Which of the following is a core measure set developed by the Joint Commission?
- A. genetics
- B. lymphoma
- C. nosocomial infections
- D. heart failure
Correct Answer: D
Rationale: Heart failure is a Joint Commission core measure set, focusing on improving care quality for common conditions. The others are not core measures.
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One week after discharge of a postpartum client, the client's husband calls the postpartum unit and asks the nurse, 'Is it normal for my wife to cry at the drop of a hat? I'm worried I've done something to upset her.' The nurse's best initial response would be:
- A. Have you noticed any pattern to her periods of crying?
- B. Try not to worry about it. I'm sure it's just the postpartum blues.
- C. Can you think of something you might have done to upset her?
- D. Let's consider some of the ways you can decrease her depression.
Correct Answer: B
Rationale: Postpartum blues are common within the first two weeks, characterized by emotional lability. Reassuring the husband while acknowledging the normalcy of this condition is appropriate.
According to Erikson's stages of physical development, school-age children 5 - 12 years old typically face which psychological crisis?
- A. ego integrity versus despair
- B. industry versus inferiority
- C. trust versus mistrust
- D. ego identity versus role confusion
Correct Answer: B
Rationale: School-age children (5-12) face industry vs. inferiority, focusing on developing competence and self-esteem through tasks and skills.
How many hours of activity per day are necessary to prevent disuse syndrome with muscle atrophy and joint contracture?
- A. 6 hours
- B. 4 hours
- C. 2 hours
- D. 1 hour
Correct Answer: C
Rationale: Approximately 2 hours of activity daily (C), including range-of-motion exercises or ambulation, helps prevent disuse syndrome, muscle atrophy, and joint contractures in immobilized clients.
The nurse is developing a plan for bowel and bladder retraining for a client with paraplegia. The primary goal of a bowel and bladder retraining program is:
- A. Optimal restoration of the client's elimination pattern
- B. Restoration of the client's neurosensory function
- C. Prevention of complications from impaired elimination
- D. Promotion of a positive body image
Correct Answer: C
Rationale: The primary goal is to prevent complications like infections or skin breakdown by establishing effective bowel and bladder management.
Which laboratory test is used to identify injury to the myocardium and can remain elevated for up to 3 weeks?
- A. Total CK
- B. CK-MB
- C. Myoglobin
- D. Troponin T or I
Correct Answer: D
Rationale: Troponin T or I is highly specific for myocardial injury and can remain elevated for up to 2-3 weeks, making it the best marker for detecting cardiac damage.
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