Nokea
Which of the ff. subjective data questions would assist the nurse in assessing the patient's eye health?
- A. "Have you had any recent upper respiratory infections?"
- B. "Have you ridden in a car recently?"
- C. "Have you been scuba diving lately?"
- D. "Have you seen halos around lights?"
Correct Answer: D
Rationale: This question specifically pertains to visual disturbances and can provide valuable information about the patient's eye health. Seeing halos around lights can indicate increased intraocular pressure, which could be a sign of conditions such as glaucoma. Therefore, this subjective data question would assist the nurse in assessing the patient's eye health. On the other hand, choices A, B, and C are not directly related to eye health and would not provide relevant information in assessing the patient's eyes.
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A guest who is diabetic attended a bridal affair. The guest started to tremble and started to feel dizzy. Luckily a nurse is present. The best action for the nurse to take is to:
- A. encourages the guest to eat some
- B. call the guest's personal hygiene
- C. offer the guest a peppermint
- D. give the guest a glass of orange juice
Correct Answer: D
Rationale: The best action for the nurse to take in this situation is to give the guest a glass of orange juice (Choice D). The guest is most likely experiencing hypoglycemia (low blood sugar) due to diabetes. Orange juice contains natural sugars that can help raise the guest's blood sugar levels quickly. Since the guest is feeling dizzy and trembling, providing a source of fast-acting sugar like orange juice is crucial in addressing the low blood sugar and preventing the situation from worsening. It is important to follow up with a source of longer-lasting carbohydrates and protein after the guest's blood sugar levels have stabilized.
Which of the following malignancies is least likely to occur in a 10-month-old infant?
- A. neuroblastoma
- B. nephroblastoma
- C. retinoblastoma
- D. hepatoblastoma
Correct Answer: D
Rationale: Hepatoblastoma is rare in infants under 1 year old, being more common in toddlers.
Which is descriptive of bulimia during adolescence?
- A. Strong sense of control over eating behavior
- B. Feelings of elation after the binge-purge cycle
- C. Profound lack of awareness that the eating pattern is abnormal
- D. Weight that can be normal, slightly above normal, or below normal
Correct Answer: C
Rationale: During adolescence, individuals with bulimia often have a profound lack of awareness that their eating pattern is abnormal. This lack of awareness can be attributed to various factors, such as societal pressures, distorted body image, and the normalization of disordered eating behaviors within their social circle. Adolescents with bulimia may not recognize their behaviors as problematic or may rationalize them as a means of coping with stress or controlling their weight. This lack of insight can make it challenging for them to seek help or receive proper treatment for their condition.
Aling Maria, a 58-year old female, was admitted for the third time because of myxedema. Initial assessment by Nurse Mida should include symptoms of:
- A. bradycardia, weight loss, heart failure, diarrhea
- B. tachycardia, constipation, exopthalmus
- C. lethargy, weight gain, slow speech, decreased RR
- D. hypothermia, weight loss, increased RR
Correct Answer: C
Rationale: The symptoms of myxedema, which is a severe form of hypothyroidism, include lethargy, weight gain, slow speech, and decreased respiratory rate. Aling Maria being a 58-year old female who was admitted for the third time because of myxedema would likely present with these symptoms upon assessment by Nurse Mida. Other common symptoms of myxedema include cold intolerance, dry skin, hair loss, and brittle nails. It is important for Nurse Mida to identify these symptoms during the initial assessment to provide appropriate care and management for Aling Maria.
The MOST appropriate advice for a 4-year-old child visiting the outpatient department with excessive crying is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate for child abuse
Correct Answer: B
Rationale: Further history may help differentiate normal behavior from developmental concerns.