The nurse is describing theChooseMyPlateprogramto a patient. Which statement from the patient indicates successful learning?
- A. “I can use this to make healthy lifestyle food choices.”
- B. “I can use this to count specific calories of food.”
- C. “I can use this for my baby girl.”
- D. “I can use this when I am sick.”
Correct Answer: A
Rationale: This statement indicates successful learning because it acknowledges the main purpose of the ChooseMyPlate program, which is to help individuals make healthy food choices for a balanced diet and overall lifestyle. By understanding that ChooseMyPlate can guide them in making healthier food choices rather than just counting calories or using it for specific circumstances like sickness or infant care, the patient demonstrates a good grasp of the program's intended use and benefits.
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Which of the following individuals would be the most appropriate candidate for immunotherapy?
- A. A patient who had an anaphylactic reaction to an insect sting
- B. A child with allergies to eggs and dairy
- C. A patient who has had a positive tuberculin skin test
- D. A patient with severe allergies to grass and tree pollen
Correct Answer: D
Rationale: Immunotherapy, also known as allergy shots, is a form of treatment that can help reduce symptoms for individuals with severe allergies to substances such as pollen, dust mites, or pet dander. This treatment involves exposing the patient to small, increasing doses of the allergen over time to help the immune system gradually build up a tolerance. Patients with severe allergies to grass and tree pollen would most likely benefit from immunotherapy as it can help reduce their allergy symptoms and improve their quality of life. On the other hand, individuals with anaphylactic reactions to insect stings (Choice A), allergies to eggs and dairy (Choice B), or a positive tuberculin skin test (Choice C) are not typically candidates for immunotherapy as their conditions are not related to the type of allergies that are commonly treated with this method.
A patients current antiretroviral regimen includes nucleoside reverse transcriptase inhibitors (NRTIs). What dietary counseling will the nurse provide based on the patients medication regimen?
- A. Avoid high-fat meals while taking this medication.
- B. Limit fluid intake to 2 liters a day.
- C. Limit sodium intake to 2 grams per day.
- D. Take this medication without regard to meals.
Correct Answer: D
Rationale: Nucleoside reverse transcriptase inhibitors (NRTIs) are a class of antiretroviral medications typically recommended to be taken without regard to meals. This means that these medications can be taken with or without food. It is important to follow the specific instructions provided by the healthcare provider regarding the timing of medication administration. Taking NRTIs without regard to meals helps ensure consistent absorption of the medication and can help maintain steady drug levels in the body. There are no specific dietary restrictions associated with NRTIs in terms of meal timing or composition.
An older adult patient has been diagnosed with macular degeneration and the nurse is assessing him for changes in visual acuity since his last clinic visit. When assessing the patient for recent changes in visual acuity, the patient states that he sees the lines on an Amsler grid as being distorted. What is the nurses most appropriate response?
- A. Ask if the patient has been using OTC vasoconstrictors.
- B. Instruct the patient to repeat the test at different times of the day when at home.
- C. Arrange for the patient to visit his ophthalmologist.
- D. Encourage the patient to adhere to his prescribed drug regimen. .
Correct Answer: C
Rationale: Distorted lines on an Amsler grid can be an indication of changes in central vision, which is commonly seen in macular degeneration. Therefore, it is crucial for the nurse to arrange for the patient to visit his ophthalmologist promptly for further evaluation and management. The ophthalmologist will be able to determine the severity of the visual changes, provide appropriate treatment options, and closely monitor the progression of macular degeneration. This proactive approach ensures that the patient receives timely and specialized care for his condition. Options A, B, and D do not directly address the urgency of the situation and the need for specialized ophthalmologic evaluation in cases of macular degeneration.
The nurse is monitoring a patient with severe preeclampsia who is on IV magnesium sulfate. Which signs of magnesium toxicity should the nurse monitor for? (Select all that apply.)
- A. Cool, clammy skin
- B. Altered sensorium
- C. Pulse oximeter reading of 95%
- D. Respiratory rate of less than 12 breaths per minute
Correct Answer: B
Rationale: The signs of magnesium toxicity that the nurse should monitor for in a patient with severe preeclampsia on IV magnesium sulfate include an altered sensorium (confusion, lethargy, slurred speech) and a respiratory rate of less than 12 breaths per minute. Altered sensorium is a common symptom of magnesium toxicity, reflecting the drug's central nervous system depressant effects. A decreased respiratory rate can indicate respiratory depression, a potentially serious complication of magnesium toxicity. Monitoring for these signs is crucial to promptly identifying and managing magnesium toxicity in patients on magnesium sulfate therapy. Signs such as cool, clammy skin and a pulse oximeter reading of 95% would not be indicative of magnesium toxicity.
The nurse is providing care for a patient who has benefited from a cochlear implant. The nurse should understand that this patients health history likely includes which of the following? Select all that apply.
- A. The patient was diagnosed with sensorineural hearing loss.
- B. The patients hearing did not improve appreciably with the use of hearing aids.
- C. The patient has deficits in peripheral nervous function.
- D. The patients hearing deficit is likely accompanied by a cognitive deficit. E) The patient is unable to lip-read.
Correct Answer: A
Rationale: A. The patient was diagnosed with sensorineural hearing loss.
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