Nokea
The physician has ordered a low-fat diet for a client with cholecystitis. The nurse recognizes that the client understands the dietary teaching if he selects:
- A. Fried chicken, mashed potatoes, and gravy
- B. Broiled fish, steamed carrots, and rice
- C. Scrambled eggs, bacon, and toast
- D. Hamburger, French fries, and coleslaw
Correct Answer: B
Rationale: Broiled fish, steamed carrots, and rice align with a low-fat diet for cholecystitis, minimizing gallbladder stimulation fried, fatty foods (chicken, bacon, hamburger) worsen inflammation. Nurses reinforce this choice, reducing pain and aiding recovery in gallbladder disease management.
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You partially darken a room and ask the client to look straight ahead. You use a penlight and, approaching from the side you shine the light, it constricts. You remove the light and then shine it on the same pupil again. You also observe the response of the other pupil. You would normally find the other pupil doing which of the following things?
- A. not make any change in size
- B. dilate in an oppositional response to the light
- C. first constrict, then dilate larger than the other pupil
- D. constrict in consensual response
Correct Answer: D
Rationale: The other pupil constricts consensually when light hits one, a normal reflex. No change, dilation, or mixed response indicates abnormality. Nurses test this for brain function.
Which of the following statement is NOT true about coping?
- A. A response to stress
- B. Can be adaptive or maladaptive
- C. Always solves the problem
- D. May involve problem solving
Correct Answer: C
Rationale: Coping responds to stress (A), can be adaptive/maladaptive (B), may solve problems (D) 'always solves' (C) isn't true, as some coping (e.g., denial) avoids, per Lazarus. C's certainty fails, making it untrue.
A nurse working on a busy acute care unit is planning care for a group of clients. Which nursing action best exemplifies the primary focus of the nurse's role?
- A. The nurse focuses on the procedures being performed for clients that day
- B. The nurse adjusts the environment of the client to facilitate provision of care
- C. The nurse monitors the health status of the client throughout the shift
- D. The nurse comforts a client who received bad results from a diagnostic test
Correct Answer: D
Rationale: Nursing's primary focus is promoting health and wellness holistically, partnering with clients to address physical, emotional, and spiritual needs. Comforting a client after bad diagnostic results exemplifies this, offering emotional support during distress, reinforcing trust, and aiding coping core to nursing's caring essence. Focusing on procedures prioritizes tasks over people, while adjusting the environment supports care delivery indirectly. Monitoring health status is vital but reactive, not the central focus. Comforting reflects nursing's commitment to the whole person, not just illness, aligning with its mission to foster well-being across diverse settings. This action embodies the nurse's role as a compassionate advocate, pivotal in acute care where emotional needs often peak alongside physical ones, enhancing overall client resilience.
Neonate of diabetic mother is at risk for all of the following except:
- A. Hypoglycemia
- B. Hypocalcemia
- C. Hyperglycemia
- D. Hyperbilirubinemia
Correct Answer: C
Rationale: Neonates of diabetic mothers (NDM) face metabolic challenges due to maternal hyperglycemia. Hypoglycemia (choice A) occurs because fetal hyperinsulinemia, triggered by high maternal glucose, persists after birth when glucose supply drops. Hypocalcemia (choice B) arises from delayed parathyroid hormone response, common in NDMs. Hyperglycemia (choice C) is less likely postnatally; it's a maternal issue, not a neonatal risk, as the infant's insulin levels typically normalize glucose after delivery. Hyperbilirubinemia (choice D) results from increased red blood cell breakdown, often linked to polycythemia in NDMs. Choice C is correct because hyperglycemia is not a typical risk after birth; instead, hypoglycemia dominates due to insulin excess. Nurses must monitor blood glucose closely in the first hours, provide calcium if needed, and watch for jaundice, ensuring timely management of these interconnected risks to prevent seizures, bone issues, or kernicterus.
Critical thinking is an active organized cognitive process used to carefully examine one's thinking. It allows the nurse to
- A. Direct the assessment in a meaningful and purposeful way
- B. Review assessment with other health care providers
- C. Determination of the nursing care delivered
- D. Indentifies anticipated client responses to illness
Correct Answer: A
Rationale: Critical thinking directs assessment purposefully e.g., probing fatigue to link it to anemia ensuring data collection is focused and relevant. This active process analyzes, synthesizes, and prioritizes, enhancing care planning. Reviewing with providers follows assessment, not its direction. Determining care is planning/implementation, not assessment's role. Identifying responses fits evaluation, not initial data-gathering. Critical thinking's role in steering assessment ensures efficiency and depth, making it the key way nurses apply this cognitive skill in practice.