Nokea
Which of the ff should the nurse identify as the earliest symptom of heart failure in many older clients?
- A. Increased urine output
- B. Dyspnea on exertion
- C. Swollen joints
- D. Nausea and vomiting
Correct Answer: B
Rationale: Dyspnea on exertion is often identified as the earliest symptom of heart failure in many older clients. This symptom occurs due to the heart's inability to pump blood efficiently, leading to a buildup of fluid in the lungs. As a result, individuals may experience shortness of breath when engaging in physical activity or even at rest. Monitoring for dyspnea on exertion can aid in the early detection and management of heart failure in older clients. Other symptoms, such as increased urine output, swollen joints, and nausea/vomiting, may also occur in heart failure, but dyspnea on exertion is typically considered one of the earliest signs to manifest.
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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.
You are assigned to evaluate the outcome of fecal occult blood test as a screening test for patients with bowel cancer. The total number of patients who underwent the test is 2030; in those whom the disease is confirmed are 30. The results of fecal occult blood test are as follows: in 20 patients who has a confirmed bowel cancer (truly positive), and in 180 patients who don't have the disease (falsely positive); in 10 patients who truly has the disease (falsely negative), and in 1820 patients who are not affected by the disease (truly negative). All the following statements are true EXCEPT
- A. the prevalence of the disease for those population is 1.48%
- B. the sensitivity of the test is 67%
- C. the specificity of the test is 91%
- D. the positive predictive value is 20%
Correct Answer: A
Rationale: Prevalence = (Total cases / Total population) * 100 = (30 / 2030) * 100 ≈ 1.48%. This statement is correct, so it is the exception as the question asks for the incorrect statement.
During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?
- A. Recommending that the client discontinue chemotherapy
- B. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
- C. monitoring the client's platelet and leukocyte counts
- D. Checking regularly for signs and symptoms of stomatitis
Correct Answer: B
Rationale: Providing a solution of hydrogen peroxide and water for use as a mouth rinse is most likely to decrease the pain of stomatitis. Stomatitis is inflammation of the oral mucous membranes and can be quite painful for oncology clients undergoing chemotherapy. Using a solution of hydrogen peroxide and water as a mouth rinse can help reduce the risk of infection and promote healing of the mucous membranes, thereby decreasing the pain associated with stomatitis. This intervention helps to maintain oral hygiene and prevent further complications, making it an effective way to manage the client's symptoms while undergoing chemotherapy. It is important to note that discontinuing chemotherapy would not be a recommended intervention as it is the primary treatment for the client's cancer. Monitoring platelet and leukocyte counts and checking for signs and symptoms of stomatitis are important aspects of care, but providing a mouth rinse would directly address the pain and discomfort experienced by the client.
What does the surgical closure of the ductus arteriosus do?
- A. Stop the loss of unoxygenated blood to the systemic circulation
- B. Decrease the edema in legs and feet
- C. Increase the oxygenation of blood
- D. Prevent the return of oxygenated blood to the lungs
Correct Answer: A
Rationale: The ductus arteriosus is a fetal blood vessel that allows blood to bypass the lungs while in utero. After birth, the ductus arteriosus should close to redirect blood flow through the lungs for oxygenation. Surgical closure of the ductus arteriosus is performed to prevent the shunting of unoxygenated blood from the pulmonary artery to the aorta, therefore stopping the loss of unoxygenated blood to the systemic circulation. This helps to ensure that oxygenated blood is properly circulated to the body tissues and organs.
Vitamin A supplementation may be recommended for the young child who has which disease?
- A. Mumps
- B. Rubella
- C. Measles (rubeola)
- D. Erythema infectiosum
Correct Answer: C
Rationale: Vitamin A supplementation may be recommended for children with measles (rubeola) due to the disease's association with vitamin A deficiency. Measles can lead to reduced levels of vitamin A in the body, which can result in increased severity of symptoms, complications, and even death. Supplementing with vitamin A during and after a measles infection helps reduce the risk of complications and mortality, particularly in young children under the age of 5 in areas where vitamin A deficiency is common. Therefore, providing vitamin A supplementation to children with measles is an important intervention to support their recovery and improve outcomes.