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When planning care for an adolescent who plays sports, which modification should the nurse include in the care plan?
- A. Increasing carbohydrates to 55% to 60% of total intake
- B. Providing vitamin and mineral supplements
- C. Decreasing protein intake to 0.75 g/kg/day
- D. Limiting water before and after exercise
Correct Answer: A
Rationale: When planning care for an adolescent who plays sports, it is important to provide adequate nutrition to meet their increased energy needs. Carbohydrates are the main source of energy, providing fuel for physical activity. Adolescents engaged in sports require a higher carbohydrate intake and should aim for 55% to 60% of their total daily kilocalories to support their activity levels. Carbohydrates are essential for providing energy during exercise, building and repairing muscles, and promoting overall performance. Increasing carbohydrate intake in the diet is a key modification to support the energy demands of an active adolescent involved in sports.
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A nurse at an allergy clinic is providing education for a patient starting immunotherapy for the treatment of allergies. What education should the nurse prioritize?
- A. The importance of scheduling appointments for the same time each month
- B. The importance of keeping appointments for desensitization procedures
- C. The importance of avoiding antihistamines for the duration of treatment
- D. The importance of keeping a diary of reactions to the immunotherapy
Correct Answer: B
Rationale: The nurse should prioritize educating the patient on the importance of keeping appointments for desensitization procedures. Immunotherapy involves gradually increasing exposure to allergens to build tolerance and reduce allergic reactions. Missing desensitization appointments can lead to interruptions in treatment and potentially decrease the effectiveness of the therapy. It is crucial for the patient to adhere to the scheduled appointments as prescribed by the healthcare provider to ensure the success of the immunotherapy treatment.
A middle-aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this offer. How should the nurse best respond?
- A. Most women with HIV dont know they have the disease. If you have it, its important we catch it early.
- B. This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history.
- C. The rationale for this testing is so that you can begin treatment as soon as testing comes back, if its positive.
- D. Youre being offered this testing because you are actually in the prime demographic for HIV infection.
Correct Answer: B
Rationale: Option B is the best response for the nurse to provide in this situation. By stating that the testing is offered to every adolescent and adult regardless of lifestyle, appearance, or history, the nurse conveys that HIV testing is a standard practice and not targeting the patient specifically. This can help reduce the patient's feeling of embarrassment or stigma associated with the offer of testing. It also emphasizes the importance of universal screening for HIV to promote early detection and treatment, regardless of risk factors or demographics. This response helps maintain the patient's dignity and encourages them to consider the testing in a non-judgmental way.
A patient with chronic open-angle glaucoma is being taught to self-administer pilocarpine. After the patient administers the pilocarpine, the patient states that her vision is blurred. Which nursing action is most appropriate?
- A. Holding the next dose and notifying the physician
- B. Treating the patient for an allergic reaction
- C. Suggesting that the patient put on her glasses
- D. Explaining that this is an expected adverse effect
Correct Answer: D
Rationale: Blurred vision is a common adverse effect of pilocarpine, a miotic agent commonly used for open-angle glaucoma. It occurs due to the constriction of the pupil, which can affect the patient's ability to focus clearly. Therefore, it is important for the nurse to explain to the patient that blurred vision is an expected adverse effect of the medication. This reassurance can help alleviate the patient's concerns and improve their understanding of the medication therapy. Holding the next dose and notifying the physician is not necessary in this situation as blurred vision is a known side effect and treating the patient for an allergic reaction or suggesting that the patient put on her glasses would not address the underlying cause of the blurred vision.
An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?
- A. Adhering to primary tumor cells
- B. Inducing mutation of cells of another organ
- C. Phagocytizing healthy cells
- D. Invading healthy host tissues
Correct Answer: D
Rationale: Malignant disease processes transfer cells from one place to another primarily through the invasion of healthy host tissues. Cancer cells have the ability to break away from the primary tumor site and invade nearby healthy tissues. Once invasive cancer cells find their way into blood vessels or lymphatics, they can be carried to distant sites in the body where they can form new tumors, establish metastases, and spread the disease. This invasive property of cancer cells underlies the ability of cancer to spread throughout the body, a process known as metastasis. Commanding the cells to appear to adhere to primary tumor cells, inducing mutation of cells of another organ, or phagocytizing healthy cells are not mechanisms by which malignant disease processes transfer cells from one place to another.
A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous?
- A. Eversion of the right nipple and mobile mass
- B. A nonmobile mass with irregular edges
- C. A mobile mass that is soft and easily delineated
- D. Nonpalpable right axillary lymph nodes
Correct Answer: B
Rationale: A nonmobile mass with irregular edges would most strongly suggest that the patient's lump is cancerous. Breast cancer lumps typically do not move easily and have irregular, poorly defined edges. These characteristics are concerning because they can indicate an invasive and aggressive growth pattern. Additionally, the fact that the lump is painless is another feature that raises suspicion for malignancy. It is important for the patient to undergo further evaluation, possibly including a mammogram, ultrasound, and biopsy, to determine the nature of the lump and provide appropriate treatment.