Nokea
Where do the lesions of atopic dermatitis (eczema) most commonly occur in the infant? (Select all that apply.)
- A. Cheeks
- B. Buttocks
- C. Extensor surfaces of arms and legs
- D. Back
Correct Answer: A
Rationale: In infants with atopic dermatitis (eczema), the lesions most commonly occur on the cheeks (option A) and the extensor surfaces of the arms and legs (option C). The cheeks are a common site of involvement due to increased exposure to irritants and saliva from drooling. The extensor surfaces of the arms and legs are also frequently affected due to scratching and rubbing against clothing. While atopic dermatitis can occur in other areas such as the buttocks, back, and trunk, the cheeks and extensor surfaces are the most common locations in infants.
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During a breast examination, which finding most strongly suggests that the client has breast cancer?
- A. Slight asymmetry of the breasts
- B. A fixed nodular mass with dimpling of the overlying skin
- C. Bloody discharge from the nipple
- D. Multiple firm, round, freely movable masses that change with the menstrual cycle
Correct Answer: B
Rationale: A fixed nodular mass with dimpling of the overlying skin is the finding that most strongly suggests breast cancer. This presentation is concerning for an invasive carcinoma that has invaded into the surrounding tissues, leading to the dimpling of the skin. Breast cancer typically presents as a painless, hard, irregularly shaped, non-mobile mass. Dimpling of the skin overlying the mass is a sign of advanced disease and is often associated with a poor prognosis. Therefore, this finding should raise suspicion for breast cancer and prompt further evaluation and workup.
Which of the ff instructions should be given to the clients family if a client with impaired swallowing has to take solid medication?
- A. Mix the medication with food
- B. Use the liquid form of the medication
- C. Check with the physician or pharmacist before crushing or breaking tablets, or opening capsules
- D. Perform ROM exercises after the medication is administered
Correct Answer: C
Rationale: It is important to instruct the client's family to check with the physician or pharmacist before crushing or breaking tablets, or opening capsules for a client with impaired swallowing who needs to take solid medication. Many medications have special formulations or coating that may alter their effectiveness if not taken whole. Consulting with a healthcare professional ensures that the medication remains safe and effective when modifying its form for a client with difficulty swallowing. Mixing the medication with food (option A) may also alter its effectiveness, so it is crucial to seek guidance before making any changes to the medication form. Using the liquid form of the medication (option B) may be a suitable alternative if available; however, this decision should also be discussed and approved by the healthcare provider. Performing ROM exercises after medication administration (option D) is unrelated to addressing the issue of impaired swallowing and medication administration.
Laboratory confirmation of the diagnosis in Question 1 can best be obtained by measuring the toxic compound's concentration in which of the following?
- A. Urine
- B. Blood
- C. Hair
- D. Saliva
Correct Answer: A
Rationale: Mercury levels are most accurately measured in urine, especially in cases of chronic exposure.
The nurse is working in a support group for client with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress?
- A. Avoiding the use of recreational drugs and alcohol
- B. Refraining from telling anyone about the diagnosis
- C. Following safer-sex practices
- D. Telling potential sex partners about the diagnosis, as required by the law
Correct Answer: C
Rationale: Following safer sex practices is the most important point for the nurse to stress when working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Safer sex practices, such as using condoms consistently and correctly, can help reduce the risk of transmitting the virus to others or acquiring other sexually transmitted infections. While avoiding the use of recreational drugs and alcohol is beneficial for overall health, it is not as crucial as practicing safer sex. Refraining from telling anyone about the diagnosis is not recommended, as social support is important for individuals living with AIDS. Telling potential sex partners about the diagnosis is also essential, not only for ethical reasons but also to prevent the transmission of the virus.
A client with serum glucose level of 618mg/dl is admitted to the facility. He's awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6F (38.1C), heart rate of 116 beats/min, and blood pressure of 108/70mHg. Based on these assessment findings, which nursing diagnosis take highest priority?
- A. Deficient volume related to osmotic diuresis
- B. Decreased cardiac output related to elevated heart rate
- C. Imbalanced nutrition: Less than body requirements related to insulin deficiency
- D. Ineffective thermoregulation related to dehydration
Correct Answer: A
Rationale: The client's serum glucose level of 618mg/dl is indicative of severe hyperglycemia, likely due to uncontrolled diabetes mellitus. The client's presentation with hot dry skin, elevated heart rate, and low blood pressure suggests dehydration as a result of osmotic diuresis, which occurs in an attempt to excrete excess glucose. With an elevated heart rate and low blood pressure, it is essential to address the deficient volume to prevent further complications such as hypovolemic shock. Rehydration and fluid replacement are crucial interventions to help restore the client's fluid balance and prevent hemodynamic instability. Addressing the deficient volume related to osmotic diuresis should take the highest priority in this case.