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Which of the following manifestation should the nurse APPROPRIATELY observe during generalized seizures?
- A. Loss of Consciousness, dilated pupils, and muscular stiffening
- B. Jerking movements of al1 extremities.
- C. Facial grimace with patting and smacking.
- D. Vacant stare with a brief Loss of consciousness
Correct Answer: A
Rationale: Generalized seizures involve both hemispheres of the brain and can present with various manifestations. The typical features of generalized seizures include loss of consciousness, dilated pupils, and muscular stiffening. These seizures may also involve other symptoms such as tonic-clonic movements, convulsions, and postictal confusion. Jerking movements of all extremities (option B) are more characteristic of tonic-clonic seizures, a subtype of generalized seizures. Facial grimace with patting and smacking (option C) may be seen in focal seizures originating from a certain area of the brain. A vacant stare with a brief loss of consciousness (option D) is more typical of absence seizures rather than generalized seizures.
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Ramon died at 10:00 PM. His father cried much and refused to move Ramon 's body. What is the APPROPRIATE approach of the nurse?
- A. Talk about the reality of death.
- B. Leave the mother and the child for the last time.
- C. Silence to allow the mother to grieve.
- D. Cry with the mother as you remember your own experience of death in family.
Correct Answer: A
Rationale: The appropriate approach of the nurse in this situation would be to talk about the reality of death with the father. It is important to provide appropriate and compassionate communication, acknowledging the father's grief while also gently guiding him towards accepting the reality of the situation. By discussing the reality of death and offering support, the nurse can help the father start the grieving process and eventually come to terms with the loss of his son. It is important to provide emotional support and guidance in a sensitive and respectful manner during such a difficult time.
The nurse prepares a care plan for the patient. Based on Ramona Mercer's becoming a mother (BAM) theory, which of the following statements fosters the process of becoming a mother?
- A. The woman becomes comfortable with her identity as a married individual.
- B. It encompasses the dynamic transformation and evolution of a woman's persona.
- C. A woman learns mothering behavior prior as early as a teenager.
- D. It accurately reflects the transitional process from being single to a married relationship.
Correct Answer: B
Rationale: Ramona Mercer's becoming a mother (BAM) theory emphasizes the dynamic transformation and evolution of a woman's persona as she transitions into motherhood. This theory acknowledges that becoming a mother is a process involving significant changes in a woman's identity, roles, and relationships. It goes beyond just the physical aspects of giving birth and delves into the psychological, emotional, and social aspects of motherhood. Therefore, statement B aligns with the core principles of Mercer's BAM theory and fosters the understanding of the process of becoming a mother.
Which is the APPROPRIATE way to correct an error in the Nurses Notes?
- A. Take the whole page out and replace with a fresh one
- B. Draw a single 1ine across the error and initial it
- C. Use the sticky side of the plastic tape to erase the error
- D. Use a rubber eraser to erase an error.
Correct Answer: B
Rationale: The appropriate way to correct an error in the Nurses Notes is to draw a single line across the error and initial it. This method is recommended because it indicates that there was an error made, while still preserving the original information for audit and legal purposes. It shows transparency and accountability in documentation, as the original information remains visible. Taking the whole page out and replacing it with a fresh one can lead to discrepancies and potential legal issues if there are inconsistencies in the documentation. Using methods like using the sticky side of the plastic tape or a rubber eraser can make the documentation look unprofessional and raises questions about the accuracy and integrity of the notes.
A patient with a history of heart failure is prescribed a beta-blocker. Which assessment finding indicates a therapeutic effect of beta-blocker therapy?
- A. Decreased heart rate
- B. Increased blood pressure
- C. Elevated respiratory rate
- D. Worsening dyspnea Pharmacology
Correct Answer: A
Rationale: Beta-blockers are medications commonly used in the management of heart failure. One of the therapeutic effects of beta-blockers is to decrease the heart rate. By blocking the action of adrenaline on the heart, beta-blockers help to slow down the heart rate, reduce the workload on the heart, and improve overall heart function. In patients with heart failure, a decreased heart rate is a favorable outcome as it can help improve cardiac output and reduce symptoms of heart failure such as fatigue and shortness of breath. Monitoring the heart rate is an important assessment parameter to evaluate the effectiveness of beta-blocker therapy in patients with heart failure. Therefore, a decreased heart rate would indicate a therapeutic effect of beta-blocker therapy in this patient.
A patient presents with a painless thyroid nodule and hoarseness of voice. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid cancer
Correct Answer: D
Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.