Nokea
The nurse assesses for the characteristic movement of Parkinson's disease which is a (n):
- A. Exaggerated muscle flaccidity that leads to frequent falls
- B. Hyperextension of the back and neck that alters normal movements
- C. Pronation- supination of the hand and forearm that interferes with normal hand activities
- D. Combination of all of the above
Correct Answer: D
Rationale: The characteristic movement of Parkinson's disease is the pronation-supination of the hand and forearm, also known as the "pill-rolling" tremor. This movement interferes with normal hand activities and is a common early sign of Parkinson's disease. Exaggerated muscle flaccidity leading to frequent falls and hyperextension of the back and neck are not typically associated with Parkinson's disease.
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A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
- A. "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear."
- B. "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal."
- C. "I will receive parenteral vitamin B12 therapy monthly for 6 months to a year."
- D. "I will receive parenteral vitamin B12 therapy for the rest of my life."
Correct Answer: D
Rationale: The correct client statement indicating effective teaching about parenteral vitamin B12 therapy for pernicious anemia is, "I will receive parenteral vitamin B12 therapy for the rest of my life." Pernicious anemia is a condition in which the body cannot absorb enough vitamin B12 from food due to a lack of intrinsic factor, a protein produced in the stomach. As a result, lifelong B12 supplementation is necessary to maintain adequate levels of the vitamin. Monthly injections are typically recommended for life to ensure proper B12 levels and prevent complications associated with the deficiency.
What should the client at risk for developing AIDS be advised to do?
- A. Abstain from anal intercourse
- B. Have a semen analysis done
- C. Have an ELISA test for antibodies
- D. Inform all sexual contacts
Correct Answer: C
Rationale: The client at risk for developing AIDS, which is caused by the Human Immunodeficiency Virus (HIV), should be advised to have an ELISA test for antibodies to check for the presence of the virus. ELISA is a standard blood test used for HIV screening because it can detect antibodies produced by the body in response to HIV infection. Early detection through testing is crucial to initiate treatment interventions and prevent further transmission of the virus. It is important for the client to undergo this test to determine their HIV status and receive appropriate medical care and support.
Laboratory studies indicate a client's blood pressure level is 185mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most occlusive diagnostic information about the client's glucose utilization?
- A. A fasting blood glucose test
- B. A test of serum glycosylated hemoglobin (HbA1c)
- C. A 6-hour glucose tolerance test
- D. A test for urine ketones
Correct Answer: C
Rationale: A 6-hour glucose tolerance test would yield the most occlusive diagnostic information about the client's glucose utilization in this case. The elevated blood pressure level of 185 mg/dL two hours after breakfast indicates poor glucose regulation. A glucose tolerance test involves monitoring the client's blood glucose levels over a period of time after ingesting a glucose solution. This test provides a comprehensive assessment of how the body processes glucose, revealing any abnormalities in glucose metabolism beyond fasting levels, such as postprandial (after-meal) glucose spikes and prolonged hyperglycemia. This can help identify conditions like insulin resistance, impaired glucose tolerance, or diabetes, which may not be evident from a fasting blood glucose test alone. Glycosylated hemoglobin (HbA1c) reflects average blood sugar levels over the past 2-3 months and would not provide immediate information about the client's current glucose metabolism. Urine ketones
A 5 months child is brought for routine care. During auscultation of heart you find a short systolic murmur at left upper sternal border with soft 2nd heart sound. The most likely diagnosis is?
- A. Ventricular septal defect
- B. Atrial septal defect
- C. Patent ductus arteriosus
- D. Pulmonary stenosis
Correct Answer: B
Rationale: Atrial septal defect (ASD) often presents with a systolic ejection murmur at the left upper sternal border and a fixed split second heart sound.
The nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will prescribe daily supplements of calcium and:
- A. Folic acid
- B. Potassium
- C. Vitamin D
- D. Iron
Correct Answer: C
Rationale: In the management of hypoparathyroidism, along with the supplementation of calcium, a physician will often prescribe vitamin D. This is because vitamin D plays a crucial role in regulating the absorption of calcium in the intestines. A deficiency in vitamin D can lead to decreased calcium absorption, which can worsen the symptoms of hypoparathyroidism. Therefore, supplementing with vitamin D along with calcium helps to maintain proper calcium levels in the body, which is essential for various physiological functions.