Nokea
Which of the ff. descriptions by the nurse would best explain glaucoma to a patient?
- A. “There is an increase in the amount of vitreous humor.”
- B. “There is an increase in the intraocular pressure.”
- C. “There is a decrease in the amount of aqueous humor.”
- D. “There is a decrease in the intraocular pressure.”
Correct Answer: B
Rationale: The correct answer is B: "There is an increase in the intraocular pressure." Glaucoma is a group of eye conditions that damage the optic nerve due to increased pressure within the eye. High intraocular pressure is a key factor in the development of glaucoma. Choice A is incorrect because glaucoma is not associated with an increase in vitreous humor. Choice C is incorrect as glaucoma is not related to a decrease in aqueous humor. Choice D is incorrect because glaucoma is characterized by an increase, not a decrease, in intraocular pressure. Therefore, the most accurate description to explain glaucoma to a patient is the one that mentions the increase in intraocular pressure.
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The nurse is aware that the shift of body fluids associated with the intravenous administration of albumin occurs by the process of:
- A. Filtration
- B. Osmosis
- C. Diffusion
- D. Active Transport
Correct Answer: A
Rationale: The correct answer is A: Filtration. Albumin is a large protein molecule that cannot pass through the semipermeable membrane of blood vessels. Therefore, the shift of body fluids associated with intravenous albumin administration occurs through the process of filtration, where fluid moves across the membrane due to a pressure difference. Osmosis (B) involves the movement of water across a semipermeable membrane, which is not the case for albumin. Diffusion (C) is the movement of molecules from an area of high concentration to low concentration, which is not how albumin moves. Active transport (D) requires energy to move substances against a concentration gradient, which is not the mechanism for albumin movement in the body.
A nurse is completing an assessment. Which findings will the nurse report as subjective data? (Select all that apply.)
- A. Patient’s temperature
- B. Patient’s wound appearance
- C. Patient describing excitement about discharge
- D. Patient pacing the floor while awaiting test results
Correct Answer: C
Rationale: The correct answer is C because subjective data refers to information provided by the patient based on their feelings, perceptions, and experiences. In this case, the patient describing excitement about discharge is subjective data as it reflects the patient's emotional state. The other choices, A, B, and D, are considered objective data because they are observable and measurable by the nurse. The patient's temperature can be measured (A), the wound appearance can be visually assessed (B), and the patient pacing the floor is an observable behavior (D). Therefore, these choices are not subjective data.
Which of the ff symptoms is observed in the client with Right Sided Heart Failure?
- A. Dependent pitting edema
- B. Orthopnea
- C. Exertional dyspnea
- D. Hemoptysis CARING FOR CLIENTS UNDERGOING CARDIOVASCULAR SURGERY
Correct Answer: A
Rationale: Rationale: Right-sided heart failure leads to fluid backup in the body causing dependent pitting edema due to fluid accumulation in the lower extremities. Orthopnea and exertional dyspnea are typically seen in left-sided heart failure. Hemoptysis is associated with conditions like pulmonary embolism or lung cancer, not right-sided heart failure. Therefore, the correct answer is A as it directly correlates with the symptoms of right-sided heart failure.
The nurse is intervening for a patient that has a risk for a urinary infection. Which direct care nursing intervention is most appropriate?
- A. Teaches proper handwashing technique
- B. Properly cleans the patient’s toilet
- C. Transports urine specimen to the lab
- D. Informs the oncoming nurse during hand-off
Correct Answer: A
Rationale: The correct answer is A: Teaches proper handwashing technique. This is the most appropriate intervention because proper handwashing can help prevent the spread of infection, including urinary infections. Teaching the patient about handwashing empowers them to take control of their own hygiene, reducing the risk of infection.
Summary of why other choices are incorrect:
B: Properly cleans the patient's toilet - While important for maintaining cleanliness, this does not directly address the patient's risk for a urinary infection.
C: Transports urine specimen to the lab - This is not a direct care intervention for preventing urinary infections.
D: Informs the oncoming nurse during hand-off - Hand-off communication is important for continuity of care but does not directly address the patient's risk for a urinary infection.
What are the periods in life when the need for iron increases?
- A. Pregnancy
- B. Infancy
- C. Old age
- D. Male reproductive years
Correct Answer: A
Rationale: The correct answer is A: Pregnancy. During pregnancy, the need for iron increases significantly to support the growth of the fetus and to prevent maternal anemia. Iron is essential for the production of hemoglobin and for oxygen transport in the blood. In contrast, infants require iron for rapid growth and development, making choice B partially correct. Choice C (Old age) and choice D (Male reproductive years) are incorrect as the need for iron typically decreases in old age and remains relatively stable during male reproductive years.