The following favour a non-organic (psychological) cause of abdominal pain:
- A. Two-year history
- B. Family history of peptic ulcer
- C. Family history of migraine
- D. Absence from school
Correct Answer: A
Rationale: A long history of abdominal pain without organic findings suggests a psychological cause. Family history of peptic ulcer or migraine is less relevant.
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A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
- A. An 86-year-old man with a history of asthma
- B. A 32-year-old Asian-American man with colorectal cancer
- C. A 45-year-old American Indian woman with diabetes mellitus
- D. A 53-year-old postmenopausal woman who is on hormone therapy
Correct Answer: C
Rationale: Diabetes mellitus is a significant risk factor for cardiovascular disease, and the 45-year-old American Indian woman with diabetes mellitus has the highest risk among the options provided.
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
- A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- B. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- C. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
- D. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
Correct Answer: A
Rationale: Tetralogy of Fallot has these four characteristics: pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not atrial stenosis in tetralogy of Fallot. Right ventricular hypertrophy, not left ventricular hypertrophy, is present in tetralogy of Fallot. Tetralogy of Fallot has right ventricular hypertrophy, not left ventricular hypertrophy, and an atrial septal defect, not aortic hypertrophy.
Of the following, the cyanotic cardiac lesion with decreased pulmonary blood flow is
- A. transposition of the great vessels
- B. single ventricle
- C. truncus arteriosus
- D. tricuspid atresia
Correct Answer: D
Rationale: Tricuspid atresia results in decreased pulmonary blood flow due to lack of right ventricular input.
A client tells the nurse that her biopsy results indicate that the cancer cells are well-differentiated. How should the nurse respond?
- A. Ask the client if the healthcare provider has given her any information about the classification of her cancer
- B. Tell the client that well-differentiated cancer cells usually have a poor prognosis.
- C. Reassure the client that the cancer is not serious.
- D. Encourage the client to seek a second opinion for confirmation of the diagnosis.
Correct Answer: A
Rationale: Well-differentiated cancer cells typically indicate a slower-growing tumor. Clarifying the client's understanding ensures accurate communication and emotional support.
Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)?
- A. Chickenpox or influenza
- B. E. coli or staphylococcus
- C. Mumps or streptococcus A
- D. Streptococcus A or staphylococcus
Correct Answer: A
Rationale: Both chickenpox and influenza are viral; during these illnesses, aspirin (a salicylate) is typically discontinued due to the risk of Reye syndrome.
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