NU370 Week 1 PrepU: Health, Wellness & Illness

Which nurse theorist developed Therapeutic Touch (TT)? Dorothea Orem Martha Rogers Jean Watson Dolores Krieger

Dolores Krieger Therapeutic Touch, a healing method used by thousands of nurses and other professionals, was developed more than 30 years ago by Dora Kunz, a healer, and Dolores Krieger, an emeritus member of New York University's nursing faculty.

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? Latency Secondary Primary Tertiary

Latency Secondary syphilis occurs when the hematogenous spread of organisms from the original chancre leads to generalized infection. A period of latency occurs when the infected person has no signs or symptoms of syphilis. Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. Tertiary syphilis presents as a slowly progressive inflammatory disease with the potential to affect multiple organs.

Which physician is known as the "Father of Pediatrics"? Joseph Brennaman Ren Spitz Abraham Jacobi John Bowlby

Abraham Jacobi Many view Abraham Jacobi, a Prussian-born physician, as the father of pediatrics.

The parents of a 15-year-old boy are frustrated at his persistent inability to fall asleep at a reasonable hour at night, as well as they extreme difficulty that they have rousing him in the morning. While sleepy after waking, the son claims not to feel drowsy after lunch or in the evening. What is the most likely classification of the boy's sleep disorder? Delayed sleep phase syndrome (DSPS). Non-24-hour sleep-wake syndrome Advanced sleep phase syndrome (ASPS) Chronic insomnia

Delayed sleep phase syndrome (DSPS). The teen's sleep patterns are characteristic of DSPS. Non-24-hour sleep-wake syndrome is characterized by a sleep cycle that greatly exceeds 24 hours and ASPS is the opposite of DSPS. Chronic insomnia would likely include afternoon and evening drowsiness.

The registered nurse is performing a nutritional assessment to ensure that the client's diet is optimal for wound healing. The nurse's intervention can be traced back to which key contributor to nursing? Florence Nightingale Clara Barton Dorothea Dix Linda Richards

Florence Nightingale Florence Nightingale's contributions to nursing included the recognition of the importance of nutrition to health. Clara Barton established the Red Cross. Dorothea Dix was a pioneer for reform of treatment for the mentally ill. Linda Richards began the practice of keeping records and writing orders.

The nurse is performing an admission assessment to a rehabilitation unit. Which assessment tools should she utilize to determine an alert client's normal activities, perceived level of activity tolerance, or level of fatigue? Human Activity Profile Ergometry Fatigue Severity Scale Mini-Mental Examination

Human Activity Profile The Human Activity Profile (HAP) is a paper and pencil test in which participants describe their normal activities, their perceived level of activity tolerance, or their level of fatigue. The Fatigue Severity Scale only assesses the fatigue and not the normal activities or tolerance. The ergometry and the Mini-Mental Examination are not directly related to assessing fatigue.

What is the central theme of Florence Nightingale's nursing theory? Humans are in a constant relationship with stressors in the environment. Meeting the personal needs of the client within the environment. Nursing is an art. Nursing is a therapeutic, interpersonal, and goal-oriented process.

Meeting the personal needs of the client within the environment. Florence Nightingale believed in meeting the personal needs of the client within the environment. Hildegard Peplau believed nursing is a therapeutic, interpersonal, and goal-oriented process. Nursing is an art is the theory of Ernestine Wiedenbach, while Betty Neuman's nursing theory states that humans are in a constant relationship with stressors in the environment.

The nurse is assessing the ear canal and tympanic membrane of a client using an otoscope. Which finding would the nurse document as normal? The tympanic membrane is translucent, shiny, and gray. The ear canal is rough and pinkish. The tympanic membrane is reddish. The ear canal is smooth and white.

The tympanic membrane is translucent, shiny, and gray. The tympanic membrane should be intact, translucent, shiny, and gray. The ear canal should be smooth and pink.

The nurse recognizes that which of the following clients is at the lowest risk for perioperative complications? A client who takes prednisone A client who takes clopidogrel A client who has a history of arthritis A client recently diagnosed with type 2 diabetes

A client who has a history of arthritis A history of arthritis does not increase the risk for complications during the perioperative period.

A nurse is caring for a client who's in labor. The health care professional still isn't present. After the neonate's head is delivered, which nursing intervention would be appropriate? checking for the umbilical cord around the neonate's neck placing antibiotic ointment in the neonate's eyes turning the neonate's head to the side to drain secretions assessing the neonate for respirations

checking for the umbilical cord around the neonate's neck After the neonate's head is delivered, the nurse should check for the cord around the neonate's neck. If the cord is around the neck, it should be gently lifted over the neonate's head. Antibiotic ointment is administered to the neonate after birth, not during delivery of the head, to prevent gonorrheal conjunctivitis. The neonate's head isn't turned during delivery. After birth, the neonate is held with the head lowered to help with drainage of secretions. If a bulb syringe is available, it can be used to gently suction the neonate's mouth. Assessing the neonate's respiratory status should be done immediately after birth.

A client is concerned that her 2-day-old, breast-feeding neonate isn't getting enough to eat. The nurse should teach the client that breast-feeding is effective if: the neonate voids once or twice every 24 hours. the neonate breast-feeds four times in 24 hours. the neonate loses 10% to 15% of the birth weight within the first 2 days after birth. the neonate latches onto the areola and swallows audibly.

the neonate latches onto the areola and swallows audibly. Breast-feeding is effective if the infant latches onto the mother's areola properly and if swallowing is audible. A breast-feeding neonate should void at least 6 to 8 times per day and should breast-feed every 2 to 3 hours. Over the first few days after birth, an acceptable weight loss is 5% to 10% of the birth weight.

A client tells a nurse that she's going to breast-feed her neonate but she isn't sure what she should eat. Which client statement requires further teaching? "I will consume 500 more calories each day than if I wasn't breast-feeding." "I will drink 10 glasses of fluid every day." "I'll take all the same medications I was taking before my pregnancy." "I'll include milk products in my diet."

"I'll take all the same medications I was taking before my pregnancy." The client indicates she needs additional teaching when she states she'll resume taking all the medications she was taking before her pregnancy because most drugs are excreted through breast milk and may affect the neonate. The client should consult with her physician before taking any drugs while breast-feeding. She should increase her daily calories by 500, drink 10 glasses of fluid, and include milk products in her diet to increase her milk production and provide adequate nutrition for her neonate and herself.

The home health nurse is admitting a client to the service for complications related to multiple sclerosis (MS) and the client asks the nurse to explain the use of complimentary health approaches. The client states, "All of the medication I am taking is making me sicker. There has to be a better way." What is the best response by the nurse? "We can discuss with your health care provider some helpful complimentary therapies." "Insurance will not pay for anything other than traditional medicine." "The government regulates all of these therapies and they are hard to obtain." "This type of therapy should only be used if there is nothing else traditional medicine can do."

"We can discuss with your health care provider some helpful complimentary therapies." The development of CAM continues to be a complimentary therapy in addition to traditional medication that will provide relief of symptoms and healing. Government and professional groups do not regulate most of the therapies. Because of this lack of regulation, there can be inconsistencies among the preparation and care provided by practitioners. CAM is a complementary and/or alternative therapy, not a last resort therapy.

A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply. encouragement of abstinence proper condom application various religious viewpoints sexually transmitted infection statistics nurse's personal opinion on abortion (elective termination of pregnancy)

encouragement of abstinence proper condom application sexually transmitted infection statistics The nurse should talk about all safer sex options, including abstinence and its 100% effectiveness. Within that teaching it is important to educate adolescents on the proper techniques for application of a condom as well as to discuss statistics related to sexually transmitted infections.

The bacteria that line the gut of a human help maintain normal gut health and provide essential nutrients. This type of relationship is: commensal. parasitic. saprophytic. mutualistic.

mutualistic. The term mutualism is applied to an interaction in which the microorganism and the host both derive benefits from the interaction. Commensalism is a relationship where the organism receives benefit at no harm to the host. A parasite is an organism that derives benefits from its biologic relationship with another organism with the potential of causing harm.

An older adult client newly diagnosed with systolic hypertension asks her health care provider why this happens. Which response is most accurate? "Everyone over the age of 50 tends to have their blood pressure creep up over the years." "With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer." "Your heart has to work harder to pump blood through your vessels as you get older." "If you slow down and rest more, your blood pressure will more than likely return to its normal level."

"With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer." Systolic blood pressure rises almost linearly between 30 and 84 years of age, whereas diastolic pressure rises until 50 years of age and then levels off or decreases. This rise in systolic pressure is thought to be related to increased stiffness of the large arteries. With aging, the elastin fibers in the walls of the arteries are gradually replaced by collagen fibers that render the vessels stiffer and less compliant.

Following a stroke, injury to nerve cells within the central nervous system needs to be repaired. The health care provider knows that which process explains how this occurs? Astrocytes fill up the space to form a glial scar, repairing the area and replacing the CNS cells that cannot regenerate. The microglia are responsible for cleaning up debris after cerebral infection, or cell death. Ependymal cells are responsible for phagocytosis. Oligodendrocytes are responsible for integrative metabolism.

Astrocytes fill up the space to form a glial scar, repairing the area and replacing the CNS cells that cannot regenerate. Astrocytes are the largest and most numerous of neuroglia and are particularly prominent in the gray matter of the CNS. They form a network within the CNS and communicate with neurons to support and modulate their activities. Astrocytes are also the principal cells responsible for repair and scar formation in the brain. The microglia is a small phagocytic cell that is available for cleaning up debris after cellular infection or cell death. The ependymal cell forms the lining of the neural tube cavity, the ventricular system. The oligodendrocytes form the myelin in the CNS. Instead of forming a myelin covering for a single axon, these cells reach out with several processes, each wrapping around and forming a multilayered myelin segment around several different axons.

A nurse is reviewing the medical record of a client at the clinic. The nurse notes that the medication and dosage prescribed for the client was based on information gathered about the client's genetic makeup from the electronic health record. The nurse interprets this as: Genetics Genomics Pharmacogenomics Telehealth

Pharmacogenomics Pharmacogenomics uses information about a person's genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that particular person. Genetics scrutinizes the functioning and composition of the single gene. Genomics addresses all genes and their interrelationships in order to identify their combined influence on the growth and development of the organism. Telehealth refers to the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, client and professional health-related education, public health, and health administration. Technologies include videoconferencing, long distance imaging review, streaming media, and terrestrial and wireless communications and can involve more than just clinical services; it can also include remote nonclinical services such as provider training, administrative meetings, and continuing medical education.

The nurse is assessing a 39-year-old client during her 32-week prenatal checkup. The client has attended regular prenatal checkups throughout the pregnancy. Which assessment data is a priority for the nurse to complete? blood pressure iron and ferritin levels urine ketones sexually transmitted infection (STI) screening

blood pressure Older pregnant women are more likely to develop gestational hypertension, so the priority assessment for this client is blood pressure. Gestational hypertension is characterized by hypertension (BP > 140/90 mmHg) without proteinuria after 20 weeks gestation. It occurs in women known to be normotensive prior to pregnancy. It resolves by 12 weeks postpartum. If the hypertension becomes too severe, preeclampsia will develop. The nurse would examine the urine for protein, not ketones. The mother could have developed iron deficiency anemia, but this is not the priority over assessing the blood pressure. Routine STI screening would have been done at an earlier prenatal checkup and will be repeated at the 37-week checkup.

A client is in the manic phase of bipolar disorder. To help the client maintain adequate nutrition, the nurse should plan to: provide large, attractive meals. offer finger foods and sandwiches. provide a stimulating mealtime environment. let the client choose some favorite foods.

offer finger foods and sandwiches. Finger foods and sandwiches help maintain adequate nutrition and provide calories for this client's high energy level. During the manic phase, the client can't sit still for large meals. Providing a stimulating mealtime environment is incorrect because a quiet mealtime environment is more beneficial than a stimulating one. Letting the client choose some favorite foods is inappropriate because the client has a short attention span and has trouble making choices.

Which statement indicates the client understands teaching about induction therapy for leukemia? "I will start slowly with medication treatment." "I will need to come every week for treatment." "I will be in the hospital for several weeks." "I know I can never be cured."

"I will be in the hospital for several weeks." Induction therapy involves high doses of several medications and the client is usually admitted to the hospital for several weeks. The treatment is started quickly and the goal is to cure or put the disease into remission.

Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"? "Don't take your insulin or oral antidiabetic agent if you don't eat." "It's okay for your blood glucose to go above 300 mg/dl while you're sick." "Test your blood glucose every 4 hours." "Follow your regular meal plan, even if you're nauseous."

"Test your blood glucose every 4 hours." The nurse should instruct a client with diabetes mellitus to check their blood glucose levels every 3 to 4 hours and take insulin or an oral antidiabetic agent as usual, even when the client is sick. If the client's blood glucose level rises above 300 mg/dl, the client should call their physician immediately. If the client is unable to follow the regular meal plan because of nausea, the client should substitute soft foods, such as gelatin, soup, and custard.

To calculate the ideal body weight for a woman, the nurse allows: 100 lb for 5 ft of height. 106 lb for 5 ft of height. 6 lb for each additional inch over 5 ft. 80 lb for 5 ft of height.

100 lb for 5 ft of height. To calculate the ideal body weight of a woman, the nurse allows 100 lb for 5 ft of height and adds 5 lb for each additional inch over 5 ft. The nurse allows 106 lb for 5 ft of height in calculating the ideal body weight for a man. The nurse adds 6 lb for each additional inch over 5 ft in calculating the ideal body weight for a man. Eighty pounds for 5 feet of height is too little.

Which would be the least consistent with the Native American/Canadian Indigenous view of disease? Disharmony with Mother Earth A result of negative thinking Violation of a taboo Balance of yin and yang

Balance of yin and yang The Native American/Canadian Indigenous view disease as a disharmony with Mother Earth, a result of negative thinking, or violation of a taboo. Chinese medicine proposes that health is the outcome of balancing yin and yang.

Which statement is a misconception about chronic disease? Almost half of chronic disease-related deaths occur prematurely in people <70 years of age. Chronic illness typically does not result in sudden death. The major cause of chronic disease is known. Chronic illnesses cannot be prevented.

Chronic illnesses cannot be prevented. A misconception regarding chronic disease is that chronic illnesses cannot be prevented. Almost half of chronic disease-related deaths occur prematurely in people younger than 70 years of age. Chronic illness typically does not result in sudden death. The major cause of chronic disease is known.

A nurse plans to conduct a research study on a group of clients who had laparoscopic gastric bypass. Which term describes this type of study? Cross-sectional Case control Cohort Morbidity

Cohort A cohort study focuses on a group of people born around the same time or who share a common characteristic such as gastric bypass. A cross-sectional study collects data simultaneously from a group of people who are exposed to a factor that may cause a condition. A case-control study examines a group of people who have been exposed to a factor that may cause a condition and compares them to those who do not have the condition. Morbidity refers to death rates.

A 23-year-old female client diagnosed with HIV is receiving lamivudine. Which assessment finding would require the nurse to notify the healthcare provider? CD4 count < 300 Positive urine pregnancy test Currently breast feeding 1-month-old baby WBC count 6,000 mm3

Currently breast feeding 1-month-old baby Because of the potential for HIV transmission, women taking lamivudine should not breast feed as is transferable to the breast-fed infant. Pregnant clients can take lamivudine and it is one of the preferred drugs. A client positive for HIV would have a low CD4 count and a positive HIV assay, and the WBC count of 6,000 mm3 is within normal limits.

A client is scheduled for a cholecystectomy. Which finding by the nurse is least likely to contribute to surgical complications? Pregnancy Diabetes Urinary tract infection Osteoporosis

Osteoporosis Osteoporosis is likely not going to contribute to complications related to a cholecystectomy. Pregnancy decreases maternal reserves. Diabetes increases wound-healing problems and risks for infection. Urinary tract infection decreases the immune system's effectiveness, increasing the chance for infections.

One group of chemical carcinogens is called indirect-reacting agents. Another term for these agents is procarcinogens, which become active only after metabolic conversion. One of the most potent procarcinogens is a group of dietary carcinogens called: Polycyclic aromatic hydrocarbons Aflatoxins Initiators Diethylstilbestrol

Polycyclic aromatic hydrocarbons Most known dietary carcinogens either occur naturally in plants (e.g., aflatoxins) or are produced during food preparation. Among the most potent of the procarcinogens are the polycyclic aromatic hydrocarbons. The polycyclic aromatic hydrocarbons are of particular interest because they are produced from animal fat in the process of charcoal-broiling meats and are present in smoked meats and fish. They also are produced in the combustion of tobacco and are present in cigarette smoke. Initiators is another term for procarcinogens. Diethylstilbestrol was a drug that was widely used in the United States from the mid-1940s to 1970 to prevent miscarriages.

The nurse is meeting with a community group to discuss the changes that need to be made to meet their health needs after a community assessment has been done. One cultural group is insisting their views need to be implemented because they are in the majority in that community. What is the best action by the nurse? Support the implementation of the ideas of the majority. Seek input from all groups and strive for consensus on what would benefit most or all of these people. Seek to promote homogeneity and common views rather than focus on differences. Make decisions based on findings from the community assessment.

Seek input from all groups and strive for consensus on what would benefit most or all of these people. The responsibility is to conduct the community assessment and to identify the key needs. All members need to have representation in this process. It is best to strive for consensus on what the key issues are and to implement programs that would benefit most of the people, rather than responding to one interest group. Listening to the majority viewpoint or helping everyone to change their views and have homogeneity would not be effective. Decisions based on the community alone are also not an appropriate answer.

A client appears to be resting comfortably 12 hours after giving birth to her first child. In contrast, she labored for more than 24 hours, the primary care provider had to use forceps to deliver the baby, and she had multiple vaginal examinations during labor. Based on this information what postpartum complication is the client at risk for developing? hemorrhage infection depression pulmonary emboli

infection There are many risk factors for developing a postpartum infection: operative procedures (e.g., forceps, cesarean section, vacuum extraction), history of diabetes, prolonged labor (longer than 24 hours), use of Foley catheter, anemia, multiple vaginal examinations during labor, prolonged rupture of membranes, manual extraction of placenta, and HIV.

A pregnant client with diabetes mellitus is at risk for having a large-for-gestational-age neonate because: excess sugar causes reduced placental functioning. insulin acts as a growth hormone on the fetus. the mother follows a high-calorie diet. excess insulin reduces placental functioning.

insulin acts as a growth hormone on the fetus. Insulin acts as a growth hormone on the fetus. Therefore, pregnant clients with diabetes must maintain good glucose control. Large babies are prone to complications and may have to be delivered by cesarean birth. Neither excess sugar nor excess insulin reduces placental functioning. A high-calorie diet helps control the mother's disease and doesn't contribute to neonatal size.

A nurse is documenting on a client who has had an appendectomy. During a dressing change of the surgical site, the nurse observed a pale pink drainage on the dressing. Which drainage type should the nurse document? serous sanguineous serosanguineous purulent

serosanguineous Serosanguineous drainage is a mixture of serum and red blood cells. It is usually pink or pink-yellow. Serous drainage is a clear drainage consisting of the serous portion of the blood. Sanguineous drainage consists of red blood cells and looks like blood. Purulent drainage has various colors, such as green or yellow; this drainage indicates infection.

A nurse is providing care for a client who underwent mitral valve replacement. The best example of a measurable client outcome goal is for the client to: change their own dressing with clean technique and be able to verbalize the steps. walk with help in the hallway by the end of the evening shift. walk from their room to the end of the hall and back before discharge. select special foods from a diet after client education by the nurse.

walk from their room to the end of the hall and back before discharge. Walking from the client's room to the end of the hall and back before discharge is a specific, measurable, attainable, and timed goal. It's also a client-oriented outcome goal. Having the client change their own dressing is incomplete and not as significant. Just walking in the hall isn't measurable. The need for a special diet isn't evident in this case.

Atypical hyperplasia increases a woman's risk for breast cancer about how many times compared with that of the general population? 2 4 6 8

4 A woman with atypical hyperplasia has a fourfold increased risk for breast cancer compared with that of the general population.

The public health nurse is designing a course about risk factors for various chronic illnesses. For risk factors about which chronic illness will the nurse consult the Framingham study? Cardiovascular disease Breast cancer Chronic obstructive pulmonary disease (COPD) Type 2 diabetes mellitus

Cardiovascular disease The Framingham Study is a longitudinal, or cohort, study which began in 1950 to study the characteristics of people who would later develop coronary heart disease. Though data has been collected about cancer diagnoses and other health conditions from this cohort, that data has not been used to create definitive risk factor data as it has been for cardiovascular disease.

Which condition does the school nurse know is of highest health concern for school-aged children? Childhood obesity Gastrointestinal disorders Dental caries Diseases affecting the immune system

Childhood obesity Childhood obesity has significantly increased and needs to be addressed in school-aged children. Approximately 17% of children between 2 and 19 years of age are obese—a percentage that has tripled since 1980. The immune system of a school-aged child is well developed. While GI disorders and dental caries can occur, they are not as serious a health issue as is childhood obesity.

Hyperresonance is audible when which area is percussed? Overinflated lung tissue Liver Thigh Air-filled stomach

Overinflated lung tissue Hyperresonance is audible when overinflated lung tissue is percussed, such as in a client with emphysema. Percussion over the liver produces a dull sound. Percussion of the thigh produces a flat sound. Tympany is the drum-like sound produced by percussing an air-filled stomach.

A primigravid client has just completed a difficult, forceps-assisted birth of a 9-lb (4.08-Kg) neonate. Her labor was unusually long and required oxytocin augmentation. The nurse who's caring for her should stay alert for uterine: inversion. atony. involution. discomfort.

atony. A large fetus, extended labor, stimulation with oxytocin, and traumatic birth commonly are associated with uterine atony, which may lead to postpartum hemorrhage. Uterine inversion may precede or follow birth and commonly results from apparent excessive traction on the umbilical cord and attempts to deliver the placenta manually. Uterine involution and some uterine discomfort are normal after childbirth.

Three major paradigms are used to explain the causes of disease and illness. Which three of the following are the paradigms? Choose all three: Biomedical or scientific view Naturalistic or holistic perspective Magico-religious view Geographic view Dynamic perspective

Biomedical or scientific view Naturalistic or holistic perspective Magico-religious view Three major views, or paradigms, attempt to explain the causes of disease and illness: the biomedical or scientific view, the naturalistic or holistic view, and the magico-religious view. The geographic view and the dynamic perspective are not considered paradigms of causes of illness.

A client in the first trimester of pregnancy joins a childbirth education class. During this trimester, the class is most likely to cover which physiologic aspect of pregnancy? signs and symptoms of labor quickening and fetal movements warning signs of complications false labor and true labor

warning signs of complications In early childbirth education classes, instruction on the physiologic aspects of pregnancy may include warning signs of complications, the anatomy and physiology of pregnancy, nutrition, and fetal development. Signs and symptoms of labor, quickening and fetal movements, and false and true labor are usually discussed in later classes.

When a client who has been newly diagnosed with HIV asks, "What are the chances that I can be cured?," what is the nurse's most therapeutic response? "Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection." "Your doctor will want to see you on a regular basis in order to evaluate your viral load and prescribe the appropriate medications." "The key to success is the management of your immune system so that life- threatening opportunistic diseases do not develop." "Routine follow-up care of a stable, asymptomatic person infected with HIV , like yourself, will include a history and physical examination along with CD4+ cell count and viral load testing every 3 to 4 months."

"Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection." There is no cure for HIV infection. The medications that are currently available to treat HIV infection decrease the amount of virus in the body, but they do not eradicate HIV. After HIV infection is confirmed, a baseline evaluation should be done. This evaluation should include a complete history and physical examination and baseline laboratory tests including a complete blood count with differential. Routine follow-up care of a stable, asymptomatic person infected with HIV should include a history and physical examination along with CD4+ cell count and viral load testing every 3 to 4 months. People who are symptomatic may need to be seen more frequently. Therapeutic interventions are determined by the level of disease activity based on the viral load, the degree of immunodeficiency based on the CD4+ cell count, and the appearance of specific opportunistic infections.

The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care? "Treatment is simple and consists of single-drug therapy." "Intrathecal chemotherapy is used primarily as preventive therapy." "The goal of therapy is palliation." "Side effects are rare with therapy."

"Intrathecal chemotherapy is used primarily as preventive therapy." Intrathecal chemotherapy is a key part of the treatment plan to prevent invasion of the central nervous system. The therapy uses multiple drugs, with many side effects. The goal of therapy is remission.

know what percentage of individuals get cataracts. The client is 78 years old. What percentage of clients over the age of 75 have cataracts? 45% 50% 65% 70%

70% Cataracts are the most common cause of blindness in the world, accounting for nearly 48 percent of all blindness. Aging is the most common cause of cataracts, with an estimated prevalence of 50 percent in persons between the ages of 65 and 74 years, and increasing to 70 percent in those over 75 years of age.

A nurse is caring for four clients. Which client is most at risk for atrial fibrillation (AF)? A middle-aged woman with shortness of breath who takes an aspirin daily An older adult man who is 2 days postcoronary artery bypass surgery A male adult post-carotid endarterectomy A female adult with diabetes mellitus and hypertension

An older adult man who is 2 days postcoronary artery bypass surgery AF can be seen in people without any apparent disease, or it may occur in people with coronary artery disease, mitral valve disease, ischemic heart disease, hypertension, myocardial infarction, pericarditis, congestive heart failure, digitalis toxicity, and hyperthyroidism. AF is the most common chronic dysrhythmia, with an incidence and prevalence that increase with age. The incidence of AF increases with age. For example, it occurs in less than 0.5% of the population aged less than 50 years and increases by 2% at ages 60-69 years old. The prevalence is also greater in men than in women.

A nurse is describing the advantages and disadvantages associated with tamoxifen therapy as a means of breast cancer prevention. The nurse would identify that the drug has a beneficial effect on which of the following? Bone mineral density High density lipoprotein levels Risk for endometrial cancer Cataract formation

Bone mineral density Besides reducing the risk of breast cancer, tamoxifen preserves bone mineral density, thus preventing osteoporosis. It also lowers the low-density lipoprotein cholesterol levels, although it is still unknown if it decreases the incidence of myocardial infarction in women. Tamoxifen can have detrimental effects. It increases the incidences of endometrial cancer, deep vein thrombosis, pulmonary embolism, and cataracts.

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care? Reinforce the care plan to the family if it is determined the client is not properly cared for. Provide referrals for health care professionals to perform the client's activities of daily living (ADLs). Encourage active participation of the client and family in health care decisions. Create a care plan based on the client's requests and inform the family of the client's wishes.

Encourage active participation of the client and family in health care decisions. In a community-based health care setting, the nurse should involve the client and the family in all health care decisions for the client. The nature of the relationship is that of a partnership based on respect, appreciation, and cooperation. Reinforcing to the family that the client is not well-cared for should be done, but it is more important to involve the client and family in the care. The client and family should be encouraged to provide ADLs as they are able. Client care decisions should be made in conjunction with the family, and the family should be encouraged to participate in those decisions. The client's plan of care should include input from the family.

A nurse is caring for a female client with symptoms of first-degree pelvic organ prolapse. Which instruction related to dietary and lifestyle modifications should the nurse provide to the client to help prevent pelvic relaxation and chronic problems later in life? Increase dietary fiber. Avoid caffeine products. Avoid excess intake of fluids. Increase high-impact aerobics.

Increase dietary fiber. The nurse should instruct the client to increase dietary fiber and fluids to prevent constipation. A high-fiber diet with an increase in fluid intake alleviates constipation by increasing stool bulk and stimulating peristalsis. Straining to pass a hard stool increases intra-abdominal pressure, which, over time, causes the pelvic organs to prolapse. Avoiding caffeine products would not help in the management of this condition. In addition to recommending increasing the amount of fiber in her diet, the nurse should also encourage the woman to drink eight 8-oz glasses of fluid daily. The nurse should instruct the client to avoid high-impact aerobics to minimize the risk of increasing intra-abdominal pressure.

Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)? Saw palmetto Garlic Ginkgo Green tea

Saw palmetto Saw palmetto is an herbal product used to treat symptoms associated with BPH.

A nurse is providing care for a pregnant client. The client asks the nurse how she can best deal with her fatigue. What instructions would the nurse give to this client? Take sleeping pills. Take an afternoon nap. Go to bed earlier at night. Sleep only on the left side.

Take an afternoon nap. Fatigue is a common part of pregnancy. It is worst in the first and third trimesters; first-trimester fatigue is often associated with the many physical and psychosocial changes of being pregnant, and third-semester fatigue is caused by sleep disturbances from increased weight and physical discomforts such as heartburn. If physical causes of the fatigue are ruled out, the client should be arranging her life to permit additional rest periods. Naps should be encouraged. It is best to sleep on the left side, but a position of comfort improves sleep. Sleeping pills should be contraindicated during pregnancy. The client should go to bed to sleep on her natural sleep schedule. If one is used to going to bed late at night, then going to bed earlier doesn't mean the client will fall asleep earlier. The client should sleep and rest when her body tells her.

A nurse is caring for a client who has an avulsion of her left thumb. Which description should the nurse understand as being the definition of avulsion? Tearing of the skin and tissue with some type of instrument; tissue not aligned Cutting with a sharp instrument with wound edges in close approximation with correct alignment Tearing of a structure from its normal position Puncture of the skin

Tearing of a structure from its normal position An avulsion involves tearing of a structure from its normal position on the body. Tearing of the skin and tissue with some type of instrument with the tissue not aligned is a laceration. Cutting with a sharp instrument with wound edges in close approximation and correct alignment is an incision. A puncture of the skin is simply a puncture.

The nurse is assessing the physiological effects of severe obsessive-compulsive disorder (OCD) in a client. What does the nurse expect to find during assessment? The client sleeps for 8 to 10 hours a day. The client is unable to maintain adequate personal hygiene. The client reports unwanted weight gain. The client is energetic and completes activities quickly.

The client is unable to maintain adequate personal hygiene. In severe OCD, the client is unable to complete routine tasks because of compulsive ritual behaviors. A lot of time is spent on performing rituals and the client may not have enough time to sleep. The client is so obsessed with thoughts and compulsive behaviors that physical needs such as sleep, food, drink, and hygiene are neglected. Thus, the client may report unwanted weight loss. Rituals also interfere with the client's ability to complete activities quickly.

A nurse is assessing the family of an infant and observes that the parents are argumentative and appear fatigued. They indicate that the baby is not breastfeeding well and cries through the night. What would be the nurse's priority nursing diagnosis for this infant? altered nutrition (less than body requirements) related to difficulty sucking parental sleep pattern disturbance related to the baby's feeding schedule knowledge deficit related to normal infant growth and development altered role performance related to new responsibilities within the family

altered nutrition (less than body requirements) related to difficulty sucking The nurse's initial priority should be to address the caloric intake of the baby through health teaching and support of the parents to ensure that the baby will meet age-appropriate growth and development milestones.

A client suffers from chronic pain. The nurse suggests the client have monthly massages. This is an example of: adjuvant medicine. palliative medicine. alternative medicine. allopathic medicine.

alternative medicine. The use of conventional therapy as seen with CAM includes the use of herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy.

A nurse is assessing a pregnant client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydramnios based on which preexisting condition? diabetes hypertension late maternal age isoimmunization

diabetes Approximately 18% of all women with diabetes will develop hydramnios during their pregnancy. Hydramnios occurs in approximately 2% of all pregnancies and is associated with fetal anomalies of development.

A nurse is reading a journal article that reviews the various theories of human behavior and mental illness. One of the theories described states that all human beings have the potential for goodness and that therapy helps clients explore their own ability to develop self-worth. The nurse is reading about which theory? humanistic theory interpersonal theory psychoanalytic theory sociocultural theory

humanistic theory Humanistic theories are based on the belief that all human beings have the potential for goodness. Humanist therapists focus on clients' ability to learn about and accept themselves. They do not investigate repressed memories. Through therapy, clients explore personal capabilities in order to develop self-worth. They learn to experience the world in a different way.Interpersonal theories stress the importance of human relationships; instincts and drives are less important. Sociocultural theories consider the the role of the individual within the family and society. Interventions are based on the understanding and significance of family and cultural norms. Psychoanalytic theory conceptualizes the human mind in terms of conscious and unconscious mental processes.

A client who used heroin during her pregnancy gives birth to a neonate. When assessing the neonate, the nurse expects to find: lethargy 2 days after birth. irritability and poor sucking. a flattened nose, small eyes, and thin lips. congenital defects such as limb anomalies.

irritability and poor sucking. Neonates of heroin-addicted mothers are physically dependent on the drug and experience withdrawal when the drug is no longer supplied. Signs of heroin withdrawal include irritability, poor sucking, and restlessness. Lethargy isn't associated with neonatal heroin addiction. A flattened nose, small eyes, and thin lips are seen in neonates with fetal alcohol syndrome. Heroin use during pregnancy hasn't been linked to specific congenital anomalies.

A newborn is being monitored for retinopathy of prematurity. Which condition predisposes an infant to this condition? respiratory distress syndrome Down syndrome hydrocephalus esophageal atresia

respiratory distress syndrome Retinopathy of prematurity (ROP) is a complication that can occur when high concentrations of oxygen are given during the course of treatment for respiratory distress syndrome (RDS). ROP is caused by separation and fibrosis of the retinal blood vessels and can often result in blindness.

Two nursing students are debating the merits and demerits of infant circumcision. Which statement is most accurate? "Circumcised men tend to have a lower incidence of penile cancer." "Getting circumcised basically rules out the possibility of getting Peyronie disease later in life." "Circumcision reduces pressure on the deep dorsal vein and the dorsal artery, making erection easier later in life." "The odds of getting infant priapism fall with circumcision."

"Circumcised men tend to have a lower incidence of penile cancer." A correlation between circumcision and lower incidence of penile cancer has been noted. Circumcision is unlikely to affect the development of Peyronie disease or priapism, and is not noted to influence the ease of attaining or maintaining erection.

What should the nurse teach the client about the Human Activity Profile (HAP)? "This is done to screen you for disease." "The screening will help determine cardiovascular fitness." "This helps to determine your perception of activity tolerance." "This tool helps the health care provider prescribe medication."

"This helps to determine your perception of activity tolerance." The HAP is a screening tool that is done to determine the client's perceived level of activity tolerance. It is not done to prescribe medications, screen for disease, or determine cardiovascular fitness.

A client is at an ideal weight when she conceives. During a prenatal visit 2 months later, the client asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response? "You should gain less than 10 lb (4.5 kg)." "You should gain 10 to 15 lb (4.5 to 6.8 kg)." "You should gain 16 to 24 lb (7.3 to 10.9 kg)." "You should gain 25 to 35 lb (11.3 to 15.9 kg)."

"You should gain 25 to 35 lb (11.3 to 15.9 kg)." For a client entering pregnancy in the ideal weight range, a gain of 25 to 35 lb (11.3 to 15.9 kg) is adequate to meet her needs and the needs of her fetus. Weight gain below the recommended range predisposes the client to complications during pregnancy, labor, and birth.

The nurse explains to the client which statement is true regarding the difference between allopathic therapy and complementary and alternative therapy? Allopathic therapy emphasizes treatments for diseases. Complementary and alternative therapy emphasizes treatments for health. Allopathic therapy integrates mind and body. Complementary and alternative therapy separates mind and body. Allopathic therapy is the absence of illness. Complementary and alternative therapy states health is the imbalance of the body systems. Allopathic therapy uses herbs to treat. Complementary and alternative therapy uses medications to treat.

Allopathic therapy emphasizes treatments for diseases. Complementary and alternative therapy emphasizes treatments for health. Allopathic therapy emphasizes treatments for diseases using traditional western medicine provided by an MD or DO. Examples of Allopathic therapy include pharmacotherapy, surgery, and radiology. Alternative medicine and complimentary medicine are terms that describes medical treatments that are used instead of traditional western therapies. Examples of complementary therapy include acupuncture, aromatherapy, homeopathy, and yoga. Alternative therapy includes acupuncture, homeopathy, and eastern oriental practices.

The nurse is conducting a routine well-visit on a 43-year-old client who is concerned about developing breast cancer, although no family members have experienced it. What is the best advice for this client at this time? Be aware of the normal appearance and feel of your breasts. Inspect your nipples every day for discharge or bleeding. Ask the health care provider for recommendations based on family history. Have a yearly mammogram as part of a comprehensive screening.

Be aware of the normal appearance and feel of your breasts. The American Cancer Society recommends that each woman know how her breasts normally look and feel, and if she finds changes, she should immediately report them to a health care provider. Discharge from the nipple is not necessarily related to cancer. For women with an average risk for breast cancer, yearly mammograms should start at age 45 and can change to every 2 years beginning at age 55. Women who are at a higher risk for breast cancer due to family history or other reasons may need to begin screening earlier and/or more often.

A nurse is developing a set of programs that focuses on reducing the risk factors for mental health problems for a community health care center. Which program would be least appropriate? Nutritional counseling for teens Yoga and relaxation classes Substance abuse education classes Genetic counseling

Genetic counseling Genetic counseling programs would be least appropriate because although genetic background is a risk factor for mental health problems, it cannot be modified. However, risk factors such as nutritional status, physical health, stress level, and alcohol and drug misuse can be modified, making nutritional counseling, yoga and relaxation classes, and substance abuse education classes appropriate strategies for risk reduction.

A client states, "Both of my parents were overweight, but I've never really had any problems maintaining a healthy weight." How should the nurse best interpret the role of genetics in the client's observation? Obesity is a polygenic trait and does not result from a single gene at one locus. The client may be a carrier for obesity and likely has a 50% chance of having an obese child. Obesity is a recessive rather than dominant trait. Obesity is a dominant trait but the client may not possess the locus where the genotype is normally found.

Obesity is a polygenic trait and does not result from a single gene at one locus. Obesity is an example of a trait that has a genetic component but which is polygenic; it does not exist by virtue of one single genotype. As such, it is not considered to be a recessive or dominant trait. Because it is polygenic, the odds of having a child who is obese cannot be precisely determined.

A nurse is reviewing the medical record of a female client diagnosed with vaginal cancer. Which factors would the nurse identify as increasing this client's risk? Select all that apply. age 62 years negative for diethylstilbestrol (DES) exposure history of genital warts chronic vaginal discharge history of previous chest radiation

age 62 years history of genital warts chronic vaginal discharge Although direct risk factors for the initial development of vaginal cancer have not been identified, associated risk factors include advancing age (over 60 years old), previous pelvic radiation, exposure to DES in utero, vaginal trauma, history of genital warts (HPV infection), HIV infection, cervical cancer, chronic vaginal discharge, smoking, and low socioeconomic level.

A community nurse is working with the family of an infant and teaching the parents about preventative health practices. What method of primary prevention the nurse to include in the teaching? child-proofing the home testing suck reflexes testing grasp reflexes performing screening tests

child-proofing the home Primary prevention involves interventions that keep a health disorder from occuring. Teaching the parents how to child-proof the home is an example of primary prevention because it explains steps the parents can take to keep injury from occuring in the first place. Testing infant reflexes and performing screening tests are methods of seconday prevention; by attempting to identify signs and symptoms of disorders that have already occured, they help limit the impact of the disorder.

A group has asked the nurse to discuss how lifestyle factors affect heart health. Which statements by members of the group would indicate that the teaching was effective? Select all that apply. "Chewing tobacco rather than smoking it lessens the negative effect on the heart." "Gradually increasing my exercise levels will help enhance circulation through the heart." "If I change my diet and lessen my intake of saturated fats and trans fatty acids, this may decrease my cholesterol levels." "As a borderline diabetic, if I lose weight and lessen my intake of simple carbohydrates, this should benefit my heart." "Walking is excellent exercise to strengthen my heart."

"Gradually increasing my exercise levels will help enhance circulation through the heart." "If I change my diet and lessen my intake of saturated fats and trans fatty acids, this may decrease my cholesterol levels." "As a borderline diabetic, if I lose weight and lessen my intake of simple carbohydrates, this should benefit my heart." "Walking is excellent exercise to strengthen my heart." Increasing exercise levels, diet changes, losing weight, and walking are all important elements of heart health. Chewing tobacco is still harmful to the body.

A graduate nurse is asking for information about chronic renal failure. Which statement by the nurse would be most accurate when providing teaching? "It is most commonly caused by recurrent pyelonephritis." "It results in an increase in erythropoietin, leading to chronic anemia and fatigue." "It results in an inability of the kidneys to convert waste products to creatinine and blood urea nitrogen." "It is characterized by azotemia, fluid volume excess, and hyperkalemia."

"It is characterized by azotemia, fluid volume excess, and hyperkalemia." When chronic renal failure occurs, the body is unable to eliminate the wastes, resulting in azotemia. In addition, the kidneys are not able to eliminate the body fluids, resulting in fluid volume overload. There is also a rise in potassium levels resulting in hyperkalemia. The most common cause of chronic renal failure is diabetes. There is a depression of erythropoietin with chronic renal failure. The liver converts wastes to creatinine and blood urea nitrogen, not the kidneys.

A client was unaware that intestinal flora are beneficial, stating, "I thought all bacteria were bad." Which is the nurse's most accurate response? "An interaction such as this is called commensalism: The colonizing bacteria acquire nutritional needs and shelter, and the host is able to keep their numbers under control." "The term 'mutualism' is applied to an interaction in which the microorganism and the host both derive benefits from the interaction." "There's a parasitic relationship by which the bacteria benefits but there's a minimal effect on the host's health." "Any organism capable of supporting the nutritional and physical growth requirements of another is called a host."

"The term 'mutualism' is applied to an interaction in which the microorganism and the host both derive benefits from the interaction." The relationship between host (human) and bacteria that colonize the gut is a mutualistic relationship. The bacteria digest and synthesize nutrients that we cannot digest. With commensalism there is no net benefit or loss, such as is seen in a parasitic relationship; the host is separate from the bacteria.

A 30-year-old client whose mother died of breast cancer at age 44, and whose sister has ovarian cancer, is concerned about developing cancer. As a member of the oncology multidisciplinary team, the nurse should suggest that the client ask the physician about which topic? Mammogram Papanicolaou (Pap) testing every 6 months Contacting the American Cancer Society Genetic counseling

Genetic counseling The nurse should suggest that the client ask the physician about genetic counseling. Genetic counseling is indicated for those at high risk because of family or personal cancer history. Genetic counseling involves obtaining a detailed medical and three-generational family history; calculating a personalized risk assessment; providing options for prevention, surveillance, and genetic testing; coordinating and interpreting genetic testing; and developing a management plan based on the test results. Mammography will assist with early detection of most breast cancers, but it won't establish a risk assessment and provide options for prevention, surveillance, and genetic testing. Pap testing every 6 months assists in early detection of most cervical cancers, but it won't establish a risk assessment. Contacting the American Cancer Society will provide the client with information about cancer but the organization won't help assess the client's risk for developing cancer.

Assessment of a patient reveals a flat and nonpalpable skin lesion that is 0.5 cm with a circumscribed border. The nurse documents this lesion as which of the following? Macule Patch Papule Plaque

Macule A flat, nonpalpable, circumscribed lesion less than 1 cm is a macule. A patch is a macule larger than 1 cm, and possibly with an irregular border. A papule is an elevated palpable solid mass with a circumscribed border and less than 0.5 cm. A plaque is a papule greater than 0.5 cm.

A pregnant woman has undergone prenatal screening that has revealed evidence of congenital heart defect in the fetus. The nurse interprets this finding as indicative of which type of inheritance? Autosomal recessive Autosomal dominant X-linked recessive Multifactorial

Multifactorial Congenital heart defects would be from multifactorial inheritance. Marfan syndrome or Huntington disease is from autosomal-dominant inheritance. Cystic fibrosis or sickle-cell anemia is from autosomal-recessive inheritance. Hemophilia is from X-linked recessive inheritance.

A nurse is preparing a presentation for a local community group about familial Alzheimer's disease. As part of the presentation, the nurse is planning to discuss the possible genetic basis for this condition. The nurse would describe the inheritance as which of the following? Autosomal dominant Autosomal recessive Multifactorial X-linked

Multifactorial Familial Alzheimer's disease reflects multifactorial inheritance that involves interactions among several genes and between genes and the environment as well as the individual's lifestyle. Autosomal-dominant, autosomal-recessive, and X-linked inheritance patterns are not involved.

The pessary is often used to treat marked prolapse. Although it may support a prolapsed pelvic organ, it does not allow for concomitant strengthening of pelvic floor muscles and does not reduce urine leakage. What newer device can both support the pelvic floor muscle and facilitate rehabilitation of the pelvic floor muscles? colpexin sphere intrauterine device (IUD) female urination device (FUD) purified protein derivative (PPD)

colpexin sphere The colpexin sphere, a new intravaginal device, supports the pelvic floor muscle and facilitates rehabilitation of the pelvic floor muscles. An IUD is an intrauterine device for the purpose of birth control. An FUD is a female urination device that allows a female to urinate while standing. PPD stands for purified protein derivative and is used for TB testing.

A client's history reveals evidence of a trisomy. The nurse interprets this as resulting from which of the following? Nondisjunction Mutation Deletion Translocation

Nondisjunction With a trisomy, a pair of chromosomes has failed to separate completely, creating a sperm or oocyte that contains three copies of a specific chromosome. This is called nondisjunction. Mutation refers to changes in the structure of the gene that permanently changes the sequence of DNA. Deletion is a type of mutation that results from the loss of a gene. Translocation is a type of mutation that occurs when the longer DNA segment is rearranged.

The nurse is educating a group of clients about why routine screening for open-angle glaucoma is important. What information should the nurse should include? Select all that apply: Open-angle glaucoma is an asymptomatic condition. Increasing intraocular pressure damages the optic nerve. Surgical intervention is required as soon as it is identified. The chance for cure is increased if diagnosed early in the disease. Early intervention can prevent vision loss.

Open-angle glaucoma is an asymptomatic condition. Increasing intraocular pressure damages the optic nerve. Early intervention can prevent vision loss. Open-angle glaucoma is usually asymptomatic and chronic, causing progressive damage to the optic nerve and visual field loss unless detected early and treated with topical solutions such as beta blocker or prostaglandin analogues. Surgical intervention is reserved for acute angle-closure glaucoma. Routine screening by applanation tonometry, which measures intraocular pressure, allows for early detection of glaucoma before vision loss has occurred.