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Which of the ff is a nursing intervention when assessing clients with hypertension?
- A. The nurse takes the temperature when the client is in a standing, sitting, and then supine position
- B. The nurses teaches the client about non pharmacologic and pharmacologic methods for restoring BP
- C. The nurse takes BP in both arms when the client is in a standing, sitting, and then supine position
- D. The nurse weighs the client each morning
Correct Answer: B
Rationale: The nursing intervention of teaching the client about non-pharmacologic and pharmacologic methods for restoring blood pressure is crucial in managing hypertension. Education empowers the client to actively participate in their care and make informed decisions regarding lifestyle changes, medication adherence, and other interventions to control their blood pressure levels. By providing education on interventions such as dietary modifications, exercise, stress management, and medication use, the nurse helps the client develop a comprehensive plan to manage hypertension effectively and improve their overall health outcomes.
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Prenatal exposure to cigarette smoke is associated with
- A. shorter neonatal length
- B. lower birthweight
- C. changes in neonatal behavior
- D. neonatal diabetes
Correct Answer: D
Rationale: Neonatal diabetes is not commonly associated with prenatal cigarette smoke exposure.
Biopsy is not usually performed for a child with suspicion of Wilms tumor EXCEPT
- A. age of 2-3 year
- B. signs of inflammation or infection
- C. significant lymph node enlargement radiologically
- D. intratumoral calcification radiologically
Correct Answer: E
Rationale: Presence of intratumoral calcifications may warrant biopsy to rule out other diagnoses.
A patient is admitted to a medical unit with a diagnosis of heart failure. The patient reports that she has had increasing fatigue during the past 2 weeks. Which of the following is the most likely cause of this fatigue?
- A. Dyspnea
- B. Decreased cardiac output
- C. Dry cough
- D. Orthopnea
Correct Answer: B
Rationale: Fatigue in a patient with heart failure is commonly caused by decreased cardiac output. In heart failure, the heart is unable to pump enough blood to meet the body's demands, resulting in reduced delivery of oxygen and nutrients to the tissues. This can lead to generalized weakness and fatigue. Dyspnea (choice A) is commonly associated with heart failure but is more specific to difficulty breathing, while a dry cough (choice C) is a symptom that can be present but is not typically the primary cause of fatigue. Orthopnea (choice D) is a symptom of heart failure characterized by difficulty breathing when lying flat but is not directly related to the patient's increasing fatigue in this scenario.
The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. To what are these behaviors most likely related?
- A. Neurologic manifestations that occur with dialysis
- B. Physiologic manifestations of renal disease
- C. Adolescents having few coping mechanisms
- D. Adolescents often resenting the control and enforced dependence imposed by dialysis
Correct Answer: D
Rationale: Adolescents often resent the control and enforced dependence imposed by dialysis. Adolescence is a challenging time marked by striving for independence and autonomy. When adolescents have to rely on medical interventions like dialysis that impose control and dependence, it can lead to feelings of anger, hostility, and depression. This is a normal psychological response to feeling restricted and not in control of their own lives. It is important for healthcare providers to recognize these emotions and provide support and coping strategies to help the adolescent adjust to the situation.
A 39 y.o. homemaker sees her physician after she falls twice for seemingly no reason. Diagnostic tests are done, and she is diagnosed with multiple sclerosis. Which of the ff. explanations will help her understand her disease?
- A. "You have a build-up of myelin in your nervous system, causing congestion and muscle weakness."
- B. "You are missing a neurotransmitter that is important to muscle contraction."
- C. "The receptor sites on your muscles are damaged, so they can't contract correctly."
- D. "The insulation on your nerve cells is damaged, which slows the impulses to the muscles."
Correct Answer: D
Rationale: Option D, "The insulation on your nerve cells is damaged, which slows the impulses to the muscles," is the most accurate explanation for multiple sclerosis. Multiple sclerosis is a chronic autoimmune disorder where the body's immune system mistakenly attacks the myelin sheath, the protective covering of nerve fibers in the central nervous system. This damage disrupts the normal flow of electrical impulses along the nerves, leading to various symptoms such as muscle weakness, coordination problems, and balance issues. By understanding that the insulation on her nerve cells is damaged, the patient can better comprehend why she is experiencing symptoms like muscle weakness and falls.