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What is the correct interpretation of a drumlike sound heard during percussion of the abdomen?
- A. Constipation
- B. Air-filled areas
- C. The presence of a tumor
- D. The presence of dense organs
Correct Answer: B
Rationale: The correct interpretation of a drumlike sound heard during percussion of the abdomen is that it indicates air-filled areas within the abdomen. This sound, known as tympany, occurs when air is present in the gastrointestinal tract or hollow organs. Percussion produces a resonant, drum-like sound over these air-filled areas. This is a normal finding during a physical examination.
Incorrect Answers:
A: Constipation does not typically produce a drumlike sound during percussion. Constipation may cause a dull sound due to fecal matter retention.
C: The presence of a tumor would not cause a drumlike sound during percussion. Tumors are typically solid masses and would produce a dull sound during percussion.
D: Dense organs such as the liver or spleen would produce a dull sound, not a drumlike sound, during percussion due to their solid nature.
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The public's concept of health has changed since the 1950s. Which of the following statements most accurately describes this change?
- A. Lifestyle, personal habits, exercise, and nutrition are essential to health.
- B. Assessment of health is critical to identifying disease-causing pathogens.
- C. Accurate diagnosis and treatment by a physician are essential for all health care.
- D. An individual is considered healthy when signs and symptoms of disease have been eliminated.
Correct Answer: A
Rationale: The correct answer is A because it reflects the shift towards a holistic view of health focusing on preventive measures and lifestyle choices. In the 1950s, the emphasis was more on treating diseases rather than preventing them through healthy habits. Choice B is incorrect as it only focuses on identifying pathogens, not overall health. Choice C is incorrect because it emphasizes physician-centered healthcare rather than individual responsibility. Choice D is incorrect as it only considers the absence of symptoms, not overall well-being. Therefore, A is the best choice as it aligns with the modern understanding of health promotion and disease prevention.
A nurse is caring for a patient who has undergone a total knee replacement. Which of the following interventions is most important to prevent post-operative complications?
- A. Encouraging early ambulation.
- B. Providing pain medication as needed.
- C. Monitoring for signs of infection.
- D. Administering antibiotics before surgery.
Correct Answer: A
Rationale: The correct answer is A: Encouraging early ambulation. Early ambulation helps prevent complications such as deep vein thrombosis and pulmonary embolism by improving circulation and preventing blood clots. It also promotes joint mobility and muscle strength. Providing pain medication (B) is important but not as crucial as preventing complications. Monitoring for signs of infection (C) is essential but not the most important intervention. Administering antibiotics before surgery (D) does not directly prevent post-operative complications related to knee replacement.
Which of the following would be included in a total health database for a well person?
- A. Nursing goals for the patient
- B. Anticipated growth and development patterns
- C. A patient's perception of his or her health status
- D. The nurse's perception of disease as related to this patient
Correct Answer: C
Rationale: The correct answer is C: A patient's perception of his or her health status. In a total health database for a well person, it is important to include the patient's own perception of their health status as it provides valuable insights into their overall well-being and can help detect any potential health issues early on. This information is crucial for preventive care and promoting a patient-centered approach to healthcare.
A: Nursing goals for the patient - This information would be relevant for a patient with specific health goals or conditions but not necessarily for a well person.
B: Anticipated growth and development patterns - This information is more relevant for pediatric or adolescent populations rather than for a well adult.
D: The nurse's perception of disease as related to this patient - The nurse's perception is subjective and not as valuable as the patient's own perception in understanding their health status.
The nurse is performing a health assessment on a 16-year-old girl, who has been brought to the clinic by her parents. Which of the following instructions would be appropriate for the parents before the interview begins?
- A. "Please stay with your daughter during the interview; you can answer for her if she is not able to."
- B. "It would help to interview the three of you together."
- C. "While I interview your daughter, will you please stay in the room and complete these family health history questionnaires?"
- D. "While I interview your daughter, will you step out to the waiting room and complete these family health history questionnaires?"
Correct Answer: D
Rationale: The correct answer is D because it respects the girl's privacy and allows her to speak freely without parental influence. By asking the parents to step out, the nurse creates a safe space for the girl to discuss any sensitive issues. Choice A may inhibit the girl's honest communication. Choice B risks the parents dominating the conversation. Choice C may make the girl uncomfortable discussing personal matters in front of her parents.
A nurse is caring for a patient who is post-operative following abdominal surgery. The nurse should prioritize which of the following interventions to prevent complications?
- A. Encouraging early ambulation and use of compression stockings.
- B. Administering pain medication regularly.
- C. Monitoring for signs of infection.
- D. Providing nutritional support and hydration.
Correct Answer: A
Rationale: The correct answer is A. Encouraging early ambulation and use of compression stockings is crucial post-abdominal surgery to prevent complications like deep vein thrombosis and pneumonia. Ambulation helps prevent blood clots and promotes lung expansion. Compression stockings aid in preventing blood pooling in the legs. Administering pain medication regularly (B) is important but not the priority. Monitoring for infection (C) is essential but not the priority immediately post-op. Providing nutritional support and hydration (D) is important but not as critical as preventing immediate complications.