Nokea
What most likely led to the 67-year-old woman who lives alone tripping on a rug in her home and fracturing her hip?
- A. Failing eyesight causing an unsafe environment.
- B. Renal osteodystrophy due to chronic renal failure.
- C. Osteoporosis due to hormonal changes.
- D. Cardiovascular changes leading to small strokes impairing mental acuity.
Correct Answer: C
Rationale: The correct answer is C. Osteoporosis, caused by hormonal changes in later life, is the most likely predisposing factor for the fracture in the proximal end of her femur. Osteoporosis leads to reduced bone density, making bones more fragile and susceptible to fractures, especially in the elderly. Choices A, B, and D are less likely to directly lead to a hip fracture in this scenario. Failing eyesight (choice A) could contribute to the fall but is not the main predisposing factor for the fracture. Renal osteodystrophy (choice B) and cardiovascular changes (choice D) are less commonly associated with hip fractures compared to osteoporosis in elderly women.
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What is the correct procedure for performing an ophthalmoscopic examination on a client's right retina?
- A. Instruct the client to focus on a distant object behind the examiner and not move their eyes during the exam.
- B. Set the ophthalmoscope on the plus 2 to 3 lens and hold it in front of the examiner's right eye.
- C. From a distance of 12 to 15 inches and slightly to the side, shine the light into the client's pupil.
- D. For optimal visualization, keep the ophthalmoscope at least 3 inches from the client's eye.
Correct Answer: C
Rationale: During an ophthalmoscopic examination, the client should focus on a distant object behind the examiner to dilate the pupil, and the examiner should stand at a distance of 12-15 inches away and slightly to the side. This angle allows for better visualization of the retina. Holding the ophthalmoscope firmly against the examiner's face and shining the light into the client's pupil helps examine the retina effectively. Choice A is incorrect because the client should look at a distant object, not the examiner's nose. Choice B is incorrect as the ophthalmoscope should be directed towards the client's eye, not the examiner's eye. Choice D is incorrect because keeping the ophthalmoscope at least 3 inches away may not provide an optimal view of the retina.
In assessing cancer risk, which woman is at greatest risk of developing breast cancer?
- A. A 35-year-old multipara who never breastfed.
- B. A 50-year-old whose mother had unilateral breast cancer.
- C. A 55-year-old whose mother-in-law had bilateral breast cancer.
- D. A 20-year-old whose menarche occurred at age 9.
Correct Answer: B
Rationale: The correct answer is B because family history of breast cancer, specifically in the mother, is a significant risk factor for developing breast cancer. The age of 50 is also a risk factor for breast cancer. Choice A is less likely as breastfeeding can actually reduce the risk of breast cancer. Choice C is less relevant since the risk is higher with a direct family member. Choice D, although early menarche is a risk factor, the age of the individual is much lower compared to the other age-related risk factors.
An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the client will most likely reveal which sign/symptom?
- A. Leukocytosis and febrile.
- B. Polycythemia and crackles.
- C. Pharyngitis and sputum production.
- D. Confusion and tachycardia.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A middle-aged male client with diabetes continues to eat an abundance of foods that are high in sugar and fat. According to the Health Belief Model, which event is most likely to increase the client's willingness to become compliant with the prescribed diet?
- A. He visits his diabetic brother who just had surgery to amputate an infected foot.
- B. He is provided with the most current information about the dangers of untreated diabetes.
- C. He comments on the community service announcements about preventing complications associated with diabetes.
- D. His wife expresses a sincere willingness to prepare meals that are within his prescribed diet.
Correct Answer: A
Rationale: According to the Health Belief Model, the most effective event to increase compliance with the prescribed diet for a middle-aged male client with diabetes is experiencing a significant consequence related to the disease. In this case, visiting his diabetic brother who just had surgery to amputate an infected foot would serve as a strong 'cue to action,' increasing the client's perceived seriousness of the disease. This event is likely to have a more immediate and impactful effect on the client than other options. Option B provides valuable information but may not have the same personal and emotional impact as witnessing a severe consequence firsthand. Option C involves indirect exposure to prevention messages, which might not be as compelling as a direct experience. Option D, while supportive, does not present a direct consequence of non-compliance like option A does.
A client who just returned from the recovery room after a tonsillectomy and adenoidectomy is restless, and her pulse rate is increased. As the nurse continues the assessment, the client begins to vomit a copious amount of bright-red blood. The immediate nursing action is to:
- A. Notify the surgeon
- B. Continue the assessment
- C. Check the client's blood pressure
- D. Obtain a flashlight, gauze, and a curved hemostat
Correct Answer: A
Rationale: In the scenario described, the client's presentation with bright-red blood vomiting after a tonsillectomy and adenoidectomy is highly concerning for an immediate postoperative hemorrhage, which can be life-threatening. The priority action for the nurse is to notify the surgeon immediately. Prompt communication with the surgeon is vital to ensure swift intervention and appropriate management to address the hemorrhage effectively. Continuing the assessment, checking the client's blood pressure, or obtaining equipment are all secondary actions in this critical situation and would delay the necessary urgent intervention required to manage the hemorrhage effectively.