Nokea
The nurse should recognize that all of the following physical changes of the head and face are associated with the aging client except:
- A. Pronounced wrinkles on the face
- B. Decreased size of the nose and ears
- C. Increased growth of facial hair
- D. Neck wrinkles
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is:
- A. The mottled appearance of the trunk
- B. The presence of conjunctival hemorrhages
- C. Cyanosis of the hands and feet
- D. Respiratory rate of 20-28 per minute
Correct Answer: C
Rationale: A 5-minute Apgar score of 9 typically reflects one point deduction, often for color, with cyanosis of the hands and feet (acrocyanosis) being common in newborns, especially post-C-section, due to initial circulation adjustments. Mottling or hemorrhages don't directly score points off, and a respiratory rate of 20-28 is low (normal is 30-60), potentially docking more points. Nurses recognize acrocyanosis as benign, resolving naturally, and use this score to reassure parents while monitoring transition, ensuring no further intervention is needed.
A healthcare professional is preparing to administer an intradermal injection. Which of the following actions should the professional take?
- A. Use a 1-inch needle.
- B. Insert the needle at a 45-degree angle.
- C. Use a tuberculin syringe.
- D. Aspirate before injecting.
Correct Answer: C
Rationale: When administering an intradermal injection, a tuberculin syringe is the appropriate choice due to its small size and precise measurement markings, which are essential for accurately delivering the medication into the dermis layer of the skin. Using a 1-inch needle (choice A) is more common for subcutaneous injections, while inserting the needle at a 45-degree angle (choice B) is typical for intramuscular injections. Aspirating before injecting (choice D) is not necessary for intradermal injections, as the goal is to deliver the medication into the dermis rather than a blood vessel.
Which domains of learning is responsible for making John and Marsha understand the different kinds of family planning methods?
- A. Cognitive
- B. Affective
- C. Psychomotor
- D. Motivative
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client has a new prescription for total parenteral nutrition (TPN). Which of the following actions should the nurse plan to take?
- A. Obtain a random blood glucose daily.
- B. Change the IV tubing every 72 hours.
- C. Apply a new dressing to the IV site every 24 hours.
- D. Weigh the client weekly.
Correct Answer: A
Rationale: When a client is on total parenteral nutrition (TPN), monitoring blood glucose levels daily is crucial to manage and detect complications like hyperglycemia, which can occur due to the high glucose content in TPN solutions. Regular blood glucose monitoring helps the healthcare team adjust the TPN infusion rate to maintain optimal glucose levels and prevent adverse events.
In Virginia Henderson's 1966 definition of nursing, a person/client has which of the following numbers of fundamental needs?
- A. 7
- B. 14
- C. 18
- D. 22
Correct Answer: B
Rationale: Virginia Henderson's 1966 definition identifies 14 fundamental needs that nursing addresses to help clients achieve independence or a peaceful death. These include breathing, eating, elimination, and rest, among others, forming a comprehensive framework for holistic care. Unlike narrower or broader counts, 14 captures the essentials Henderson deemed universal, guiding nurses to assess and support each area. For example, assisting a client with mobility meets one need, while ensuring nutrition meets another, illustrating practical application. This specificity distinguishes her model, balancing detail with practicality in nursing practice.