What is a mental status assessment of the older adult especially important in determining?
- A. Potential for independent living
- B. Eligibility for federal health programs
- C. Service and placement needs of the individual
- D. Whether the person should be classified as frail
Correct Answer: C
Rationale: Mental status assessments help determine appropriate services and placements based on cognitive and functional abilities.
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When performing tracheostomy care, which intervention should the nurse implement?
- A. Use aseptic technique.
- B. Clean the inner cannula with mild soap and water.
- C. Secure new tracheostomy ties before removing old ones.
- D. Apply suction when inserting the catheter.
Correct Answer: C
Rationale: The correct answer is C: Secure new tracheostomy ties before removing old ones. This is essential to ensure the patient's airway remains stable and secure during the procedure. By securing the new ties first, the tracheostomy tube will not accidentally dislodge or become displaced.
A: Using aseptic technique is important but not the immediate priority in this situation.
B: Cleaning the inner cannula is a routine part of tracheostomy care but not the primary intervention during tie change.
D: Applying suction when inserting the catheter is incorrect as suctioning should be performed after securing the new ties to maintain airway patency.
15. What is the role of the professional nurse related to the use of complementary and alternative therapies (CAT) (select all that apply)?
- A. Seeking further education on CAT
- B. Evaluating the evidence regarding CAT
- C. Collecting data on the use of CAT as part of the nursing assessment
- D. Suggesting specific herbs the patient should take to help with his or her condition
Correct Answer: A
Rationale: Options A, B, and C reflect appropriate roles for nurses in relation to CAT, including seeking education, evaluating evidence, and collecting relevant data during assessments.
Mr. Jones is being discharged today. Which of the following statements by Mr. Jones would indicate that he understands his postoperative regimen?
- A. I'm taking my nephew to the amusement park next week and we are going to ride the roller-coasters.'
- B. My brother will be coming over every day to help me with my bath and to shave me.'
- C. I think I'll watch the baseball games on TV this week rather than driving to the stadium.'
- D. I guess I'll have to take an early retirement since my job as an accountant requires me to use my eyes a lot.'
Correct Answer: C
Rationale: Avoiding strenuous activities like driving or riding roller coasters demonstrates understanding of activity restrictions necessary during recovery from retinal surgery.
Mary asks how the pulmonary function test ordered by her physician is performed. You respond by saying
- A. You breathe into a spirometer to measure your lung capacity.
- B. You breathe through a mouthpiece into a spirometer until all air in your lungs is expelled; then you take a deep breath through the mouthpiece. This is done three times and a computer calculates the capacity of your lungs.
- C. A computer is used to measure your volume and vital capacity.
- D. A tube is inserted into your lungs while you are asleep to expand your lungs to their full capacity.
Correct Answer: B
Rationale: Pulmonary function tests measure lung capacity using spirometry.
Which of the following is a finding that is most often associated with endometrial cancer?
- A. Thickened endometrial lining on ultrasound
- B. Irregular periods
- C. Young age
- D. Dyspareunia
Correct Answer: A
Rationale: A thickened endometrial lining on ultrasound is commonly associated with endometrial cancer, indicating abnormal cell growth.