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The priority goal for a family who practices Chinese medicine would be to:
- A. Achieve harmony
- B. Maintain a balance of energy
- C. Respect life
- D. Restore yin and yang
Correct Answer: D
Rationale: In Chinese medicine, the concept of yin and yang represents the balance of opposing forces in the body. When there is an imbalance between yin and yang, it can result in illness. Therefore, the priority goal for a family practicing Chinese medicine would be to restore the harmony and balance between yin and yang. Choices A, B, and C are not the priority goal in Chinese medicine. While achieving harmony, maintaining a balance of energy, and respecting life are important aspects of Chinese medicine, the fundamental principle revolves around maintaining the equilibrium of yin and yang for optimal health.
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A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?
- A. Myocardial infarction due to a history of atherosclerosis.
- B. Pulmonary embolism due to deep vein thrombosis (DVT).
- C. Anxiety attacks due to worries about her baby's health.
- D. Congestive heart failure due to fluid overload.
Correct Answer: B
Rationale: In a hospitalized patient on prolonged bed rest, the most likely cause of sudden onset shortness of breath and chest pain is pulmonary embolism. Pregnancy and prolonged inactivity both increase the risk of clot formation in the deep veins of the legs, known as deep vein thrombosis (DVT). These clots can dislodge and travel to the lungs, causing a pulmonary embolism. Myocardial infarction (Choice A) is less likely in a young patient without a significant history of atherosclerosis. Anxiety attacks (Choice C) may present with similar symptoms but are less likely in this context. Congestive heart failure (Choice D) is less probable given the acute onset of symptoms and absence of typical signs like peripheral edema in this case.
A nurse is providing discharge instructions for a client who had back surgery. All of the following indicate that the client is ready for discharge EXCEPT:
- A. The client still has sutures at the incision site
- B. The client is able to take a shower
- C. The client must still use an ice pack at the wound site
- D. The client has a temperature of 100.8°F
Correct Answer: D
Rationale: When determining if a client is ready for discharge after back surgery, it is essential to ensure that there are no signs of complications or emerging issues. A postoperative temperature of 100.8°F may indicate a developing infection, and the client should not be discharged until this is further evaluated by the physician. Choices A, B, and C are indicators that the client is progressing well and ready for discharge, as having sutures, being able to shower, and using an ice pack are typically expected postoperative activities without indicating a need for further hospitalization.
Which action represents the evaluation stage of the plan of care?
- A. The nurse assigns a nursing diagnosis of Impaired Skin Integrity related to diminished skin circulation
- B. The nurse assesses the client's vital signs and asks about symptoms
- C. The nurse determines that the client is not meeting his set outcomes and makes revisions
- D. The nurse discusses the client's health history
Correct Answer: C
Rationale: The correct answer is C. The evaluation stage of the nursing process involves reviewing the assessments, diagnoses, and interventions given to the client and then determining if the client is meeting expected outcomes. In this scenario, the nurse is assessing whether the client is meeting the outcomes set for their care plan and making revisions as needed. Choice A is incorrect as assigning a nursing diagnosis is part of the nursing diagnosis phase, not the evaluation phase. Choice B represents the assessment phase of the nursing process, not the evaluation phase. Choice D involves discussing the client's health history, which is more aligned with the assessment phase rather than the evaluation phase.
A child has recently been diagnosed with Duchenne muscular dystrophy (DMD). The parents are receiving genetic counseling prior to planning another pregnancy. Which of the following statements includes the most accurate information?
- A. Duchenne is an X-linked recessive disorder, so daughters have a 50% chance of being carriers and sons a 50% chance of developing the disease.
- B. Duchenne is an X-linked recessive disorder, so both daughters and sons have a 50% chance of developing the disease.
- C. Each child has a 1 in 4 (25%) chance of developing the disorder.
- D. Sons only have a 1 in 4 (25%) chance of developing the disorder.
Correct Answer: A
Rationale: The correct answer is that Duchenne is an X-linked recessive disorder, meaning the affected gene is located on one of the two X chromosomes of a female carrier. If a son receives the X chromosome bearing the gene, he will develop the disease, giving him a 50% chance of being affected. Daughters, on the other hand, are not affected by Duchenne but have a 50% chance of being carriers since they inherit one copy of the defective gene from the mother. The other X chromosome is inherited from the father, who cannot be a carrier. Therefore, choice A is accurate. Choice B is incorrect because daughters do not develop the disease, and sons have a 50% chance of developing, not both having a 50% chance. Choice C is incorrect as it does not consider the X-linked inheritance pattern of Duchenne. Choice D is inaccurate as it incorrectly states that only sons have a 25% chance of developing the disorder, omitting the carrier status of daughters.
A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?
- A. Family history of heart disease
- B. Overweight
- C. Smoking
- D. Age
Correct Answer: A
Rationale: A family history of heart disease is an inherited risk factor for developing atherosclerosis. This factor is not modifiable through lifestyle changes. Studies have shown that having a first-degree relative with heart disease significantly increases the individual's risk of developing atherosclerosis. Overweight, smoking, and age are not hereditary risk factors for atherosclerosis. Overweight and smoking are lifestyle-related risk factors, while age is a non-modifiable risk factor that increases with time but is not directly inherited.