Nokea
The nurse is discussing ocular disorders with a group of nursing students. Which of the following statements would be correct for the nurse to make? Select all that apply.
- A. Cataracts are caused by increased ocular pressure (IOP).
- B. Graves' disease may cause exophthalmos.
- C. Macular degeneration is manifested by loss of peripheral vision.
- D. Angle-closure glaucoma is manifested by headache and eye pain.
- E. Hyphema results in increased aqueous humor in the anterior chamber.
Correct Answer: B,D
Rationale: Graves' disease can cause exophthalmos (bulging eyes) due to autoimmune inflammation. Angle-closure glaucoma presents with headache and eye pain due to sudden increases in intraocular pressure. Cataracts are caused by lens opacity, not IOP. Macular degeneration affects central vision, not peripheral. Hyphema is blood in the anterior chamber, not increased aqueous humor.
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A client with Parkinson's disease asks the nurse to explain to his nephew "what the doctor said the pallidotomy would do." The nurse's best response includes stating that the main goal for the client after pallidotomy is improved:
- A. Functional ability.
- B. Emotional stress.
- C. Alertness.
- D. Appetite.
Correct Answer: A
Rationale: Pallidotomy aims to improve functional ability by reducing symptoms like tremors and rigidity. Emotional stress, alertness, and appetite are not primary targets of this procedure.
A nurse is assessing a female who is receiving the second administration of chemotherapy for breast cancer. When obtaining this client's health history, what is the most important information the nurse should obtain?
- A. Has your hair been falling out in clumps?
- B. Have you had nausea or vomiting?
- C. Have you been sleeping at night?
- D. Do you have your usual energy level?
Correct Answer: B
Rationale: Nausea and vomiting are critical to assess during chemotherapy, as they can lead to dehydration, malnutrition, and treatment delays if not managed promptly.
A client is admitted from the emergency department after falling down a flight of stairs at home. Her vital signs are stable and her history states that she had a gastric stapling 2 years ago and takes neomycin for acne. The client jokes about how she is clumsy lately and trips over things. The nurse should ask the client which of the following questions? Select all that apply.
- A. Are you experiencing numbness in your extremities?'
- B. How much vitamin B12 are you getting?'
- C. Are you feeling depressed?'
- D. Do you feel safe at home?'
- E. Are you getting sufficient iron in your diet?'
Correct Answer: A,B,D
Rationale: Gastric stapling can impair vitamin B12 absorption, and neomycin may further reduce B12 levels by altering gut flora. The client's clumsiness and falls suggest possible B12 deficiency neuropathy, warranting questions about numbness and B12 intake. Asking about safety at home is crucial to assess for environmental or abuse-related causes of falls. Depression and iron intake are less directly related to the symptoms described.
An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of:
- A. Left ventricular atrophy.
- B. Irregular heartbeats.
- C. Peripheral vascular occlusion.
- D. Pacemaker placement.
Correct Answer: A
Rationale: Aging leads to left ventricular atrophy, reducing cardiac reserve and impairing the heart's ability to respond to stress, unlike irregular heartbeats or pacemakers.
A client tells the nurse on admission that she is uneasy about having to leave her children with a relative while being in the hospital for surgery. The most appropriate action by the nurse is to do which of the following?
- A. Reassure the client that her children will be fine and she should stop worrying.
- B. Contact the relative to determine their capacity to be an adequate care provider.
- C. Encourage the client to call the children to make sure they are doing well.
- D. Gather more information about the client's feelings about the childcare arrangements.
Correct Answer: D
Rationale: The health history is conducted to ascertain a client's state of wellness or illness. A personal dialogue between a client and a nurse is conducted to obtain information. To achieve a relationship of mutual trust and respect, the nurse must have the ability to communicate a sincere interest in the client. The therapeutic communication must be adapted to the responses, problems, and needs of the client. Reassurance and the remaining options do not demonstrate that the nurse is genuinely interested in the client's needs. (CN: Psychosocial adaptation; CL: Synthesize)