Nokea
Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:
- A. A sense of purpose in life
- B. Circadian rhythm disruption
- C. Age-related renal dysfunction
- D. Excessive weight gain or loss
Correct Answer: A
Rationale: A strong sense of purpose in life is associated with better stress coping mechanisms, which can enhance a person's capacity to adapt. Having a clear sense of purpose provides individuals with motivation, direction, and resilience to face challenges. Choices B, C, and D are not directly related to an increased capacity to adapt to stress. Circadian rhythm disruption, age-related renal dysfunction, and excessive weight gain or loss may have negative impacts on overall well-being and stress management.
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What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?
- A. Take the medication at the same time each day to maintain consistent hormone levels.
- B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
- C. Discontinue medroxyprogesterone if side effects occur.
- D. Medroxyprogesterone should be taken once a week to maintain effectiveness.
Correct Answer: A
Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.
A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?
- A. Begin an exercise regimen.
- B. Begin smoking cessation.
- C. Begin daily aspirin therapy.
- D. Begin taking a loop diuretic to aid weight loss.
Correct Answer: B
Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.
Which scenario would be an example of a child born with congenital insensitivity to pain?
- A. A child who does not cry when injured and fails to respond to painful stimuli.
- B. A child who cries excessively and has a heightened response to pain.
- C. A child who experiences pain but has difficulty expressing it.
- D. A child who is sensitive to minor stimuli but has a delayed response to severe pain.
Correct Answer: A
Rationale: The correct scenario depicting a child with congenital insensitivity to pain is when the child does not cry when injured and fails to respond to painful stimuli. This condition is characterized by the inability to feel and react to pain, resulting in a lack of typical responses such as crying or withdrawal when hurt. Choice B is incorrect as it describes a child with heightened pain sensitivity, opposite to the insensitivity seen in the condition. Choice C is incorrect as it suggests the child feels pain but struggles to communicate it, which is not the case with congenital insensitivity to pain. Choice D is incorrect as it describes a child who is sensitive to minor stimuli and has delayed responses to severe pain, which is not indicative of congenital insensitivity to pain.
A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What therapeutic effect is expected from this medication?
- A. Reduction in prostate size and improvement in urinary symptoms
- B. Increase in urine flow and relief of urinary obstruction
- C. Improvement in erectile function
- D. Relief of pain associated with BPH
Correct Answer: A
Rationale: The correct answer is A: Reduction in prostate size and improvement in urinary symptoms. Finasteride works by reducing the size of the prostate gland, which in turn helps alleviate urinary symptoms such as frequency, urgency, weak stream, and incomplete emptying of the bladder. Choice B is incorrect as while finasteride can improve urine flow indirectly by reducing prostate size, it does not directly increase urine flow. Choice C is incorrect because finasteride is not intended to improve erectile function. Choice D is incorrect as finasteride does not primarily provide relief from pain associated with BPH.
While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:
- A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
- B. interruption of the blood/oxygen supply to the brain.
- C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
- D. a blood clot coming from the heart and occluding the carotid arteries.
Correct Answer: B
Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.