Which is the MOST appropriate intervention should the nurse do to help family perform the health tasks?
- A. Allow family to decide to use health resources
- B. Help the family recognize the problem
- C. Leave the family what action take on their problem
- D. Refer family to barangay offficials for guidance
Correct Answer: B
Rationale: Helping the family recognize the problem is the most appropriate intervention to assist them in performing health tasks. By recognizing the problem, the family can better understand the need for action and be motivated to take steps to address it. This intervention enables the family to become more engaged in their healthcare decision-making process and enhances their ability to effectively manage their health tasks. It empowers them to seek appropriate health resources and make informed choices in promoting their health and well-being. Ultimately, by acknowledging the problem, the family is better equipped to initiate positive changes and improve their overall health outcomes.
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The nurse specialist explains the characteristics of Hodgkin`s disease. Which of the following is NOT a characteristics of Hodgkin`s disease?
- A. There is presence of Reed-Sternberg cells
- B. The disease occurs the most often in the older adult
- C. The lymph nodes, spleen, and liver are involved
- D. The prognosis depends on the stage of the disease
Correct Answer: B
Rationale: Hodgkin's disease commonly affects young adults between the ages of 15 to 35 and older adults over the age of 50. It is not a disease that occurs most often in older adults. In fact, Hodgkin's disease has a bimodal distribution, meaning it peaks in young adults and again in older adults. It is important to consider the age distribution when suspecting Hodgkin's disease and not exclusively associate it with older adults.
It a medicine is unavailable and therefore not given to the patient, how is it charted?
- A. Leave it blank.
- B. Sign and make an explanation in the Nurses Notes.
- C. With an asterisk or mark, as per hospital protocol.
- D. Write the letter.
Correct Answer: B
Rationale: When a medication is unavailable and therefore not given to the patient, it is important to document this in the Nurses Notes along with an explanation. Leaving it blank (Option A) may lead to confusion or errors as the reason for not administering the medication would not be clear. Using an asterisk or mark as per hospital protocol (Option C) may not provide enough information about why the medication was missed. Writing the letter (Option D) without any explanation would not suffice in terms of documentation and accountability. Therefore, signing and making an explanation in the Nurses Notes (Option B) is the correct way to chart when a medication is unavailable. This ensures proper documentation of the situation and helps in maintaining the continuity of care for the patient.
Which of the following clinical manifestations would the nurse expect to find when performing admission assessment?
- A. Rapid progressive muscular atrophy.
- B. Ascending paralysis with ataxia .
- C. Hyperactive deep tendon reflexes
- D. Paresthesia and muscle weakness of upper body.
Correct Answer: D
Rationale: When performing an admission assessment, the nurse should expect to find clinical manifestations that are indicative of a variety of conditions. Paresthesia (abnormal sensation like tingling, prickling, or numbness) and muscle weakness of the upper body are commonly associated with neurological conditions such as peripheral neuropathy or cervical radiculopathy. These symptoms suggest dysfunction in the nerves that supply the upper body muscles, leading to sensory changes and weakness. This finding would prompt further assessment and evaluation by healthcare providers to determine the underlying cause and appropriate interventions. Rapid progressive muscular atrophy, ascending paralysis with ataxia, and hyperactive deep tendon reflexes are not typically expected findings during an admission assessment and may signal more specific neurological conditions such as amyotrophic lateral sclerosis, Guillain-Barré syndrome, or spinal cord injury, respectively.
Nurse Roberto assists in the care of a 30 year old male post surgical client undergoing nasogastric suctioning. The nurse understands that clients with nasogastric suction is MOST at risks with what imbalances?
- A. Respiratory acidosis
- B. Metabolic alkalosis
- C. Metabolic acidosis
- D. Respiratory alkalosis
Correct Answer: C
Rationale: Clients undergoing nasogastric suctioning are at highest risk for developing metabolic imbalances, specifically metabolic acidosis. Nasogastric suctioning can lead to the loss of gastric acid, which in turn can cause metabolic acidosis due to a decrease in bicarbonate levels in the body. This disruption in the acid-base balance can result in symptoms such as confusion, headache, and overall malaise. It is crucial for the nurse to monitor the client's acid-base status closely and provide appropriate interventions to prevent or correct metabolic acidosis.
If Nurse Tarly and her core group decide to formulate a directional hypothesis it will be ________.
- A. There is an increase relationship between the caring staff nurses and degree of satisfaction of ostomized patients.
- B. The caring behaviors of the staff nurses is related to increased satisfaction of ostomized patients.
- C. The staff nurses' behaviors have an effect on the patient's satisfaction with osomized patients.
- D. A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients.
Correct Answer: D
Rationale: A directional hypothesis predicts the direction of the relationship between variables. In this case, the statement "A significant relationship exists between the caring behaviors of the staff-nurses and degree of satisfaction of ostomized patients" clearly indicates the direction of the expected relationship. This hypothesis suggests that there will be a positive or negative relationship between the caring behaviors of staff nurses and the satisfaction of ostomized patients. The terms "significant relationship" and "degree of satisfaction" indicate that the hypothesis is specific and measurable, making it suitable for testing through research methods.
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