Nokea
These facts are true regarding the developmental stage of preschool children EXCEPT
- A. handedness is achieved by 3 years of age
- B. boys are usually later than girls in achieving bladder control
- C. knowing gender by 4 years
- D. musturbation
Correct Answer: D
Rationale: Musturbation is not a recognized developmental milestone.
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Which of the following medications can be used to quickly reduce SOB in a crisis situation for a patient with end-stage respiratory disease?
- A. Oral cortisone
- B. IV morphine
- C. IM meperidine (Demerol)
- D. IV propanolol (Inderal)
Correct Answer: B
Rationale: IV morphine is the most appropriate choice among the options provided for quickly reducing shortness of breath (SOB) in a crisis situation for a patient with end-stage respiratory disease. Morphine is commonly used in palliative care for symptom management in patients with severe respiratory distress. It acts as a respiratory depressant by reducing the perception of breathlessness, which can help alleviate the distressing symptoms of dyspnea. The rapid onset of action of IV morphine makes it an effective option for immediate relief in emergency situations for patients experiencing significant SOB due to end-stage respiratory disease. Oral cortisone, IM meperidine (Demerol), and IV propranolol (Inderal) are not primary choices for quickly reducing SOB in this context.
You are examining a 12-year-old female adolescent with a small nevus in the thigh; the mother is concerned regarding the future development of melanoma. All the following findings raise suspicion of melanoma EXCEPT
- A. enlarging nevus
- B. changing colors
- C. irregular margins
- D. easily bleeds
Correct Answer: E
Rationale: Spitz nevus is a benign mimic of melanoma and does not raise suspicion.
The nurse is caring for a patient with a bowel resection. Which of the following would indicate that the patient's gastrointestinal tract is resuming normal function?
- A. Firm abdomen
- B. Presence of flatus
- C. Excessive thirst
- D. Absent bowel sounds
Correct Answer: B
Rationale: The presence of flatus (gas) is a positive sign that the patient's gastrointestinal tract is resuming normal function after a bowel resection surgery. Flatus production indicates that peristalsis and normal bowel motility are returning, allowing gas to move through the intestine. This is an important milestone in the postoperative recovery process, as it suggests the return of normal bowel function. The other options provided are not indicative of the return of normal gastrointestinal function.
The client with rheumatoid arthritis reports GI irritation after taking piroxicam (Feldene). To prevent GI upset, the nurse should provide which instruction?
- A. Space the administration every 4 hours.
- B. Use the drug for a short time only
- C. Take piroxicam with food or oral antacid
- D. Decrease the piroxicam dosage
Correct Answer: C
Rationale: Piroxicam is a nonselective NSAID (nonsteroidal anti-inflammatory drug) that can irritate the gastrointestinal (GI) tract, leading to symptoms such as heartburn, indigestion, and stomach pain. Taking piroxicam with food or an oral antacid can help reduce GI irritation by providing a protective barrier and reducing acid production within the stomach. Encouraging the client to take piroxicam with a meal or antacid can help prevent or minimize GI upset associated with the medication. Additionally, using a proton pump inhibitor (PPI) or histamine-2 receptor antagonist (H2 blocker) along with piroxicam may further protect the stomach lining from irritation.
A client becomes upset when the physician diagnoses diabetes mellitus as the cause of current signs and symptoms. The client tells the nurse, "This must be a mistake. No one in my family has ever had diabetes." Based on this statement, the nurse suspects the client is using which coping mechanism?
- A. Denial
- B. Anger
- C. Withdrawal
- D. Resolution
Correct Answer: A
Rationale: The client's response of stating that diabetes cannot be possible because it is not prevalent in the family indicates that the client is using the coping mechanism of denial. Denial is a common defense mechanism where individuals refuse to accept reality or facts that are too uncomfortable for them to acknowledge. In this situation, the client is denying the diagnosis of diabetes as a way to cope with the distressing news, hoping that it may not be true because it has not affected their family members in the past. Recognizing this coping mechanism is important for the nurse to provide support and education to help the client come to terms with the diagnosis and start managing the condition effectively.