Nokea
Which of the following changes are associated with normal aging?
- A. The outer layer of skin is replaced with new cells every 3 days.
- B. Subcutaneous fat and extracellular water decrease.
- C. The dermis becomes highly vascular and assists in the regulation of body temperature.
- D. Collagen becomes elastic and strong.
Correct Answer: B
Rationale: Aging reduces subcutaneous fat and extracellular water, leading to thinner, drier skin. Cell replacement slows, vascularity decreases, and collagen loses elasticity.
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The nurse is reviewing the chart of a 55-year-old male client who is scheduled for a lumbar laminectomy. The nurse should report which of the following to the surgeon?
- A. Pimple on the lower back.
- B. Abnormal electrocardiogram (ECG).
- C. Hearing aid.
- D. Allergy to iodine.
Correct Answer: B
Rationale: An abnormal ECG indicates potential cardiac issues that could affect surgical safety under anesthesia. This must be reported to the surgeon for further evaluation. A pimple, hearing aid, or iodine allergy, while notable, are less immediately critical unless directly related to the procedure.
The nurse is preparing to insert a peripheral vascular access device. Place the following actions in the order in which they need to be performed, starting from first to last.
- A. Apply sterile dressing over the intravenous site.
- B. Clean the selected area using an alcohol-based 2% chlorhexidine solution using friction for 30 seconds.
- C. Place the tourniquet 10 to 15 cm (4-6 inches) above the proposed site.
- D. Insert the intravenous catheter at a 15 to 30 degree angle.
- E. Advance the catheter until a flash of blood is seen, then advance the catheter into the vein while removing the needle.
- F. Palpate vein at intended insertion site by pressing downward.
- G. Release tourniquet temporarily.
Correct Answer: C,F,G,B,D,E
Rationale: The correct order ensures proper vein selection, site preparation, catheter insertion, and securement while minimizing complications.
A client is admitted on the day of surgery for an arthroscopy of the left knee. Which nursing activities should be completed to avoid wrong-site surgery? Select all that apply.
- A. Ask the surgeon preoperatively to mark with a permanent marker the correct knee for the surgical site.
- B. Verbally ask the client to state his name, surgical site, and procedure.
- C. Verify the correct client with the correct operative site by medical records and radiographic diagnostic reports.
- D. Call a 'time-out' in the operating room to have the surgeon verify the correct knee before making the incision.
- E. Show the client an anatomic model of the surgery site.
Correct Answer: A,B,C,D
Rationale: To prevent wrong-site surgery, the surgeon marks the site (A), the client verifies identity and procedure (B), records are checked (C), and a time-out confirms the site (D). Showing a model (E) is educational but not a standard safety measure.
Which of the following diets would be most appropriate in the chronic obstructive pulmonary disease (COPD)?
- A. Low-fat, low-cholesterol diet.
- B. Bland, soft diet.
- C. Low-sodium diet.
- D. High-calorie, high-protein diet.
Correct Answer: D
Rationale: A high-calorie, high-protein diet supports nutritional needs in COPD, where energy expenditure is high and appetite may be low. Other diets are less specific to COPD requirements.
A client is in the acute phase of rheumatoid arthritis. Which of the following should the nurse identify as lowest priority in the plan of care?
- A. Relieving pain.
- B. Preserving joint function.
- C. Maintaining usual ways of accomplishing tasks.
- D. Preventing joint deformity.
Correct Answer: C
Rationale: During the acute phase, relieving pain, preserving joint function, and preventing deformity are critical to manage inflammation and prevent long-term damage. Maintaining usual ways of accomplishing tasks is less urgent.