Nokea
Which of the ff. statements, if made by a patient with hypertension, indicates to a nurse a need for more teaching?
- A. “High BP may affect the kidneys and eyes.”
- B. “Most people with hypertension watch their diet.”
- C. “Medication will no longer be needed when I feel better.”
- D. “Many people do not know when their BP is high.”
Correct Answer: C
Rationale: Step-by-step rationale:
1. Statement C indicates a misunderstanding that medication can be stopped when feeling better, which is incorrect.
2. Hypertension is a chronic condition that often requires lifelong medication.
3. This demonstrates a lack of understanding regarding the necessity of long-term management.
4. Statements A, B, and D show knowledge about hypertension's effects, dietary management, and awareness, respectively.
Summary: Statement C is incorrect as it suggests stopping medication, while statements A, B, and D show accurate understanding of hypertension.
You may also like to solve these questions
Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?
- A. Inform the physician immediately
- B. Check the area after the next menstrual
- C. Squeeze the nipple to check for period
- D. Put a heating pad on the area to reduce inflammation
Correct Answer: A
Rationale: The correct answer is A: Inform the physician immediately. This is important because finding a lump in the breast could be a sign of breast cancer, so prompt medical evaluation is crucial. Checking after the next menstrual cycle (B) may delay diagnosis and treatment. Squeezing the nipple (C) can cause harm and is not a reliable method for assessing a lump. Using a heating pad (D) is not recommended as it may mask symptoms and delay proper evaluation. Early detection and intervention are key in improving outcomes for breast cancer.
Before, during and after seizure. The nurse knows that the patient is ALWAYS placed in what position?
- A. Low fowler’s
- B. Modified trendelenburg
- C. Side lying
- D. Supine NERVOUS SYSTEM
Correct Answer: C
Rationale: The correct answer is C: Side lying position. This position helps prevent aspiration of secretions and promotes drainage from the mouth during and after a seizure. Placing the patient in a side lying position also helps prevent injury from falling and facilitates monitoring of the patient's airway.
Incorrect choices:
A: Low fowler's - This position does not provide optimal airway protection and may increase the risk of aspiration during a seizure.
B: Modified trendelenburg - This position may worsen the patient's airway patency and does not facilitate drainage of secretions.
D: Supine - Placing the patient in a supine position can lead to aspiration and compromise the airway, especially during a seizure.
Summary: The side lying position is the most appropriate choice as it ensures airway protection, facilitates drainage, and reduces the risk of aspiration during and after a seizure.
The most common buffer system in the body is the:
- A. Plasma protein buffer system
- B. Phosphate buffer system
- C. Hemoglobin buffer system
- D. Bicarbonate-carbonic system
Correct Answer: D
Rationale: The correct answer is D, the bicarbonate-carbonic system. This buffer system is crucial in maintaining the body's pH balance. When CO2 combines with water in the blood, it forms carbonic acid, which dissociates into bicarbonate ions and hydrogen ions. Bicarbonate acts as a base, accepting excess hydrogen ions to prevent a decrease in pH. Hemoglobin and plasma proteins primarily function as transport molecules, not as buffer systems. Phosphate buffer system is present in intracellular fluids, not as commonly in the body. The bicarbonate-carbonic system is the most prevalent buffer system in the blood and plays a vital role in regulating blood pH.
A hospital’s wound nurse consultant made a recommendation for nurses on the unit about how to care for the patient’s dressing changes. Which action should the nurses take next?
- A. Include dressing change instructions and frequency in the care plan.
- B. Assume that the wound nurse will perform all dressing changes.
- C. Request that the health care provider look at the wound.
- D. Encourage the patient to perform the dressing changes.
Correct Answer: A
Rationale: The correct answer is A: Include dressing change instructions and frequency in the care plan. This is the correct action because it ensures consistency in care and communication among the nursing team. By documenting the dressing change instructions and frequency in the care plan, all nurses will have clear guidance on how to perform the dressing changes correctly and at the appropriate intervals. This promotes continuity of care and helps prevent errors or omissions in the dressing change process.
Option B is incorrect as it is not realistic to expect the wound nurse to perform all dressing changes. Option C is unnecessary unless there are specific concerns requiring the health care provider's attention. Option D is not appropriate as encouraging the patient to perform dressing changes may not be safe or feasible depending on the patient's condition.
Minda, a 65-year old female has been admitted with a left hemisphere stroke. Which behavioral change would the nurse expect to find upon assessment?
- A. impulsive, unsafe activity
- B. motor deficits on the right eye
- C. motor deficits on the left side of the body
- D. error in word choices
Correct Answer: D
Rationale: The correct answer is D: error in word choices. In left hemisphere stroke, language and speech centers are usually affected, leading to aphasia. This results in errors in word choices, difficulty expressing thoughts, and understanding language. Impulsivity and unsafe activities (choice A) are more commonly associated with frontal lobe damage. Motor deficits on the right eye (choice B) and left side of the body (choice C) are typical in strokes affecting the motor cortex, which is located in the contralateral hemisphere.