Nokea
Which of the following changes was enacted by the Patient Protection and Affordable Care Act?
- A. Creation of national health insurance exchanges for affordable insurance coverage
- B. Expansion of school-based health centers
- C. Free preventative services for all
- D. Medically managed clinics eligible for federal funding
Correct Answer: B
Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.
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Your patient has been diagnosed with giant cell arthritis. What medication will this patient most likely be given?
- A. High doses of aspirin
- B. High doses of prednisone
- C. Methotrexate
- D. Albuterol
Correct Answer: B
Rationale: High doses of prednisone are commonly prescribed for giant cell arthritis to reduce inflammation. Aspirin is not typically used for this condition. Methotrexate is more commonly used for conditions like rheumatoid arthritis, not giant cell arthritis. Albuterol is a bronchodilator used for respiratory conditions, not for giant cell arthritis.
Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?
- A. Intravenous potassium supplementation
- B. Intravenous calcium supplementation
- C. Kidney dialysis
- D. Parenteral nutrition
Correct Answer: C
Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.
A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level?
- A. The client with renal failure
- B. The client who is taking diuretics
- C. The client with hyperaldosteronism
- D. The client who is taking corticosteroids
Correct Answer: B
Rationale: The correct answer is B. Clients taking diuretics are at risk for hyponatremia due to excessive sodium loss. In this scenario, a sodium level of 130 mEq/L indicates hyponatremia, which is commonly associated with diuretic use. Options A, C, and D are not the highest risk factors for developing low sodium levels in this context. Renal failure, hyperaldosteronism, and corticosteroid use are not directly linked to sodium loss as seen with diuretics.
Which statement about appendicitis is accurate and true?
- A. Appendicitis is more common among females than males.
- B. A high fiber diet is a risk factor associated with appendicitis.
- C. Left lower quadrant pain is suggestive of appendicitis.
- D. McBurney's point tenderness is suggestive of appendicitis.
Correct Answer: D
Rationale: The correct answer is D: McBurney's point tenderness is suggestive of appendicitis. McBurney's point is located in the right lower abdomen and tenderness at this point is a classic sign of appendicitis. Choice A is incorrect as appendicitis is slightly more common in males than females. Choice B is incorrect as a high fiber diet is actually considered to be protective against appendicitis. Choice C is incorrect as appendicitis typically presents with pain in the right lower quadrant, not the left.
Multifetal pregnancies with triplets occur at a rate of 1 in 8,100 births, but twins occur much more frequently with a rate of:
- A. 1 in 85 births.
- B. 1 in 5400 births.
- C. 1 in 2700 births.
- D. 1 in 540 births
Correct Answer: A
Rationale: The correct answer is A: 1 in 85 births. The rate of twin pregnancies is approximately 1 in 85 births. This means that twins are more common compared to triplets, which occur at a rate of 1 in 8,100 births. Choices B, C, and D are incorrect because they do not reflect the correct frequency of twin pregnancies as stated in the question.