Nokea
The nurse calculates the body mass index (BMI) for an obese adult. Which additional assessment finding places the client at high risk for cardiac disease?
- A. Large waist circumference with central fat
- B. High serum insulin level
- C. Hyperpigmentation on neck skin folds
- D. Poor muscle tone
Correct Answer: A
Rationale: A large waist circumference with central fat is associated with an increased risk for cardiac disease due to visceral fat accumulation.
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What does the surgical closure of the ductus arteriosus do?
- A. Stop the loss of unoxygenated blood to the systemic circulation
- B. Decrease the edema in legs and feet
- C. Increase the oxygenation of blood
- D. Prevent the return of oxygenated blood to the lungs
Correct Answer: D
Rationale: The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a right-to-left shunt. If this is surgically closed, no additional oxygenated blood (from the aorta) will return to the lungs through the pulmonary artery. The aorta carries oxygenated blood to the systemic circulation. Because of the higher pressure in the aorta, blood is shunted into the pulmonary artery and the pulmonary circulation. Edema in the legs and feet is usually a sign of heart failure. This repair would not directly affect the edema. Increasing the oxygenation of blood would not interfere with the return of oxygenated blood to the lungs.
After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone (SIADH), a client develops pontine myelinolysis. Which intervention should the nurse implement first?
- A. Reorient client to his room
- B. Place a patch on one eye
- C. Evaluate client's ability to swallow
- D. Perform range of motion exercises
Correct Answer: A
Rationale: Reorienting the client helps in managing confusion and disorientation, which are common in pontine myelinolysis.
A male client with pernicious anemia takes supplemental folate and self-administers monthly Vitamin B12 injections. He reports feeling increasingly fatigued. Which laboratory value should the nurse review?
- A. Complete blood count
- B. Serum ferritin level
- C. Serum potassium level
- D. Liver function tests
Correct Answer: A
Rationale: Fatigue in pernicious anemia may indicate inadequate treatment. A complete blood count helps assess hemoglobin and red blood cell levels.
Pulsus paradoxus is associated with
- A. pericarditis
- B. endocarditis
- C. rheumatic fever
- D. myocarditis
Correct Answer: A
Rationale: Pulsus paradoxus is commonly associated with pericardial diseases such as constrictive pericarditis.
The family suspects that AIDS dementia is occurring in their son who is HIV positive. Which symptom confirms their suspicions?
- A. A change has recently occurred in his handwriting.
- B. The client has a persistent cough and fever.
- C. The client experiences shortness of breath.
- D. The client exhibits a loss of appetite.
Correct Answer: A
Rationale: Changes in handwriting may indicate cognitive decline, a hallmark of AIDS dementia.