Nokea
When caring for a Native-American family, what does the nurse need to consider?
- A. The family may consist of extended family members beyond parents and children.
- B. Native Americans tend to value their heritage and traditions.
- C. Some Native Americans use herbs and psychologic treatments for illnesses.
- D. Health care practices vary among different tribes and individuals.
Correct Answer: C
Rationale: When caring for a Native-American family, it is crucial to acknowledge and respect their cultural beliefs and practices. Choice A, while relevant, is not as specific as understanding the use of herbs and psychologic treatments in Native American healing practices. Choice B, though generally true, does not directly impact the nursing care provided. Choice D, although true, is too broad and does not focus on the specific aspect of treatment practices. Choice C is the most appropriate answer as it highlights the importance of recognizing and incorporating traditional healing methods into the nursing care plan, promoting culturally sensitive and holistic care.
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Some drugs are excreted into bile and delivered to the intestines. Prior to elimination from the body, the drug might be absorbed. This process is known as:
- A. hepatic clearance.
- B. total clearance.
- C. enterohepatic cycling.
- D. first-pass effect.
Correct Answer: C
Rationale: The correct answer is 'enterohepatic cycling.' This process involves drugs being excreted into bile, delivered to the intestines, reabsorbed into the circulation, and can prolong the drug's presence in the body. 'Hepatic clearance' (Choice A) refers to the amount of drug eliminated by the liver. 'Total clearance' (Choice B) is the sum of all types of clearance including renal, hepatic, and respiratory. 'First-pass effect' (Choice D) is the amount of drug absorbed from the GI tract and metabolized by the liver before entering circulation, reducing the amount of drug available for systemic circulation.
As a type of quality indicator, an example of a structure standard is:
- A. a written philosophy.
- B. a procedure for a straight catheterization.
- C. a protocol for treatment of a client with chest pain.
- D. the diagnostic work-up for a client with abdominal pain.
Correct Answer: A
Rationale: The correct answer is 'a written philosophy.' Structure standards define the conditions needed to operate a system and do not directly involve client care. Examples include philosophy, objectives, goals, hours of operation, and management responsibility. Choices B, C, and D involve specific procedures and protocols related to client care, which are not structure standards.
Hormonal agents are used to treat some cancers. An example is:
- A. thyroxine to treat thyroid cancer.
- B. ACTH to treat adrenal carcinoma.
- C. estrogen antagonists to treat breast cancer.
- D. glucagon to treat pancreatic carcinoma.
Correct Answer: C
Rationale: Estrogen antagonists are commonly used to treat estrogen hormone-dependent cancers such as breast carcinoma. One well-known estrogen antagonist used in breast cancer therapy is Tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs, reduces breast cancer recurrence by 30%. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history. Thyroxine is a thyroid hormone used to treat hypothyroidism, not thyroid cancer. ACTH is an anterior pituitary hormone that stimulates the adrenal glands to release glucocorticoids; it does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone that stimulates glycogenolysis and gluconeogenesis; it does not treat pancreatic cancer.
When questioning an elder about suspected abuse, how should the nurse keep the questions?
- A. Nonjudgmental.
- B. Probing.
- C. Confrontational.
- D. Indirect.
Correct Answer: A
Rationale: When questioning an elder about suspected abuse, the nurse should keep the questions nonjudgmental. This approach helps the elder feel safe and more willing to share information. Probing questions might be perceived as invasive, confrontational questions can lead to defensiveness and denial, and indirect questions may not elicit the necessary information, resulting in confusion or misinterpretation.
Which of the following statements by a client with spinal cord injury indicates a need for further teaching by the nurse regarding bowel management?
- A. "I should avoid eating foods that produce gas."?
- B. "I should drink more fluids like water and non-caffeinated fruit juices."?
- C. "I should set a regular schedule for bowel movements."?
- D. "I should sit in an upright position for bowel movements."?
Correct Answer: B
Rationale: The corrected statement indicates the need for further teaching because it suggests consuming fluids like fruit juices, which can include caffeinated options that may stimulate fluid loss through increased urination. It is more appropriate to emphasize the consumption of fluids like water and non-caffeinated fruit juices for proper hydration. Choices A, C, and D demonstrate a correct understanding of bowel management by focusing on dietary considerations, establishing a regular bowel movement schedule, and using proper positioning during bowel movements. Option B is incorrect as it may lead to increased fluid loss due to caffeine content in some fruit juices.