The coronary vessels, unlike any other blood vessels in the body, respond to sympathetic stimulation by
- A. Vasoconstriction
- B. Vasodilatation
- C. Decreases force of contractility
- D. Decreases cardiac output
Correct Answer: B
Rationale: The coronary vessels are unique because they respond to sympathetic stimulation with vasodilatation, unlike most other blood vessels which constrict. Sympathetic stimulation activates the fight-or-flight response, increasing heart rate and oxygen demand. To meet this demand, the coronary arteries dilate to supply more blood to the heart muscle. Vasoconstriction (A) is incorrect as it would reduce blood flow, countering the heart's needs during stress. Decreases in force of contractility (C) or cardiac output (D) are unrelated to the vascular response and pertain more to myocardial function, not the coronary vessels' behavior. This vasodilatation is mediated by beta-adrenergic receptors, ensuring adequate perfusion during heightened activity, making B the correct choice.
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The physician has ordered a 2-gram sodium diet for a client with hypertension. Which food should be limited due to its sodium content?
- A. Potato chips
- B. Baked chicken
- C. Steamed broccoli
- D. Fresh apple
Correct Answer: A
Rationale: Potato chips are high in sodium often 120-180 mg per ounce exceeding a 2-gram (2000 mg) daily limit for hypertension, necessitating restriction to control blood pressure. Baked chicken, steamed broccoli, and fresh apples have minimal natural sodium, fitting the diet. Nurses educate clients on hidden sodium in processed snacks, promoting fresh alternatives to reduce cardiovascular strain, aligning with therapeutic goals for long-term health management.
The nurse questions a doctors order of Morphine sulfate 50 mg, IM for a client with pancreatitis. Which role best fit that statement?
- A. Change agent
- B. Client advocate
- C. Case manager
- D. Collaborator
Correct Answer: B
Rationale: Questioning an inappropriate order like morphine for pancreatitis, which worsens sphincter of Oddi spasm reflects the client advocate role. Nurses protect patient rights and safety by challenging harmful directives, ensuring optimal care (e.g., suggesting alternatives like meperidine). This differs from change agent (lifestyle shifts), case manager (coordination), or collaborator (teamwork), emphasizing advocacy's focus on patient well-being, a core ethical duty in nursing.
You highly suspect that your assigned client has abdominal distention. You most need to do and chart which of the following things?
- A. Have another nurse verify your suspicions.
- B. Measure the abdominal girth at the umbilicus.
- C. Measure abdominal girth at the most distended level.
- D. Ask the client if they are distended.
Correct Answer: C
Rationale: Measuring girth at the most distended level and charting it confirms abdominal distention objectively, critical for tracking. Verification, umbilicus measurement, or client query are less precise. Nurses rely on this for accurate monitoring.
The parents of a healthy 6-year-old ask the nurse for advice about preventing obesity in their child. Which response reflects health promotion?
- A. Limit screen time and encourage outdoor play.'
- B. Weigh your child monthly to monitor for weight gain.'
- C. Give your child a multivitamin daily to prevent obesity.'
- D. Have your child's cholesterol checked annually.'
Correct Answer: A
Rationale: For a healthy 6-year-old, health promotion prevents obesity by fostering active habits limiting screen time and encouraging outdoor play boosts physical activity, burning calories and building muscle, key to avoiding weight gain at this age. Evidence links sedentary screen hours to childhood obesity; play counters it, aligning with nursing's focus on lifestyle over surveillance. Monthly weighing is secondary, tracking not preventing, and may stress the child. Multivitamins don't prevent obesity caloric balance does while annual cholesterol checks detect, not avert, issues. The nurse's reply promotes wellness through fun, practical steps like biking or tag tailored to a child's energy, ensuring long-term health without medicalizing a well kid, a cornerstone of pediatric nursing's preventive approach.
What is nurse's primary critical observation when performing an assessment for determining an Apgar score?
- A. Heart rate
- B. Respiratory rate
- C. Presence of meconium
- D. Evaluation of Moro reflex
Correct Answer: A
Rationale: Apgar score assesses newborn vitality at 1 and 5 minutes post-birth across five criteria: heart rate, respiration, muscle tone, reflex, color. Heart rate (choice A) is primary; absent (<60 bpm = 0, <100 = 1, >100 = 2) dictates immediate resuscitation, making it the most critical. Respiratory rate (choice B) follows, but weak/absent breathing often ties to heart rate. Meconium (choice C) isn't scored directly, though it flags distress. Moro reflex (choice D) tests tone/reflex, secondary to vitals. A is correct, as heart rate drives initial intervention. Nurses prioritize it, ensuring rapid response to stabilize the infant.