Nokea
The nurse is assessing an 8-year-old child whose growth rate measures below the third percentile for
a child his age. He appears significantly younger than his stated age and is chubby with infantile
facial features. Which condition does this child likely have?
- A. Acromegaly
- B. Marfan syndrome
- C. Hypopituitary dwarfism
- D. Achondroplastic dwarfism
Correct Answer: C
Rationale: Hypopituitary dwarfism is caused by a deficiency in growth hormone in childhood and results in a
retardation of growth below the third percentile, delayed puberty, and other problems. The child's
appearance fits this description. Achondroplastic dwarfism is a genetic disorder resulting in
characteristic deformities; Marfan syndrome is an inherited connective tissue disorder characterized
by a tall, thin stature and other features. Acromegaly is the result of excessive secretion of growth
hormone in adulthood which causes overgrowth of bone in the face, head, hands, and feet.
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A 60-year-old patient has been treated for pneumonia for the past 6 weeks. The patient is seen today in the clinic for an unexplained weight loss of 10 pounds over the last 6 weeks. Which is an appropriate rationale for this patient's weight loss?
- A. Chronic diseases such as hypertension do not usually cause weight loss.
- B. Weight loss is more likely due to underlying medical conditions than unhealthy eating habits.
- C. Unexplained weight loss often accompanies short-term illnesses.
- D. Weight loss is not typically caused by mental health dysfunctions.
Correct Answer: C
Rationale: Unexplained weight loss in a patient with pneumonia could indicate an underlying short-term illness or a chronic condition like endocrine disease, malignancy, depression, anorexia nervosa, or bulimia. Hypertension is not commonly associated with weight loss; it usually leads to weight gain due to fluid retention. Unhealthy eating habits are less likely to explain significant unexplained weight loss over a short period. Mental health dysfunctions can affect appetite but are not typically primary causes of significant unexplained weight loss.
When assessing the force or strength of a pulse, what would the nurse recall about the pulse?
- A. Is a reflection of the heart's stroke volume
- B. Typically recorded on a 0- to 3-point scale
- C. Demonstrates elasticity of the blood vessel wall
- D. Reflects the blood volume in the arteries during diastole
Correct Answer: A
Rationale: When assessing the force or strength of a pulse, the nurse should recall that it is a reflection of the heart's stroke volume. The heart pumps an amount of blood (the stroke volume) into the aorta, causing arterial walls to flare and generate a pressure wave felt as the pulse in the periphery. The force of the pulse is typically recorded on a 0- to 3-point scale, not a 0- to 2-point scale. The force of the pulse does not demonstrate the elasticity of blood vessel walls or reflect the blood volume in the arteries during diastole. Therefore, choices B, C, and D are incorrect.
When checking for proper blood pressure cuff size, which guideline is correct?
- A. The standard cuff size is appropriate for all sizes.
- B. The length of the rubber bladder should equal 80% of the arm circumference.
- C. The width of the rubber bladder should equal 80% of the arm circumference.
- D. The width of the rubber bladder should equal 40% of the arm circumference.
Correct Answer: D
Rationale: When selecting the correct blood pressure cuff size, it is essential to ensure that the width of the rubber bladder equals 40% of the circumference of the person's arm. This ensures proper fitting and accurate readings. The length of the bladder should actually equal 80% of the arm circumference, not 80% of the width, making choices B and C incorrect. Choice A stating that the standard cuff size is appropriate for all sizes is inaccurate, as using an incorrectly sized cuff can lead to inaccurate blood pressure readings.
When evaluating the temperature of older adults, what aspect should the healthcare provider remember about an older adult's body temperature?
- A. The body temperature of the older adult is lower than that of a younger adult.
- B. An older adult's body temperature is approximately the same as that of a young child.
- C. Body temperature varies based on the type of thermometer used.
- D. In older adults, body temperature can fluctuate widely due to less effective heat control mechanisms.
Correct Answer: A
Rationale: When evaluating the temperature of older adults, it is important to note that their body temperature is usually lower than that of younger adults, with a mean temperature of 36.2°C. Choice B is incorrect because an older adult's body temperature is not approximately the same as that of a young child. Choice C is incorrect because body temperature is a physiological parameter and does not vary based on the type of thermometer used. Choice D is incorrect because while older adults may have less effective heat control mechanisms, their body temperature is typically lower, not widely fluctuating.
A patient's blood pressure is 118/82 mm Hg. The patient asks the nurse, "What do the numbers mean?"? Which is the best reply by the nurse?
- A. "The numbers are within the normal range and are nothing to worry about."?
- B. "The bottom number is the diastolic pressure and reflects the pressure in the arteries when the heart relaxes."?
- C. "The top number is the systolic blood pressure and reflects the pressure of the blood against the arteries when the heart contracts."?
- D. "The concept of blood pressure can be complex. The primary thing to be concerned about is the top number, or the systolic blood pressure."?
Correct Answer: C
Rationale: The systolic pressure is the maximum pressure felt on the artery during left ventricular contraction, or systole. The diastolic pressure is the elastic recoil, or resting, pressure that the blood constantly exerts in between each contraction. The nurse should answer the patient's question in terms they can understand and not just say it is normal and there is nothing to worry about. The diastolic pressure is the pressure in the vessels when the heart is at rest, not the stroke volume. Both the systolic and diastolic blood pressure are important. Choice A is incorrect as providing a vague reassurance does not address the patient's query. Choice B is incorrect as it inaccurately describes the diastolic pressure as reflecting stroke volume, which is incorrect. Choice D is incorrect as it oversimplifies the explanation, focusing solely on the top number without providing a complete understanding of blood pressure.