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Which of the following positions would be most appropriate for a patient with right-sided paralysis following a stroke?
- A. On the side with support to the back, with pillows to keep the body in alignment, hips slightly flexed, and hands tightly holding a rolled washcloth.
- B. On the side with support to the back, pillows to keep the body in alignment, hips slightly flexed, and a washcloth placed so that fingers are slightly curled.
- C. On the back with two large pillows under the head, pillow under" the knees, and a footboard.
- D. On the back with no pillows used, with trochanter rolls and a footboard.
Correct Answer: B
Rationale: The most appropriate position for a patient with right-sided paralysis following a stroke is Option B - On the side with support to the back, pillows to keep the body in alignment, hips slightly flexed, and a washcloth placed so that fingers are slightly curled.
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For a client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?
- A. "Client verbalizes feelings of anxiety."
- B. "Client doesn't guess at prognosis."
- C. "Client uses any effective method to reduce tension."
- D. "Client stops seeking information."
Correct Answer: C
Rationale: The expected outcome that would be appropriate for a client with newly diagnosed cancer experiencing anxiety related to the threat of death would be "Client uses any effective method to reduce tension." This outcome focuses on the client actively engaging in coping strategies to reduce their anxiety. It is important for the client to actively participate in managing their anxiety by utilizing various methods to promote relaxation and reduce tension. It is a more proactive and empowering goal compared to simply verbalizing feelings of anxiety or stopping seeking information. By actively using effective methods to reduce tension, the client is taking steps to improve their emotional well-being and cope with the anxiety related to the cancer diagnosis.
You are examining an infant with multiple cutaneous hemangiomas; you suspect involvement of internal organs. The MOST common site of visceral involvement by hemangiomas is
- A. brain
- B. heart
- C. lung
- D. liver
Correct Answer: D
Rationale: Liver is the most common site of visceral involvement by hemangiomas.
Which chromosomal abnormality is often characteristic of infantile ALL?
- A. t(4;11)
- B. t(12;21)
- C. t(9;22)
- D. t(1;19)
Correct Answer: A
Rationale: The t(4;11) translocation is commonly found in infantile ALL and is associated with a poor prognosis.
What should be included in the teaching plan to young adults about the spread of AIDS?
- A. Heterosexual transmission of HIV is on the rise
- B. The increase of HIV in children is primarily attributed to the rise in sexual abuse
- C. Herpes zoster is a form of the HIV virus
- D. Transmission of HIV by IV drug users is prominent even when sterile equipment is used
Correct Answer: A
Rationale: It is crucial to include in the teaching plan to young adults that heterosexual transmission of HIV is on the rise. This information is important as many young adults may not be aware of the risks associated with heterosexual transmission of HIV, leading to a false sense of security. By educating them about this fact, young adults can be more informed about how HIV spreads and take necessary precautions to protect themselves and others. Providing accurate information about the modes of HIV transmission will help prevent the further spread of the virus among young adults.
By which age should the nurse expect an infant to be able to pull to a standing position?
- A. 6 months
- B. 8 months
- C. 11 to 12 months
- D. 14 to 15 months
Correct Answer: B
Rationale: By the age of 8 months, most infants are able to pull themselves up to a standing position by holding onto furniture or other support. This milestone signifies the development of leg strength and coordination required for standing. While some infants may achieve this skill earlier or later, on average, 8 months is a common age for this milestone to be reached.