Nokea
The nurse is preparing to assist in examining a Hispanic child who was brought to the clinic by the mother. During the assessment of the child, the nurse should take which action(s)?
- A. Building rapport with the child
- B. Taking the child's temperature
- C. A, D
- D. Obtaining an interpreter if necessary
Correct Answer: C
Rationale: Building rapport with the child is essential to establish trust and cooperation during the assessment. Admiring the child may not be appropriate in a professional setting and might not contribute significantly to the assessment. Taking the child's temperature is a routine part of the assessment but may not be the most critical action in this scenario. Obtaining an interpreter is crucial to ensure effective communication between the healthcare team and the child and their mother, especially considering potential language barriers.
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The nurse is caring for clients on a medical floor. Which client will the nurse assess first?
- A. The client with an abdominal aortic aneurysm who is constipated
- B. The client on bed rest who ambulated to the bathroom
- C. The client with essential hypertension who has epistaxis and a headache
- D. The client with arterial occlusive disease who has a decreased pedal pulse
Correct Answer: C
Rationale: The correct answer is C because epistaxis and headache in a client with hypertension are signs of a hypertensive crisis, requiring immediate intervention. Option A is incorrect as constipation in a client with an abdominal aortic aneurysm, though important, does not indicate an immediate need for assessment. Option B, a client on bed rest who ambulated to the bathroom, does not present with urgent signs or symptoms requiring immediate assessment. Option D, a client with arterial occlusive disease and a decreased pedal pulse, needs attention but is not the priority compared to a hypertensive crisis with epistaxis and headache.
The nurse cares for a client receiving furosemide (Lasix). The nurse determines that teaching is effective if the client selects which of the following foods?
- A. One medium baked potato
- B. One slice of white bread
- C. One medium apple
- D. One scrambled egg
Correct Answer: A
Rationale: The correct answer is A: One medium baked potato. Potatoes are high in potassium, which is essential for clients on Lasix to prevent hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, so consuming potassium-rich foods like baked potatoes can help maintain normal potassium levels. Choices B, C, and D do not provide a significant source of potassium, which is crucial for clients on furosemide therapy.
Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task 'Conduct physical training'?
- A. Accountability
- B. Personal/professional development
- C. Individual training
- D. Military appearance/physical condition
Correct Answer: D
Rationale: The correct answer is D: 'Military appearance/physical condition.' The task 'Conduct physical training' aligns with the category of 'Military appearance/physical condition,' as it involves overseeing physical training activities related to maintaining a certain physical standard. Choices A, B, and C are incorrect because 'Accountability' pertains to being answerable for one's actions, 'Personal/professional development' focuses on individual growth and learning, and 'Individual training' is specific to training on a personal level, none of which directly relate to the task of conducting physical training in the context of military appearance and physical condition.
The nurse is teaching a community class to people with Type 2 diabetes mellitus. Which explanation would explain the development of Type 2 diabetes?
- A. The islet cells in the pancreas stop producing insulin
- B. The client eats too many foods that are high in sugar
- C. The pituitary gland does not produce vasopressin
- D. The cells become resistant to the circulating insulin
Correct Answer: D
Rationale: The correct answer is D. In Type 2 diabetes, the primary issue is insulin resistance, where cells do not respond effectively to insulin. Choice A is incorrect because in Type 1 diabetes, the islet cells in the pancreas stop producing insulin. Choice B is not directly related to the development of Type 2 diabetes but rather to its management. Choice C is incorrect as it refers to a dysfunction in vasopressin production, which is not related to Type 2 diabetes.
Who is at higher risk for drug-nutrient interactions?
- A. Infants
- B. People with diabetes
- C. Women of childbearing age
- D. Older men and women
Correct Answer: D
Rationale: Older men and women are at higher risk for drug-nutrient interactions due to factors such as polypharmacy and physiological changes. Polypharmacy, common in older adults, increases the likelihood of interactions between drugs and nutrients. Physiological changes that occur with aging can affect how drugs and nutrients are absorbed, distributed, metabolized, and excreted in the body. Infants, people with diabetes, and women of childbearing age are not typically considered high-risk groups for drug-nutrient interactions compared to older adults.