Nokea
The healthcare professional has collected the following information on a patient: palpated blood pressure"?180 mm Hg; auscultated blood pressure"?170/100 mm Hg; apical pulse"?60 beats per minute; radial pulse"?70 beats per minute. What is the patient's pulse pressure?
- A. 10
- B. 70
- C. 80
- D. 100
Correct Answer: B
Rationale: Pulse pressure is the numerical difference between the systolic and diastolic blood pressure readings. In this case, the systolic blood pressure is 170 mm Hg, and the diastolic blood pressure is 100 mm Hg. Therefore, the pulse pressure is calculated as 170 - 100 = 70 mm Hg. Pulse pressure reflects the stroke volume, the amount of blood ejected from the heart with each beat. Choices A, C, and D are incorrect because they do not accurately represent the difference between the systolic and diastolic blood pressure readings provided.
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During the evaluation of the quality of home care for a client with Alzheimer's disease, the priority for the nurse is to reinforce which statement by a family member?
- A. "At least two (2) full meals a day are eaten."?
- B. "We go to a group discussion every week at our community center."?
- C. "We have safety bars installed in the bathroom and have 24-hour alarms on the doors."?
- D. "The medication is not a problem to have taken three (3) times a day."?
Correct Answer: C
Rationale: The correct answer is, '"We have safety bars installed in the bathroom and have 24-hour alarms on the doors."?' Ensuring the safety of a client with Alzheimer's disease is crucial in home care. Installing safety features like bars in the bathroom and alarms on doors help prevent accidents and injuries. This contributes to creating a safe environment that promotes independence and autonomy for the client. Choices A, B, and D are incorrect because while they are important aspects of care, ensuring safety in the home environment takes precedence in caring for a client with Alzheimer's disease.
The healthcare professional is preparing to measure the length, weight, chest, and head circumference of a 6-month-old infant. Which measurement technique is correct?
- A. Measuring the infant's length using a tape measure
- B. Weighing the infant on an electronic standing scale
- C. Measuring the chest circumference at the nipple line with a tape measure
- D. Measuring the head circumference by wrapping the tape measure around the head
Correct Answer: C
Rationale: For accurate measurements, specific techniques are required for different parameters in infants. Measuring the chest circumference involves encircling the chest at the nipple line. Length should be measured on a horizontal measuring board. Weight should be measured using a platform-type balance scale. Head circumference measurement entails ensuring the tape is aligned at the eyebrows and prominent frontal and occipital bones for the widest span. Therefore, the correct technique for measuring the chest circumference is at the nipple line with a tape measure. The other options are incorrect because length should be measured on a horizontal board, weight should be measured on a balance scale, and head circumference should be measured around the head, not over the nose and cheekbones.
The healthcare professional notices that a colleague is preparing to check the blood pressure of a patient who is obese by using a standard-sized blood pressure cuff. How would this likely affect the blood pressure reading?
- A. Yield a falsely low blood pressure
- B. Yield a falsely high blood pressure
- C. Be the same, regardless of cuff size
- D. Vary as a result of the technique of the person performing the assessment
Correct Answer: B
Rationale: Using a cuff that is too narrow for an obese patient would likely yield a falsely high blood pressure reading. This occurs because the standard cuff is too small for the arm's circumference, requiring more pressure to compress the artery. A tight cuff can lead to inaccurate and elevated blood pressure readings. Choices A, C, and D are incorrect because using an improperly sized cuff would not yield a falsely low blood pressure, the blood pressure reading does vary with cuff size, and the technique of the person performing the assessment is not the primary factor affecting the reading in this situation.
How many cc are there in 25 ounces?
- A. 250
- B. 500
- C. 750
- D. 1000
Correct Answer: C
Rationale: To convert ounces to cc, we know that there are 30 cc in 1 ounce. Therefore, to find out how many cc are in 25 ounces, we multiply 30 cc/ounce by 25 ounces which equals 750 cc. This makes choice C, 750, the correct answer. Choices A, B, and D are incorrect as they do not correctly convert ounces to cc.
Which playroom activities should the nurse organize for a small group of 7-year-old hospitalized children?
- A. Sports and games with rules.
- B. Finger paints and water play.
- C. "Dress-up"? clothes and props.
- D. Chess and television programs
Correct Answer: A
Rationale: For 7-year-old children, play serves an important role in developing cooperation, logical reasoning, and social skills. Organizing sports and games with rules is beneficial as it helps children understand the importance of rules, promotes teamwork, and fosters social interactions. Finger paints and water play, while fun, may not target the specific developmental needs of this age group. Similarly, 'Dress-up' clothes and props can encourage imaginative play but may not necessarily promote cooperation and logical reasoning. Chess and television programs are more suited for older children and may not engage 7-year-olds as effectively in developing the desired skills.