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The genetic profile determines the prevalence of diabetic nephropathy in a population group. Question: Which population group has the LOWEST risk to develop endstage renal disease as a consequence of diabetes?
- A. Afro-Americans
- B. Iberians (Spanish origin)
- C. Caucasians
- D. Native Americans
Correct Answer: C
Rationale: Caucasians dodge worst kidney doom Afro-Americans, Native Americans soar high, Iberians mid-tier. Genes and diabetes hit lighter here, a chronic renal risk low nurses screen this gradient.
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A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?
- A. I've had a backache for several days
- B. I feel nauseated and have no appetite
- C. I can walk a mile a day
- D. I am urinating more frequently
Correct Answer: B
Rationale: Digoxin's tightrope nausea and anorexia flag toxicity, a common adverse hit as levels climb, risking arrhythmias. Backache's vague, walking's a win, urination's unrelated. Nurses catch this, checking levels, a red light in this heart-boosting med's dance.
A patient diagnosed with moderate COPD would have a FEV1 of which percentage of their predicted range?
- A. 40%
- B. <80%
- C. 60-79%
- D. 40-59%
Correct Answer: D
Rationale: Moderate COPD's FEV1 lands 40-59% predicted airflow's pinched, not trashed, fitting GOLD staging, a middle ground of huff and puff. Over 40's too broad; under 80's loose; 60-79's mild. Nurses clock this, tuning chronic care's pace.
A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action would address the cause of the patient problem?
- A. Add protein powder to foods such as casseroles.
- B. Tell the patient to eat foods that are high in nutrition.
- C. Avoid giving the patient foods that are strongly disliked.
- D. Add spices to enhance the flavor of foods that are served.
Correct Answer: C
Rationale: Chemo twists taste bitter, metallic, off killing appetite. Skipping disliked foods sidesteps the cause, boosting intake over forcing nutrition or masking with protein or spices , which might flop. Nurses in oncology nail this tailoring to taste quirks beats generic fixes, tackling the root of this nutrition dip.
The Lee Revised Cardiac Risk Index:
- A. Has been validated to predict the risk of mortality after major non-cardiac surgery.
- B. Is a complex algorithm.
- C. Provides a simple additive score incorporating six risk factors.
- D. Discriminates well between patients at moderate and severe risk of adverse cardiac outcome.
Correct Answer: C
Rationale: The Lee Revised Cardiac Risk Index (RCRI) predicts cardiac complications (e.g., myocardial infarction) after non-cardiac surgery. It's validated for morbidity, not mortality specifically, though it correlates with outcomes. It's not a complex algorithm but a straightforward tool: six factors (high-risk surgery, ischemic heart disease, heart failure, stroke/TIA, diabetes on insulin, renal insufficiency) are scored additively (0-6). This simplicity aids clinical use, providing risk percentages (e.g., 0.4% for 0 points, 11% for ≥3). It discriminates moderate-to-high risk well but less so at extremes. Age >70 isn't an automatic point; risk factors are specific. Its strength lies in its evidence-based, user-friendly design for perioperative cardiac risk stratification.
A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.