Nokea
Which of the following is expected to be most likely true in the near future?
- A. Quality improvement projects will decline due to cost-cutting measures.
- B. Alternative and complementary approaches will gain acceptance in medical practice.
- C. Care will primarily shift away from the hospital setting.
- D. Increased focus on care transitions will involve nursing.
Correct Answer: D
Rationale: In the near future, there will be an increased focus on care transitions involving nursing. This means that nurses will play a crucial role in preparing patients for transitions between different care settings, ensuring continuity and quality of care. Choice A is incorrect because quality improvement projects are essential and are not expected to decline. Choice B is incorrect as alternative and complementary approaches are increasingly being integrated into medical practice. Choice C is incorrect as there is a growing trend towards providing care in community settings and homes, moving away from primarily hospital-based care.
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A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique?
- A. Elevating the head of the client's bed to 30 degrees during mealtime
- B. Withholding fluids until the end of the meal
- C. Providing a 10-minute rest period prior to meals
- D. Instructing the client to place her chin toward her chest when swallowing
Correct Answer: D
Rationale: The correct technique for a client with dysphagia is to instruct them to place their chin toward their chest when swallowing. This action helps to close off the airway during swallowing, reducing the risk of aspiration. Elevating the head of the client's bed to 30 degrees during mealtime helps prevent aspiration, but this is not the responsibility of the AP. Withholding fluids until the end of the meal can lead to dehydration and is not a recommended practice. Providing a 10-minute rest period prior to meals is not specifically related to improving swallowing safety for clients with dysphagia.
Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess?
- A. Potassium
- B. AST (aspartate aminotransferase)
- C. Serum amylase
- D. Sodium
Correct Answer: A
Rationale: The correct answer is A: Potassium. Patients with type 1 diabetes receiving insulin are at risk of developing hypokalemia due to insulin's effects on potassium levels. Monitoring potassium levels is crucial to prevent complications such as cardiac arrhythmias. Choices B, C, and D are incorrect because AST, serum amylase, and sodium levels are not directly impacted by insulin therapy in type 1 diabetes and are not the primary concern that needs monitoring in this scenario.
You are performing a neurological assessment of your adolescent patient. The patient has the Moro reflex. How should you interpret this neurological assessment finding?
- A. It is normal among adolescents.
- B. It indicates that the patient has an intact peripheral nervous system.
- C. It indicates that the patient has an intact central nervous system.
- D. It is not a normal finding.
Correct Answer: D
Rationale: The Moro reflex, also known as the startle reflex, is typically present in infants up to around 4-6 months of age and is characterized by the infant's response to a sudden loss of support or loud noise. It is not a normal finding in adolescents or older individuals. Therefore, if an adolescent patient exhibits the Moro reflex during a neurological assessment, it is considered abnormal and warrants further evaluation. Choices A, B, and C are incorrect because the Moro reflex is not expected or normal among adolescents and does not specifically indicate the status of either the peripheral or central nervous system in this age group.
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.
Rotating injection sites when administering insulin prevents which of the following complications?
- A. Insulin edema
- B. Insulin lipodystrophy
- C. Insulin resistance
- D. Systemic allergic reactions
Correct Answer: B
Rationale: Rotating injection sites when administering insulin helps prevent insulin lipodystrophy, which is the abnormal distribution of fat at injection sites. Insulin edema (choice A) is not prevented by rotating injection sites; it is characterized by swelling at the site of insulin injection due to increased capillary permeability. Insulin resistance (choice C) is a condition where the body's cells become less responsive to insulin, and rotating injection sites does not directly prevent this. Systemic allergic reactions (choice D) are not specifically prevented by rotating injection sites; they are related to an allergic response to insulin.