Nokea
Which of the following statement best describe secondary care?
- A. Routine health check up
- B. Specialized care by referral
- C. Care after diagnosis
- D. Basic health education
Correct Answer: B
Rationale: Secondary care is specialized care by referral (B), per system e.g., cardiologist post-GP. Check-ups (A) and education (D) are primary, post-diagnosis (C) tertiary. B best defines secondary's role, making it correct.
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When working as a licensed vocational nurse, you determine that your client scheduled for surgery does not understand the physician's earlier explanation of the surgery. The client is asking many questions about the risks and seems worried. Which of the following actions would be best on your part?
- A. Quickly explain the surgery procedures and the risks to the client.
- B. Cancel the surgery.
- C. Ask your supervising RN to explain the surgery procedure and its risks.
- D. Notify the physician.
Correct Answer: D
Rationale: When a client scheduled for surgery shows a lack of understanding and expresses concern, notifying the physician is the best action for a licensed vocational nurse. The physician, as the primary decision-maker and the one obtaining informed consent, has the responsibility to ensure the client fully comprehends the procedure, risks, and benefits. The nurse's role is to facilitate communication and advocate for the client's needs, not to independently explain complex medical details outside their scope or cancel the surgery, which exceeds their authority. Asking the supervising RN might help, but it delays direct resolution by the physician, who is legally accountable for ensuring consent is informed. This approach upholds the nurse's duty to prioritize client understanding and safety while respecting professional boundaries and legal standards.
When John has been given paracetamol, his fever was brought down dramatically from 40 degrees Celsius to 36.7 degrees in a matter of 10 minutes. The nurse would assess this event as:
- A. The goal of reducing john's fever has been met with full satisfaction of the outcome criteria
- B. The desired goal has been partially met
- C. The goal is not completely met
- D. The goal has been met but not with the desired outcome criteria
Correct Answer: A
Rationale: Paracetamol dropping fever from 40°C to 36.7°C in 10 minutes fully meets the goal of fever reduction e.g., normal range (36.6-38°C) achieved. Partial or unmet goals imply residual fever; undesired criteria suggest side effects (none here). Nurses document this success, per outcome evaluation standards.
Which of the following is NOT true about BP?
- A. BP is dependent on blood volume, Cardiac output and peripheral resistance
- B. BP is dependent on age and body weight
- C. The BP on the left arm is higher than the right
- D. BP is taken on the left arm because it is nearest to the heart
Correct Answer: C
Rationale: BP depends on blood volume, cardiac output, and peripheral resistance (A), and varies with age and weight (B), per cardiovascular physiology. The left arm isn't inherently higher (C) it's false; differences are minimal and individual. Left arm use (D) is convention, not proximity (it's not significantly closer). C's absolute claim lacks evidence, making it the untrue statement, as BP symmetry is typical unless pathology exists.
The nurse is completing a health history with an older adult client who reveals smoking one pack of cigarettes daily for the past 50 years. Which illness prevention strategy should the nurse recommend?
- A. Referral to a smoking cessation program
- B. Screening for lung cancer
- C. Referral to a nutritionist
- D. Mobility exercises
Correct Answer: A
Rationale: For an older adult with a 50-year, pack-a-day smoking history, the nurse prioritizes illness prevention via a smoking cessation program referral primary prevention to halt further damage from a modifiable risk tied to lung cancer, COPD, and heart disease. Quitting slashes these risks studies show even late cessation improves lung function. Screening for lung cancer is secondary, detecting issues, not preventing them, though relevant later. Nutrition or mobility exercises enhance wellness but don't address smoking's root threat 20% of smokers develop COPD. Cessation directly targets the habit, aligning with nursing's preventive ethos, offering practical support like group therapy or nicotine aids. This strategy empowers the client to alter a decades-long risk, maximizing health gains despite age, a cornerstone of tailored care.
When recording blood pressure, the sounds which can be heard with a stethoscope placed over the artery is termed as:
- A. Wheeze
- B. Murmurs
- C. Crackle sounds
- D. Korotkoff sounds
Correct Answer: D
Rationale: Blood pressure measurement involves listening to arterial sounds via a stethoscope as the cuff deflates. These sounds, known as Korotkoff sounds, occur in five phases, starting with a tapping (systolic pressure) and fading to silence (diastolic pressure). Wheezes are respiratory sounds, murmurs relate to heart valves, and crackles indicate lung fluid none apply to blood pressure. Named after Nikolai Korotkoff, these sounds are a cornerstone of manual blood pressure assessment, ensuring accurate readings essential for diagnosing hypertension or hypotension, reflecting cardiovascular health.