Nokea
A healthcare professional is screening patients for immunizations. Which of the following is not a contraindication for immunization?
- A. Seizures
- B. Fever lasting more than 3 days
- C. Malignancy within the past 3 months
- D. Illness lasting more than 6 months
Correct Answer: D
Rationale: The correct answer is D, 'Illness lasting more than 6 months.' Chronic conditions lasting more than 6 months are not considered a contraindication for immunization. Choice A, 'Seizures,' can be a contraindication in certain situations, especially if linked to a specific vaccine component. Choice B, 'Fever lasting more than 3 days,' can be a temporary precaution but not a general contraindication. Choice C, 'Malignancy within the past 3 months,' is a contraindication due to the compromised immune system in cancer patients.
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A nurse is caring for a patient in the step-down unit. The patient has signs of increased intracranial pressure. Which of the following is not a sign of increased intracranial pressure?
- A. Bradycardia
- B. Increased pupil size bilaterally
- C. Change in LOC
- D. Vomiting
Correct Answer: B
Rationale: The correct answer is 'Increased pupil size bilaterally.' When assessing for signs of increased intracranial pressure, bilateral pupil dilation is not typically associated with this condition. Instead, unilateral pupil changes, especially one pupil becoming dilated or non-reactive while the other remains normal, are indicative of increased ICP. Bradycardia, a change in level of consciousness (LOC), and vomiting are commonly seen in patients with increased intracranial pressure due to the brain's response to the rising pressure. Therefore, the presence of bilateral pupil dilation goes against the typical pattern observed in patients with increased intracranial pressure.
A patient has been diagnosed with diabetes mellitus. Which of the following is not a clinical sign of diabetes mellitus?
- A. Polyphagia
- B. Polyuria
- C. Metabolic acidosis
- D. Lower extremity edema
Correct Answer: D
Rationale: Polyphagia, polyuria, and metabolic acidosis are common clinical signs of diabetes mellitus. Polyphagia refers to excessive hunger, polyuria is excessive urination, and metabolic acidosis can occur due to poorly controlled diabetes. Lower extremity edema, on the other hand, is not a typical clinical sign of diabetes mellitus. Edema in the lower extremities is more commonly associated with conditions like heart failure or kidney disease rather than diabetes mellitus.
Which sexually transmitted disease, sometimes referred to as the silent STD, is more common than gonorrhea and a leading cause of PID?
- A. Genital herpes.
- B. Trichomoniasis.
- C. Syphilis.
- D. Chlamydia.
Correct Answer: D
Rationale: The correct answer is Chlamydia. Chlamydia is a common sexually transmitted infection that can often be asymptomatic, earning it the nickname 'silent STD.' It is more common than gonorrhea and is a leading cause of Pelvic Inflammatory Disease (PID). Genital herpes (Choice A) is a viral infection, not a bacterial STD like chlamydia. Trichomoniasis (Choice B) is a parasitic infection and not commonly associated with causing PID. Syphilis (Choice C) is a bacterial infection but is not as common as chlamydia and is not a leading cause of PID.
A mother who has never breastfed a child before is having trouble getting the baby to latch on to the breast. The baby has lost 3% of its birth weight within the first 2 days of life. The best statement is:
- A. The baby will eventually take to the breast.
- B. I can prepare a bottle if you want to try that.
- C. A small amount of weight loss in the first few days is normal.
- D. I can arrange for the charge nurse to come and talk to you about breastfeeding.
Correct Answer: C
Rationale: The correct answer is 'A small amount of weight loss in the first few days is normal.' It is important to reassure the mother that a small amount of weight loss, such as 5-10% of birth weight, in the first few days of life is considered normal for newborns. This reassurance helps alleviate the mother's concerns. Option A is incorrect because it does not address the concern about weight loss; it focuses more on the baby eventually latching on. Option B is not recommended as the first solution for breastfeeding issues, as introducing a bottle early on may lead to nipple confusion. Option D involves escalating the situation to the charge nurse when it can be addressed by providing appropriate information and support directly, making it less necessary in this scenario where reassurance and education are key.
A client with sickle cell disease is worried about passing the disease on to children. Which of the following statements by the PN is most appropriate for this client?
- A. "You should discuss the inheritance risk with your physician."?
- B. "Sickle cell disease is genetically based and might be passed on to children."?
- C. "Sickle cell disease is genetically based and is not passed on to children."?
- D. "Sickle cell disease is caused by an infection and cannot be passed on to children."?
Correct Answer: B
Rationale: A client with sickle cell disease has a genetic condition that can be passed on to their offspring. The most appropriate statement for the PN to provide is to acknowledge this fact and inform the client that sickle cell disease is genetically based and might be passed on to children. This empowers the client with accurate information. Choice A has been refined to emphasize discussing the inheritance risk, making it a better option than the vague original choice. Choices C and D provide incorrect information. Sickle cell disease is indeed genetically based and can be inherited.