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Which of the following statements best describes the purpose of a health history?
- A. To provide an opportunity for interaction between patient and nurse
- B. To provide a form for obtaining the patient's biographical information
- C. To document the normal and abnormal findings of a physical assessment
- D. To provide a database of subjective information about the patient's past and current health
Correct Answer: D
Rationale: The correct answer is D because a health history aims to gather subjective information about a patient's past and current health. It helps in understanding the patient's health concerns, medical history, lifestyle factors, and other relevant information. By collecting this data, healthcare providers can make informed decisions regarding the patient's care. Option A is incorrect as the purpose is more than just interaction. Option B is incorrect as it focuses solely on biographical information. Option C is incorrect as it pertains to physical assessment findings, not subjective health information.
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A nurse is providing education to a patient with chronic obstructive pulmonary disease (COPD). The nurse should prioritize which of the following lifestyle changes?
- A. Quitting smoking.
- B. Increasing fluid intake.
- C. Increasing physical activity.
- D. Taking over-the-counter cold medications.
Correct Answer: A
Rationale: The correct answer is A: Quitting smoking. Smoking is the most important lifestyle change for a patient with COPD as it is the primary cause of the disease and continues to worsen symptoms. Quitting smoking can slow down the progression of COPD, decrease exacerbations, and improve overall lung function.
Summary of other choices:
B: Increasing fluid intake - While staying hydrated is important for overall health, it is not the top priority for a patient with COPD.
C: Increasing physical activity - Exercise is beneficial for COPD patients, but quitting smoking takes precedence as it directly impacts the disease progression.
D: Taking over-the-counter cold medications - Cold medications may provide temporary relief for symptoms, but they do not address the underlying cause of COPD which is smoking.
A nurse is caring for a patient who has undergone a knee replacement. The nurse should encourage which of the following to promote recovery?
- A. Strict bed rest for the first 48 hours.
- B. Ambulation as soon as possible after surgery.
- C. Limiting physical activity for 2 weeks post-op.
- D. Prolonged use of the affected leg in a cast.
Correct Answer: B
Rationale: The correct answer is B: Ambulation as soon as possible after surgery. Ambulation helps prevent complications like blood clots and aids in circulation and muscle strength. Bed rest can lead to stiffness and decrease in range of motion. Limiting physical activity delays recovery. Prolonged use of a cast can hinder mobility and delay rehabilitation.
A visiting nurse is making an initial home visit to a patient who has a number of chronic medical problems. Which type of database is most appropriate to collect in this setting?
- A. A follow-up database to evaluate changes at appropriate intervals
- B. An episodic database because of the continuing, complex medical problems of this patient
- C. A complete health database because of the nurse's primary responsibility for monitoring the patient's health
- D. An emergency database because of the need to rapidly collect information and make accurate diagnoses
Correct Answer: C
Rationale: The correct answer is C: A complete health database because of the nurse's primary responsibility for monitoring the patient's health. In this initial home visit, the nurse needs to gather comprehensive information about the patient's medical history, current health status, medications, allergies, and lifestyle factors to establish a baseline for ongoing care. This complete health database will help the nurse make informed decisions and provide personalized care.
Choice A (follow-up database) is incorrect as it is used to evaluate changes over time, not for the initial assessment. Choice B (episodic database) is incorrect because the patient's chronic medical problems require a more comprehensive approach. Choice D (emergency database) is incorrect as it is used for urgent situations, not for routine assessments.
Which of the following responses might the nurse expect during the functional assessment of a patient whose leg is in a cast?
- A. "I broke my right leg in a car accident 2 weeks ago."
- B. "The pain is getting less, but I still need to take Tylenol."
- C. "I check the colour of my toes every evening just like I was taught."
- D. "I'm able to transfer myself from the wheelchair to the bed without help."
Correct Answer: D
Rationale: The correct answer is D because the nurse would expect the patient to demonstrate functional independence in activities like transferring from a wheelchair to the bed despite having a leg in a cast. This response indicates good mobility and strength, which are positive signs of recovery. Choices A, B, and C are incorrect as they do not directly address the functional assessment of the patient. Choice A provides historical information, choice B focuses on pain management, and choice C mentions a self-care routine that is not related to functional ability.
The nurse is assessing a 75-year-old male patient. At the beginning of the mental status portion of the assessment, the nurse expects that this patient:
- A. Will have no decrease in any of his abilities, including response time.
- B. Will have difficulty on tests of remote memory because this typically decreases with age.
- C. May take a little longer to respond, but his general knowledge and abilities should not have declined.
- D. Will have had a decrease in his response time because of language loss and a decrease in general knowledge.
Correct Answer: C
Rationale: Rationale for Correct Answer C:
- As individuals age, it is normal to experience a slight decline in cognitive abilities, such as response time.
- However, general knowledge and abilities are usually well-preserved in older adults.
- It is expected that the 75-year-old patient may take a little longer to respond due to age-related changes but should not have a significant decline in general knowledge.
Summary of Incorrect Choices:
- Choice A is incorrect because it is unrealistic to expect no decrease in any abilities with age.
- Choice B is incorrect because while remote memory may decline with age, it is not a universal expectation for all older adults.
- Choice D is incorrect as it inaccurately attributes language loss and a decrease in general knowledge to all older adults.