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Which of the following statements about the mental health examination is true?

  • A. A patient's family is the best resource for information about the patient's coping skills.
  • B. It is usually sufficient to gather mental health information during the health history interview.
  • C. It takes an enormous amount of extra time to integrate the mental health examination into the health history interview.
  • D. It is usually necessary to perform a complete mental health examination to get a good idea of the patient's level of functioning.
Correct Answer: B

Rationale: The correct answer is B because the mental health examination should be integrated into the health history interview. This allows for a comprehensive understanding of the patient's mental health status. Gathering mental health information during the health history interview is crucial as it provides insight into the patient's current mental state, past history, and potential risk factors. This integrated approach is efficient and effective in assessing the patient's mental health needs.

A is incorrect because while family input can be valuable, it is not always the best or only resource for information about coping skills.

C is incorrect as integrating the mental health examination into the health history interview should not necessarily take an enormous amount of extra time if done efficiently.

D is incorrect as a complete mental health examination may not always be necessary to assess the patient's level of functioning; integrating mental health information into the health history interview can often provide sufficient insight.

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What should be done for a client who is post-op and develops a fever within the first 48 hours?

  • A. Administer antipyretics
  • B. Monitor for signs of infection
  • C. Administer fluids
  • D. Perform an abdominal assessment
Correct Answer: B

Rationale: The correct answer is B: Monitor for signs of infection. Within the first 48 hours post-op, fever is often indicative of an infection. Monitoring for signs such as increased pain, redness, swelling, warmth at the surgical site, elevated white blood cell count, and changes in vital signs helps in early detection and prompt treatment of infections. Administering antipyretics (choice A) may help reduce fever but does not address the underlying cause. Administering fluids (choice C) is important for hydration but does not directly address the fever's cause. Performing an abdominal assessment (choice D) is not specific to addressing fever in a post-op client.

Which medication should be administered first for a client with acute asthma exacerbation?

  • A. Albuterol
  • B. Epinephrine
  • C. Levalbuterol
  • D. IV corticosteroids
Correct Answer: A

Rationale: Step-by-step rationale for choosing Albuterol as the correct answer:
1. Albuterol is a rapid-acting bronchodilator that provides immediate relief by relaxing the airway muscles during asthma exacerbation.
2. It is the first-line medication recommended by guidelines for acute asthma attacks due to its quick onset of action.
3. Albuterol helps in opening the airways, improving airflow, and relieving symptoms like shortness of breath and wheezing.
4. Epinephrine is not the first choice for asthma exacerbation as it can have more systemic side effects.
5. Levalbuterol is a similar medication to Albuterol but may not be as widely available or cost-effective.
6. IV corticosteroids are important for long-term control but take longer to show effects, making them less suitable as the initial treatment for acute exacerbation.

A nurse is caring for a patient with chronic kidney disease (CKD). Which of the following lab results would the nurse expect to be elevated in this patient?

  • A. Blood urea nitrogen (BUN).
  • B. Calcium.
  • C. Potassium.
  • D. Sodium.
Correct Answer: A

Rationale: The correct answer is A: Blood urea nitrogen (BUN). In CKD, the kidneys are unable to effectively filter waste products, leading to an increase in BUN levels. Elevated BUN indicates impaired kidney function. Calcium, potassium, and sodium levels may also be affected in CKD, but they are more likely to be imbalanced rather than consistently elevated. Calcium levels may be low due to impaired vitamin D activation, potassium levels may be high due to decreased excretion, and sodium levels can fluctuate based on fluid status. Therefore, while these lab values may be abnormal in CKD, BUN is the most consistently elevated marker of kidney dysfunction.

What should a nurse assess for in a client with an arteriovenous fistula for hemodialysis?

  • A. Inspect for visible pulsation
  • B. Palpate for thrill
  • C. Auscultate for bruit
  • D. Percuss for dullness
Correct Answer: A

Rationale: The correct answer is A: Inspect for visible pulsation. This is because an arteriovenous fistula for hemodialysis should have a visible pulsation, indicating proper blood flow. Palpating for thrill (B) and auscultating for bruit (C) are also common assessments for an arteriovenous fistula, but inspecting for visible pulsation is the most direct and reliable way to assess the patency of the fistula. Percussing for dullness (D) is not relevant in this context as it does not provide information about the vascular access site.

What is the most appropriate nursing action for a client with suspected peritonitis?

  • A. Administer antibiotics
  • B. Administer analgesics
  • C. Apply an ice pack
  • D. Perform a laparotomy
Correct Answer: A

Rationale: The correct answer is A: Administer antibiotics. Peritonitis is an inflammation of the peritoneum often caused by infection. Administering antibiotics is crucial to combat the infection. It is important to treat the underlying cause first before focusing on symptom management. Administering analgesics (B) may provide temporary relief but won't address the infection. Applying an ice pack (C) is not appropriate for peritonitis as it won't treat the infection. Performing a laparotomy (D) is a surgical procedure that may be necessary in severe cases but is not the initial nursing action.

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