who have had a myocardial infarction. CPK-BB is elevated in clients who have brain damage, and CPK-MM is elevated in clients who have skeletal muscle damage. CPK-MI does not exist.
A client with a diagnosis of Schizophrenia has been released from an acute care setting. The client had a prolonged recovery from relapse. One of the parents says to the discharge nurse, 'I do not understand what is going on. The hospital said she was better, but all she does is sit around all day and smoke. We cannot get her to go to the vocational training you arranged.' The nurse recognizes that more teaching is needed about
- A. the pathophysiology and behavioral manifestations of schizophrenia.
- B. support groups that can help the parents cope with their frustration.
- C. the prolonged recovery time and side effects of medications to prevent relapse.
- D. motivational techniques that are effective in engaging clients with schizophrenia.
Correct Answer: C
Rationale: The nurse conducting discharge teaching must emphasize the extended recovery process and the potential side effects of medications used to prevent relapse in individuals with schizophrenia. In this scenario, it is crucial for the parents to understand that the client's behavior may be influenced by the medication's sedative qualities and the time required for full recovery. While support groups can assist caregivers in coping with their emotions and providing better care, the priority here is educating on the recovery process and medication effects. Motivational techniques are beneficial but may not be the immediate focus in this situation.
A successful resolution of the nursing diagnosis Negative Self-Concept (related to unrealistic self-expectations) is when the client can:
- A. report a positive self-concept.
- B. identify negative thoughts.
- C. recognize positive thoughts.
- D. give one positive cue with each negative cue
Correct Answer: A
Rationale: The correct answer is to 'report a positive self-concept.' The problem statement is Negative Self-Concept, so the goal is for the client to achieve a positive self-concept. This involves helping the client recognize their worth and strengths. Choices B, C, and D do not directly address the resolution of Negative Self-Concept. Identifying negative thoughts (B) is a step towards improvement but does not represent a successful resolution. Recognizing positive thoughts (C) is positive but not the primary goal in addressing Negative Self-Concept. 'Give one positive cue with each negative cue' (D) is not as comprehensive as achieving an overall positive self-concept.
A mother has just given birth to a baby who died soon after. The mother has been crying and states, 'I can't believe this has happened to me. I did everything right during this pregnancy.' How should the nurse respond to this mother?
- A. Tell her she did nothing wrong; it was God's will.
- B. Tell her she can have another baby.
- C. Tell her that her behavior is not going to solve anything.
- D. Tell her nothing and let her mourn this loss in the manner she chooses.
Correct Answer: D
Rationale: Perinatal loss is a great tragedy for the parents. A bereaved mother must resolve the crisis of perinatal loss in addition to the crisis of pregnancy. Such a loss is described as losing part of one's self-loss of self-worth. The perinatal grief response must involve attachment and detachment as a part of the mourning process.