Nokea
Which of the following patients is at the greatest risk for a stroke?
- A. A 60-year-old male who weighs 270 pounds, has atrial fibrillation, and has had a TIA in the past
- B. A 75-year-old male who has frequent migraines, drinks a glass of wine every day, and is Hispanic
- C. A 40-year-old female who has high cholesterol and uses oral contraceptives
- D. A 65-year-old female who is African American, has sickle cell disease, and smokes cigarettes
Correct Answer: A
Rationale: The correct answer is the 60-year-old male who has a combination of significant risk factors for stroke, including atrial fibrillation, a history of a transient ischemic attack (TIA), and obesity. These factors greatly increase his risk of stroke. While other choices may have some individual risk factors, they do not collectively pose as high a risk as the patient described in option A. Option B includes migraines and alcohol consumption but lacks other major risk factors seen in option A. Option C mentions high cholesterol and oral contraceptives, which are risk factors but not as significant as atrial fibrillation and a prior TIA. Option D includes smoking and sickle cell disease but lacks the crucial risk factors present in option A.
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A patient with Glaucoma is verbalizing his daily medication routine to the nurse. He states he has two different eye drop medications, both every twelve hours. He washes his hands, instills the drops, closes his eyes gently, and presses his finger to the corner of his eye nearest his nose. After waiting 1 minute with his eyes closed, he instills the other medication in the same way. What is the nurse's best response?
- A. You should wait more than 1 minute between different medications.''
- B. Your routine is very good! Can you demonstrate it for me?''
- C. It is actually not the best practice to close your eyes after instilling eye drops.''
- D. You should actually be pressing your finger in the other corner of the eye.''
Correct Answer: A
Rationale: It is recommended to wait 10-15 minutes between different eye drop medications to give them time to absorb and avoid one medication washing another one out. Choice A is the correct response as the patient should wait more than 1 minute between administering different eye drop medications. Choice B is incorrect as the routine described by the patient needs improvement. Choice C is inaccurate as closing the eyes after instilling eye drops is a best practice to ensure proper absorption. Choice D is incorrect as pressing the finger to the corner of the eye nearest the nose is the correct technique.
Which question should the nurse ask the parents of a child suspected of having glomerulonephritis?
- A. Did your child fall off a bike onto the handlebars?
- B. Has the child had persistent nausea and vomiting?
- C. Has the child been itching or had a rash anytime in the last week?
- D. Has the child had a sore throat or a throat infection in the last few weeks?
Correct Answer: D
Rationale: Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Group A β-hemolytic streptococcal infection is a common cause of glomerulonephritis. Children with glomerulonephritis often develop symptoms after a throat infection caused by streptococcal bacteria. Therefore, asking about a sore throat or throat infection in the last few weeks is crucial to assess the possible link to glomerulonephritis. Choices A, B, and C are not directly associated with the pathophysiology of glomerulonephritis. Asking about falling off a bike, nausea and vomiting, or itching and rash do not provide relevant information for assessing glomerulonephritis in this context.
Why should a 30-year-old Caucasian woman who works the night shift take Vitamin D supplements?
- A. It's a standard part of the overall nutritional treatment for the prevention of osteomalacia.
- B. It helps your intestines absorb calcium, which is important for bone formation.
- C. It stimulates skin cells to produce calcium, which is then released into the bloodstream to be used for bone formation.
- D. Vitamin D supplements should not be taken by someone of your age.
Correct Answer: B
Rationale: The correct answer is B: 'It helps your intestines absorb calcium, which is important for bone formation.' Vitamin D plays a crucial role in aiding the absorption of calcium from the intestines into the bloodstream, which is essential for bone health and formation. Choice A is incorrect because it does not specifically address the role of Vitamin D in calcium absorption. Choice C is incorrect as Vitamin D does not stimulate skin cells to produce calcium; rather, it helps regulate calcium levels in the body. Choice D is incorrect as age alone is not a contraindication for Vitamin D supplementation; the need for supplementation is based on individual health status and risk factors.
The nurse is creating a plan of care for a 10-year-old child diagnosed with acute glomerulonephritis. What is the priority nursing intervention?
- A. Promoting bed rest
- B. Restricting oral fluids
- C. Allowing the child to play
- D. Encouraging visits from friends
Correct Answer: A
Rationale: During the acute phase of glomerulonephritis, promoting bed rest is a priority to reduce stress on the kidneys and promote recovery. As the condition improves, activity can be gradually increased. Restricting oral fluids is not recommended as maintaining adequate hydration is crucial. Allowing the child to play quietly can be beneficial but is not the priority over rest during the acute phase. Encouraging visits from friends may disrupt the rest needed for recovery, so visitors should be limited.
The child with hemolytic-uremic syndrome is anuric and will undergo peritoneal dialysis. Which measure should the nurse implement?
- A. Restrict fluids as prescribed.
- B. Care for the arteriovenous fistula.
- C. Encourage foods high in potassium.
- D. Administer analgesics as prescribed.
Correct Answer: A
Rationale: In hemolytic-uremic syndrome, often associated with bacterial toxins and viruses, acute kidney injury occurs in children, leading to symptoms like anemia, thrombocytopenia, renal injury, and CNS symptoms. For an anuric child with hemolytic-uremic syndrome undergoing peritoneal dialysis, fluid restriction is vital to prevent fluid overload. Pain management is not directly related to hemolytic-uremic syndrome. Foods high in potassium should be limited, not encouraged, due to impaired kidney function. Peritoneal dialysis does not involve an arteriovenous fistula, which is specific to hemodialysis.