Exam 1 Review

older adults need increased vitamin ____ to decrease risk of osteoporosis

D

The nurse manager oversees an organization that provides secondary care for clients with cancer. Which service would be provided by this type of organization? a. providing long term care for fatigue b. providing treatment for pain management c. teaching the client about prevention of infection d. teaching the client about adverse effects of the therapy

c. teaching the client about prevention of infection *preventing disease complications- teaching client about prevention of infection

nursing health assessment =

comprehensive health history and complete physical examination

tachycardia, hypotension

fluid volume deficiency/dehydration

secondary level of preventative care

focuses on identifying illness, providing treatment and preventing a worsening health status (detection, screenings, health fairs- could find a disease, preventing complications, education, programs)

fluid overload

overhydration

dehydration s/s

wt loss, decreased BP, increased HR, weakness

petechiae, echhymoses

vit K deficiency

beefy red tongue

vitamin B12 deficiency

bone pain, bow leg

vitamin D or calcium deficiency

edema

protein deficiency

thinning dry hair

protein deficiency

pale skin

anemia

wt loss

decreased calorie intake or inadequate nutrition intake

objective data

nurse observes: assessment, diagnostic testing, observations, measurements

weakness/faitgue

anemia/electrolyte imbalance

cardiac diet

high in monosaturated fats (omega 3 fats)

adolescent females need an increase in what?

iron and folate

brittle, spoon shaped nails

iron deficiency

the client's pain score is... data

subjective but used as objective data when giving pain meds

Which questions would the nurse initially ask to conduct a culturally competent assessment interview? SATA a. can you tell me about the reasons for coming here today? b. what do you believe is the cause of your depression? c. does religion have a role in your perception of health and wellness? d. do you believe that we can help with your mental health issues? e. have you ever sought treatment for a mental health problem before?

a. can you tell me about the reasons for coming here today? b. what do you believe is the cause of your depression? c. does religion have a role in your perception of health and wellness? e. have you ever sought treatment for a mental health problem before? *ask open ended questions to get answers

decrease in iron

anemia; pale-pallor in color

vegans avoid all...

animal and fish

BMI of 28

overweight

Muslim and Jewish cultures do not eat...

pork products

ascites

protein deficiency

BMI less than 20

underweight

The nurse is providing education about excellent food sources of Vitamin A for a client who is deficient in this vitamin. Which foods would the nurse include in the teaching? SATA a. carrots b. oranges c. tomatoes d. leafy green vegetables e. cantaloupe

a. carrots, d. leafy green vegetables, e. cantaloupe orange vegetables (like sp), green leafy vegetables are a go to

The nurse is assessing a client who had knee replacement surgery. Which assessment finding gathered by the nurse is an example of objective data? a. client weighs 68.5 kg b. client's pain is 7 on the numeric pain scale (1-10) c. client's blood sugar is 95 mg/dL d. client's blood pressure is 140/90 mm Hg

a. client weighs 68.5 kg c. client's blood sugar is 95 mg/dL d. client's blood pressure is 140/90 mm Hg

Which questions would the nurse ask the client when obtaining the health history? SATA a. tell me about your food habits b. do you use alcohol or tobacco? c. have you sustained any personal loss recently? d. have you experienced any allergic reactions? e. does any family member have a long-term illness?

a. tell me about your food habits b. do you use alcohol or tobacco? (habits and lifestyle patterns) d. have you experienced any allergic reactions? only clients personal health history

What activities would the nurse participate in while providing a primary level of preventive care? SATA a. individual and mass screening activities b. education about adequate housing and recreation c. education about attention to personality development d. instruction about the standard of nutrition adjusted to development phases of life e. providing a hospital and community facilities for retraining to maximum use of remaining capacities

b. education about adequate housing and recreation c. education about attention to personality development e. providing a hospital and community facilities for retraining to maximum use of remaining capacities

A client is admitted to the hospital after a motor vehicle accident with multiple abrasions and lacerations to the chest and all four extremities. Which food items would the nurse recommend the client to select for the upcoming meals? a. meatloaf and fried potatoes b. meatloaf and strawberries c. chicken soup and baked apple pie d. chicken soup and buttered bread

b. meatloaf and strawberries (Protein and vit C- both promote wound healing)

Which activities would the nurse consider to be a part of the secondary level of preventative care? SATA a. using specific immunizations b. preventing the spread of communicable disease c. providing facilities to limit disability and prevent death d. providing adequate treatment to arrest the disease process e. educating the public and industry to use rehabilitated individuals to the fullest possible extent

b. preventing the spread of communicable disease c. providing facilities to limit disability and prevent death d. providing adequate treatment to arrest the disease process

Which actions would the nurse take to obtain subjective data about a client's respiratory status? SATA a. palpate the chest and back for masses b. question the client about SOB c. check the hematocrit and hemoglobin values d. inspect the skin and nails for integrity and color e. ask the client about the color and quantity of sputum

b. question the client about SOB e. ask the client about the color and quantity of sputum *collected directly from the client

weight loss

inadequate nutritional intake

tertiary level of prevention

individuals already have the disease- goal to improve quality of life and restoring function; prevent longterm consequences of chronic illness

primary level of preventative care

promote health and prevent diseases w/ specific protections: immunizations, nutrition-fitness activities, health education in schools/communities, health maintenance measures *educate and give instruction

fluid overload first s/s

respiratory crackles, SOB/dyspnea

hypovolemic shock first s/s

tachycardia and hypotensive

dry, flaky skin

vit A, B-complex or linoleic acid deficiency

parethesia

vit B12, pyridoxine or thiamine deficiency

sores that won't heal

vit C or K deficiency

night-blindness

vitamin A deficiency

soft spongy bleeding gums

vitamin C deficiency

petechiae

vitamin K deficiency

BMI of 20

weight appropriate

A primary healthcare provider tells a client that Vitamin E is important for healthier skin. Which foods would the nurse recommend? a. legumes and whole grains b. seeds and pb c. oranges and grapefruit d. carrots and sweet potatoes

b. seeds and pb antioxidants inhibit tissue breakdown

hypovolemic

dehydration

poor skin turgor

dehydration

poor skin turgor, scaly

dehydration

altered mental status

dehydration, thiamine or B12 deficiency

nursing health assessment includes

demographic info CC- chief complaint HPI- history of present illness PMH- past medical history family history psychosocial history health promo ROS- review of systems PE- physical exam

muscle wasting

protein, carb or fat deficiency

when assessing nutrition, a _______ recall is done

24 hr

An adolescent w/ a BMI of 30 reports fatigue, frequent urination and a tingling sensation on the feet. They are diagnosed w/ type II diabetes. Which nursing interventions would be appropriate? SATA a. bariatric surgery b. physical activities/exercise c. dietary restrictions d. dietary counseling e. behavior modification

b. physical activities/exercise d. dietary counseling e. behavior modification

cracks at corner of mouth

riboflavin or niacin (B vitamins) deficiency

The client reports difficulty in breathing. The nurse auscultates lung sounds and assess the respiratory system. What is the purpose of the nurses' actions? a. data collection b. data validation c. data clustering d. data interpretation

a. data collection collecting objective data to support the subjective data the client reports- difficulty breathing

Which belief of the nurse may have a negative effect on health services for minority clients? a. the mind, body and spirit are distinct entities b. the focus of an assessment should be on the culture rather than the race for children from multiracial/cultural marriages c. Chinese clients may believe that disease is caused by fluctuations in opposing forces- the yin-yang energies d. when taking a client history, the nurse should record the client's race according to how they identify

a. the mind, body and spirit are separate entities in nursing, body, mind and spirit are a single entity; nursing is holistic- looking at human response

The nurse assesses a client w/ dry, brittle hair, flaky skin, a beefy red tongue and bleeding gums. The nurse recognizes that these clinical manifestations are a result of what? a. a food allergy b. noncompliance w/ meds c. side effects from meds d. a nutritional deficiency

d. a nutritional deficiency

Which scenario would contribute to health disparities? a. an English-speaking critical care nurse assess a Hispanic client in a coma b. an English-speaking nurse plans the nursing procedures for a black Latino client c. an English-speaking nurse provides discharge instructions to an English-speaking client who is hard of hearing d. an English-speaking nurse conducts the admission interview on a Puerto Rican immigrant w/ limited knowledge of English

d. an English-speaking nurse conducts the admission interview on a Puerto Rican immigrant w/ limited knowledge of English

A nurse is caring for a client who follows a vegan diet. Which of the following foods should the nurse offer the client? a. bagel w/ cream cheese b. fried egg c. fruit w/ vanilla yogurt d. wheat toast w/ pb

d. wheat toast w/ pb no animal products; plant based

swollen neck (goiter)

iodine deficiency

protein buildup

liver/kidney cannot keep up; ascites: edema of abdomen; fluid in stomach

heart health diet

low sodium and low fat diet

BMI of 30 and over

obese

BMI of 25

overweight