Nursing Review Exam

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1

Fundamentals of Nursing Maternity Nursing Pediatric Nursing Community Health Nursing Medical Surgical Nursing Psychiatric Nursing Professional Adjustment Leadership and Management Nursing Research Compiled by:

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2009 THE EVER POPULAR LAST MINUTE TIPS FOR


NURSING LICENSURE EXAMINATIONS

In NP1, Please FOCUS on the following: 1 !ypes of leade"ship: #$to%"ati%& 'aisse( fai"e& )emo%"ati%& t"ansfo"mational& t"ansa%tional et% et% 2 Patte"n of *$"sing %a"e: P"ima"y n$"sing& %ase n$"sing& f$n%tional& team et% + ,-panded *$"sing "ole: *$"se anesthetist& *$"se p"a%titione"& *$"se "esea"%he" et% et% . 'e/els of p"e/ention by 'ea/ell and Cla" emembe" that %"isis is always se%onda"y  + way bottle system: simply "e%onne%t the t$be& %ontin$o$s b$bble is a sign of leaage& no b$bbling is obst"$%tion 3in the wate"seal4 and yo$ sho$ld palpate the s$""o$nding a"ea fo" s$b%$taneo$s emphysema 5 Ca"e of %lients with t"a%heostomy and s$%tioning a t"a%heostomy t$be 3ste"ile te%hni6$e4 now the f$n%tions of the %$ff& obt$"ato" and the tie %a"e of %lients with pooling of se%"etions Post$"al d"ainage: do this befo"e meals& the positioning depending on the lo%ation of se%"etion& POP,7ICO 3a""angement4 that is positioning& pe"%$ssing& /ib"ating and %o$ghing et% st$dy s$%tioning 8 !he independent and the dependent /a"iable in "esea"%h  now yo$" PU, and #PP'I,) as well as ,;P,I<,*!#' and *O*=,;P,I<,*!#' also yo$" >U#*!I!#!I7, and >U#'I!#!I7, designs 9 I7 fl$id toni%ity: )' is hype"toni% while ' is isotoni% 10 Compli%ation of I7 and its inte"/ention s$%h as F'UI) O7,'O#)& P?',@I!IS& I*FI'!#!IO* 11 @lood t"ansf$sion 12 Compli%ation of immobility: ),CU@I!US U'C,& ?APO P*,U
1 Stages of labo" !he fi"st stage $p to the fo$"th stage and the '#!,*! #C!I7, #*) !#*SI!IO* of the fi"st stage st$dy the inte"/ention in all stages ead pillete"i fo" this 2 !he menst"$al %y%le& what glands se%"et what ho"mones !he <,*S!U#'& PO'IF,#!I7,& S,C,!OA and ISC?,
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +

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1 @$"ns& Classifi%ation of @$"ns and *$"sing )iagnosis fo" @$"ns& )"$g $se in b$"ns 3Sil/e" S$lfadia(ine4& ,le%t"olyte %hanges in b$"n 3?ype"alemia& ?yponate"mia4 !he H?O Pain ladde" s%ale& Pain medi%ations espe%ially )eme"ol& 1 & SUDIC#' F'OO +0 . Pan%"eatitis& Chole%ystitis& ?epatitis
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .

1+ Ca"e of %lients with hype"= and hypothy"oidism& st$dy !#P#JO',G<,!?I<#JO', and 'UDO'S SO'U!IO*& P!U Ca"e of %lients afte" thy"oide%tomy:
1 In yo$" !est 7 st$dy the following: #n-iety and an-iety diso"de"s& !he le/el of an-iety and yo$" an-iolyti%s& S%hi(oph"enia: Pa"anoid type and Catatoni% type and yo$" n$"sing inte"/entions fo" these %lients as well as yo$" p"io"ity n$"sing diagnosis 2 )ep"ession and yo$" antidep"essants&
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 

!?, 5 !,C?*IC#' !IPS FO !?, @O#) ,;#
efe"en%es: #dele Pillitte"i <#!,*#' N C?I') ?,#'!? *USI*D: Ca"e of the Childbea"ing N Child"ea"ing Family 200 wwwn$"sing%"ib%om wwws%"ibd%om

Ca"e has been taen to %onfi"m the a%%$"a%y of the info"mation p"esented *e/e"theless& it is diffi%$lt to ens$"e that all the info"mation p"esented is enti"ely a%%$"ate fo" all %i"%$mstan%es& and the a$tho" %annot a%%ept any "esponsibility fo" any e""o" o" omission !he a$tho" maes no wa""anty& e-p"essed o" implied& with "espe%t to this wo"& and dis%laims any liability& loss& o" damage as a %onse6$en%e& di"e%tly o" indi"e%tly& of the $se and appli%ation of any of the %ontents of this wo"


PRAYERS TO ST. JOSEPH OF CUPERTINO FOR SUCCESS IN EXAMINATIONS

First Pra!r

O D"eat St Boseph of C$pe"tino who while on ea"th did obtain f"om Dod the g"a%e to be ased at yo$" e-amination only the 6$estions yo$ new& obtain fo" me a lie fa/o$" in the e-aminations fo" whi%h I am now p"epa"ing In "et$"n I p"omise to mae yo$ nown and %a$se yo$ to be in/oed !h"o$gh Ch"ist o$" 'o"d St Boseph of C$pe"tino& P"ay fo" $s #men S!"#$% Pra!r

O St Boseph of C$pe"tino who by yo$" p"aye" obtained f"om Dod to be ased at yo$" e-amination& the only p"eposition yo$ new D"ant that I may lie yo$ s$%%eed in the *$"sing 'i%ens$"e ,-amination In "et$"n& I p"omise to mae yo$ nown and %a$se yo$ to be in/oed O St Boseph of C$pe"tino p"ay fo" me O ?oly Dhost enlighten me O$" 'ady of Dood St$dies p"ay fo" me Sa%"ed ?ead of Bes$s& Seat of di/ine wisdom& enlighten me

PRAYER TO SAINT JUDE THADDEUS, PATRON OF THE IMPOSSIBLE

PRINCIPLES OF TEST TA&ING I' PRINCIPLE OF CONTRADICTION Hhen two options %ont"adi%t ea%h othe"& the"e is a highe" %han%e of one of them being the %o""e%t answe"

,-ample: Hhi%h physiologi% effe%t sho$ld the n$"se e-pe%t in a %lient addi%ted to hall$%inogensQ # )ilated p$pils @ Const"i%ted p$pils C @"ady%a"dia ) @"adypnea II' PRINCIPLE OF COMMONALIT( AND DIFFERENCE

!wo o" mo"e options that has the same essential %onfig$"ation and tho$ght is $nliely the %o""e%t answe" ,-ample: Hhen inEe%ting s$b%$taneo$s inEe%tion in an obese patient& it sho$ld be angled at a"o$nd: # .R @ 90R C 10R ) Pa"allel to the sin III' PRINCIPLE OF CENTRAL TENDENC( Co""e%t answe"s in an all n$me"i% options is most liely lo%ated in between the e-t"emes

,-ample: Hhat is the 7O "ate of @!Q #  gttsGmin @ 10 gttsGmin C 1 gttsGmin ) 20 gttsGmin IV' PRINCIPLE OF POSITIVE AND NEGATIVE HARMON( # positi/e 6$estion will always as fo" a positi/e answe" and so is a negati/e 6$estion FO$estion 34 34   >$estion 3=4 34  = >$estion

,-ample: #ll b$t one of the following is an #n-iolyti%: 34 3=4 # !"an-ene @
,-ample: !he most effe%ti/e way in limiting the n$mbe" of mi%"oo"ganism in the hospital is: # Using st"i%t asepti% te%hni6$e in all p"o%ed$"es @ Hea"ing mas and gown in %a"e of all patients with %omm$ni%able diseases C Ste"ili(ation of all inst"$ments ) ?andwashing VI' PRINCIPLE OF INITIATIVE CRITICAL THIN&ING 1 Co/e" the options 2 ead the 6$estion %a"ef$lly + !"y answe"ing the 6$estion witho$t looing at the options . Sele%t the option that most %losely mat%hes yo$" answe"

,-ample: !he n$"se new that the no"mal %olo" of
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 

VII' PRINCIPLE OF GRAMMATICAL HARMON( Options that do not %oin%ide with the g"ammati%al %onfig$"ation of the stem is *O! the %o""e%t answe" Choi%es that a"e g"ammati%ally in%o""e%t o" %ontain typog"aphi%al e""o"s a"e p"obably not the %o""e%t answe"

,-ample: Hhen planning a %a"e fo" a %lient who is pan%ytopeni%& !he maEo" goal sho$ld be: CP"e/ent hemo""hage& infe%tion and de%"ease o-ygenation @ #dministe"ing an o"al i"on p"epa"ation C P"e/enting Fatig$e and fl$id o/e"load ) ,n%o$"aging a %ons$mption of a ne$t"openi% diet VIII' PRINCIPLE OF UM)RELLA EFFECT # %hoi%e that is mo"e in%l$si/e is $s$ally the %o""e%t answe"

,-ample: !o /iew a pe"son holisti%ally& the n$"se sho$ld thin of him o" he" as: # Physi%al being who e-pe"ien%es pathology and so%iologi%al %hanges @ So%ial being who needs the dynami%s of g"o$p inte"a%tion C Psy%hologi%al being whose mind infl$en%es his o" he" health stat$s ) @iopsy%hoso%ial being who is in %onstant inte"a%tion with the en/i"onment IX' Pri$"i*+! # A)C, Mas+#-.s Hi!rar"/ a$% N0rsi$ Pr#"!ss Hhen 6$estions "e6$i"e p"io"iti(ation& these p"in%iples sho$ld apply eywo"ds that indi%ate the need to p"io"iti(e in%l$de: @,S! 7I!#' ,SS,*!I#' PI<#A FIS! ?ID?,S! PIOI!A I<<,)I#!, I*I!I#'
,-ample: # n$"se is "e/iewing the plan of %a"e fo" a p"egant %lient with a diagnosis of si%le %ell anemia Hhi%h n$"sing diagnosis& if stated on the plan of %a"e& wo$ld the n$"se sele%t as "e%ei/ing the highest p"io"ityQ ##n-iety @Ineffe%ti/e %oping C)ist$"bed body image ))efi%ient fl$id /ol$me ,-ample: Hhen %a"ing fo" #ida afte" a %hest s$"ge"y& yo$" p"io"ity wo$ld be to maintain: # S$pplementa"y o-ygen @ Chest t$be d"ainage C @lood "epla%ement ) 7entilation e-%hange X' Pri$"i*+! # T!++ M! M#r! In Psy%hiat"i% *$"sing& emembe" to fo%$s on the %lientKs feeling& %on%e"ns& an-ieties and fea"s !his is best s$mma"i(ed by a "esponse that en%o$"ages the %lientKs /e"bali(ation of feelings

,-ample: # mothe" says to the n$"se& I am af"aid that my %hild might ha/e anothe" sei($"eT Hhi%h "esponse by the n$"se is most the"ape$ti%Q # Hhy wo""y abo$t something yo$ %annot %ont"olQT @ 
,-ample: # %h"oni%ally ill s%hool=age %hild is most /$lne"able to whi%h st"esso"Q # <$tilation an-iety @ #nti%ipato"y g"ief C #n-iety o/e" s%hool absen%es ) Fea" of hospital p"o%ed$"es


XII' T/! Dr0 T!"/$i0!
,-ample: !he n$"se is assessing a %lient who has E$st been admitted to the eme"gen%y depa"tment Hhi%h signs wo$ld s$ggest an o/e"dose of an antian-iety agentQ # Combati/eness& sweating& and %onf$sion @ #gitation& hype"a%ti/ity& and g"andiose ideation C S$spi%io$sness& dilated p$pils& and in%"eased blood p"ess$"e ) ,motionally bl$nt& letha"gy and impai"ed memo"y


CO*!,*!S

FU*)#<,*!#'S OF *USI*D MMMM12 <#!,*I!A *USI*D MMMMMMMMMMM ++ P,)I#!IC *USI*DMMMMMMMMMMMM8 CO<


FUNDAMENTALS OF NURSING PART 1

1 Using the p"in%iples of standa"d p"e%a$tions& the n$"se wo$ld wea" glo/es in what n$"sing inte"/entionsQ a P"o/iding a ba% massage b Feeding a %lient % P"o/iding hai" %a"e d P"o/iding o"al hygiene 2 !he n$"se is p"epa"ing to tae /it al sign in an ale"t %lient admitted to the hospital with dehyd"ation se%onda"y to /omiting and dia""hea Hhat is the best method $sed to assess the %lientKs tempe"at$"eQ a O"al b #-illa"y % adial d ?eat sensiti/e tape + # n$"se obtained a %lientKs p$lse and fo$nd the "ate to be ab o/e no"mal !he n$"se do%$ment this findings as: a !a%hypnea b ?ype" py"e-ia % #""ythmia d !a%hy%a"dia . Hhi%h of the following a%tions sho$ld the n$"se tae to $se a wid e base s$ppo"t when assisting a %lient to get $p in a %hai"Q a @end at the waist and pla%e a"ms $nde" the %lientKs a"ms and lift b Fa%e the %lient& bend nees and pla%e hands on %lientKs fo"ea"m and lift % Sp"ead his o" he" feet apa"t d !ighten his o" he" pel/i% m$s%les  # %lient had o"al s$"ge"y following a moto" /ehi%le a%%ident !he n$"se assessing the %lient finds the sin fl$shed and wa"m Hhi%h of the follo wing wo$ld be the best metho d to tae the %lien tKs body tempe"at$"eQ

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a O"al b #-illa"y % #"te"ial line d e%tal # %lient who is $n%ons%io$s needs f"e6$ent mo$th %a"e Hhen pe"fo"ming a mo$th %a"e& the best position of a %lient is: a Fowle"Ks position b Side lying % S$pine d !"endelenb$"g # %lient is hospitali(ed fo" the fi"st time& wh i%h of the following a%tions ens$"e the safety of the %lientQ a eep $nne%essa"y f$"nit$"e o$t of the way b eep the lights on at all time % eep side "ails $p at all time d eep all e6$ipment o$t of /iew # wal=in %lient ente"s into the %lini% with a %hief %omplaint of abdominal pain and dia""hea !he n$"se taes the %lientKs /ital sign he"eafte" Hhat ph"ase of n$"sing p"o%ess is being implemented he"e by the n$"seQ a #ssessment b )iagnosis % Planning d Implementation It is best des%"ibe as a systemati%& "ational method of planning and p"o/iding n$"sing %a"e fo" indi/id$al& families& g"o$p and %omm$nity a #ssessment b *$"sing P"o%ess % )iagnosis d Implementation ,-%hange of gases taes pla%e in whi%h of the following o"ganQ a idney b '$ngs % 'i/e" d ?ea"t !he Chambe" of the hea"t that "e%ei/es o-ygenated blood f"om the l$ngs is theQ a 'eft at"i$m

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+

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b ight at"i$m % 'eft /ent"i%le d ight /ent"i%le # m$s%$la" enla" ge po$%h o" sa% that lies slig htly to the left whi%h is $sed fo" temp o"a"y sto"a ge of foodM a Dallbladde" b U"ina"y bladde" % Stoma%h d '$ngs !he ability of the body to defend itself against s%ientifi% in/ading agent s$%h as ba%e"ia& to-in& /i"$ses and fo"eign body a ?o"mones b Se%"etion % Imm$nity d Dlands ?o"mones se%"eted by Islets of 'ange" hans a P"ogeste"one b !estoste"one % Ins$lin d ?emoglobin It is a t"anspa"ent memb"ane that fo%$ses the light that ente"s the eyes to the "etina a 'ens b S%le"a % Co"nea d P$pils Hhi%h of the following is in%l$ded in O"emKs theo"yQ a
18 Hhi%h of the following %l$ste" of data belong to
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.

2. !he abb"e/iation fo" mi%"o d"op isM a gtt b gtt % md" d mgts 2 Hhi%h of the following is the meaning of P*Q a Hhen ad/i%e b Immediately % Hhen ne%essa"y d *ow 25 Hhi%h of the following is the app"op"iate meaning of C@Q a Ca"dia% @oa"d oom b Complete @ath"oom % Complete @ed est d Complete @oa"d oom 28 1 tsp is e6$als to how many d"opsQ a 1 b 50 % 10 d +0 2 20 %% is e6$al to how many mlQ a 2 b 20 % 2000 d 20000 29 1 %$p is e6$al to how many o$n%esQ a  b 0 % 00 d 000 +0 !he n$"se m$st /e"ify the %lientKs identity befo"e administ"ation of medi%ation Hhi%h of the following is the safest way to identify the %lientQ a #s the %lient his name b Che% the %lientKs identifi%ation band % State the %lientKs name alo$d and ha/e the %lient "epeat it d Che% the "oom n$mbe" +1 !he n$"se p"epa"es to administe" b$%%al medi%ation !he medi%ine sho$ld be pla%edM a On the %lientKs sin b @etween the %lientKs %hees and g$ms % Unde" the %lientKs tong$e d On the %lientKs %onE$%ti/a +2 !he n$"se administe"s %leansing enema !he %ommon position fo" this p"o%ed$"e isM a Sims left late"al b )o"sal e%$mbent % S$pine d P"one ++ # %lient %omplai ns of diffi%$lty of swallow ing& when the n$"se t"y to administe" %aps$le medi%ation Hhi%h of the following meas$"es the n$"se sho$ld doQ a )issol/e the %aps$le in a glass of wate" b @"ea the %aps$le and gi/e the %ontent with an applesa$%e % Che% the a/ailability of a li6$id p"epa"ation d C"ash the %aps$le and pla%e it $nde" the tong$e +. Hhi%h of the following is the app"op"iate "o$te of administ"ation fo" ins$linQ a Int"am$s%$la" b Int"ade"mal % S$b%$taneo$s d Int"a/eno$s + !he n$"se is o"de"ed to administe" ampi%illin %aps$le !IP po !he n$"se sho$d gi/e the medi%ationM a !h"ee times a day o"ally b !h"ee times a day afte" meals % !wo time a day by mo$th d !wo times a day befo"e meals +5 @a% Ca"e is best des%"ibe as: a Ca"ing fo" the ba% by means of massage b Hashing of the ba%

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% #ppli%ation of %old %omp"ess at the ba% d #ppli%ation of hot %omp"ess at the ba% It "efe"s to the p"epa"ation of the bed with a new set of linens a @ed bath b @ed maing % @ed shampoo d @ed lining Hhi%h of the following is the most impo"tant p$"pose of handwashing a !o p"omote hand %i"%$lation b !o p"e/ent the t"ansfe" of mi%"oo"ganism % !o a/oid to$%hing the %lient with a di"ty hand d !o p"o/ide %omfo"t Hhat sho$ld be done in o"de" to p"e/ent %ontaminating of the en/i"onment in bed maingQ a #/oid f$nning soiled linens b St"ip all linens at the same time % Finished both sides at the time d ,mb"a%e soiled linen !he most impo"tant p$"pose of %leansing bed bath is: a !o %leanse& "ef"esh and gi/e %omfo"t to the %lient who m$st "emain in bed b !o e-pose the ne%essa"y pa"ts of the body % !o de/elop sills in bed bath d !o %he% the body tempe"at$"e of the %lient in bed Hhi%h of the following te%hni6$e in/ol/es the sense of sightQ a Inspe%tion b Palpation % Pe"%$ssion d #$s%$ltation !he fi"st te%hni6$es $sed e-amining the abdomen of a %lient is: a Palpation b #$s%$ltation % Pe"%$ssion d Inspe%tion # te%hni6$e in physi%al e-amination that is $se to assess the mo/ement of ai" th"o$gh the t"a%heob"on%hial t"ee: a Palpation b #$s%$ltation % Inspe%tion d Pe"%$ssion #n inst"$ment $sed fo" a$s% $ltation is: a Pe"%$ssion=hamme" b #$diomete" % Stethos%ope d Sphygmomanomete" esonan%e is best des%"ibe as: a So$nds %"eated by ai" filled l$ngs b Sho"t& high pit%h and th$dding %

b Den$=pe%to"al % 'ithotomy d SimKs 0 !he n$"se p"epa"e I< inEe%tion that is i""itating to the s$b%$taneo$s tiss$e Hhi%h of the following is the best a%tion in o"de" to p"e/ent t"a%ing of the medi%ation a Use a small ga$ge needle b #pply i%e on the inEe%tion site % #dministe" at a .R angle d Use the J=t"a% te%hni6$e

ANSERS #r FUNDAMENTALS OF NURSING PART 1

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1 !he most app"op"iate n$"sing o"de" fo" a patient who de/elops dyspnea and sho"tness of b"eath wo$ld beM a
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1

11

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1

15

18

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d !he holisti% app"oa%h p"o/ides fo" a the"ape$ti% "elationship& %ontin$ity& and effi%ient n$"sing %a"e If n$"se administe"s an inEe%tion to a patient who "ef$ses that inEe%tion& she has %ommitted: a #ssa$lt and batte"y b *egligen%e % $iet %"ying % Immobility& diapho"esis& and a/oidan%e of deep b"eathing o" %o$ghing d Changing position e/e"y 2 ho$"s # patient is admitted to the hospital with %omplaints of na$sea& /omiting& dia""hea& and se/e"e abdominal pain Hhi%h of the following wo$ld immediately ale"t the n$"se that the patient has bleeding f"om the DI t"a%tQ a Complete blood %o$nt b D$aia% test % 7ital signs d #bdominal gi"th !he %o""e%t se6$en%e fo" assessing the abdomen is: a !ympani% pe"%$ssion& meas$"ement of abdominal gi"th& and inspe%tion b #ssessment fo" distention& tende"ness& and dis%olo"ation a"o$nd the $mbili%$s % Pe"%$ssions& palpation& and a$ s%$ltation d #$s%$ltation& pe"%$ssion& and palp ation ?igh=pit%hed g$"gles head o/e" the "ight lowe" 6$ad"ant a"e: a # sign of in%"eased bowel motility b # sign of de%"eased bowel motility % *o"mal bowel so$nds d # sign of ab dominal %"amping # patient abo$t to $nde"go abdominal inspe%tion is best pla%ed in whi%h of the following positionsQ a P"one b !"endelenb$"g % S$pine d Side=lying Fo" a "e%tal e-amination& the patient %an be di"e%ted to ass$me whi%h of the following positionsQ a Den$pe%te"ol b Sims % ?o"i(ontal "e%$mbent d #ll of the abo/e )$"ing a ombe"g test& the n$"se ass the patient to ass$me whi%h positionQ a Sitting b Standing


22

2+

2.

2

25

28

2

29

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% Den$pe%to"al d !"endelenb$"g If a patientKs blood p"ess$"e is 10G95& his p$lse p"ess$"e is: a . b 95 % 10 d 2.5 # patient is ept off food and fl$ids fo" 10 ho$"s befo"e s$"ge"y ?is o"al tempe"at$"e at  am is 99 F +88 C !his tempe"at$"e "eading p"obably indi%ates: a Infe%tion b ?ypothe"mia % #n-iety d )ehyd"ation Hhi%h of the following pa"amete"s sho$ld be %he%ed when assessing "espi"ationsQ a ate b hythm % Symmet"y d #ll of the abo/e # +=yea" old pat ientKs /ital signs at  am a"e a-illa"y tempe"at$"e 995 F +85 CW p$lse "ate & W "espi"ato"y "ate& +0 Hhi%h findings sho$ld be "epo"tedQ a espi"ato"y "ate only b !empe"at$"e only % P$lse "ate and tempe"at$"e d !empe"at$"e and "espi"ato"y "ate #ll of the following %an %a$se ta%hy%a"dia e-%ept: a Fe/e" b ,-e"%ise % Sympatheti% ne"/o$s system stim$lation d Pa"asympatheti% ne"/o$s system stim$lation Palpating the mid%la/i%$la" line is the %o""e%t te%hni6$e fo" assessing a @aseline /ital signs b Systoli% blood p"ess$"e % espi"ato"y "ate d #pi%al p$lse !he absen%e of whi%h p$lse may not be a signifi%ant finding when a patient is admitted to the hospitalQ a #pi%al b adial % Pedal d Femo"al Hhi%h of the following patients is at g"eatest "is fo" de/eloping p"ess$"e $l%e"sQ a #n ale"t& %h"oni% a"th"iti% patient t"eated with ste"oids and aspi"in b #n =yea" old in%ontinent patient with gast"i% %an%e" who is %onfined to his bed at home % #n apatheti% 5+=yea" old COP) patient "e%ei/ing nasal o-ygen /ia %ann$la d # %onf$sed 8=yea" old patient with %ongesti/e hea"t fail$"e C?F who "e6$i"es assistan%e to get o$t of bed !he physi%ian o"de"s the adminis t"ation of high=h$midity o-ygen by fa%e mas and pla%ement of the patient in a high Fowle"Ks position #fte" assessing <"s Pa$l& the n$"se w"ites the following n$"sing diagnosis: Impai"ed gas e-%hange "elated to in%"eased se%"etions Hhi%h of the following n$"sing inte"/entions has the g"eatest potential fo" imp"o/ing this sit$ationQ a ,n%o$"age the patient to in%"ease he" fl$id intae to 200 ml e/e"y 2 ho$"s b Pla%e a h$midifie" in the patientKs "oom % Contin$e administe"ing o-ygen by high h$midity fa%e mas d Pe"fo"m %hest physiothe"aphy on a "eg$la" s%hed$le !he most %ommon defi%ien%y seen in al%oholi%s is: a !hiamine b ibofla/in % Py"ido-ine d Pantotheni% a%id Hhi%h of the following statement is in%o""e%t abo$t a patient with dysphagiaQ a !he patient will find p$"eed o" soft foods& s$%h as %$sta"ds& easie" to swallow than wate" b Fowle"Ks o" semi Fowle"Ks position "ed$%es the "is of aspi"ation d$"ing swallowing % !he patient sho$ld always feed himself d !he n$"se sho$ld pe"fo"m o"al hygiene befo"e assisting with feeding !o assess the idney f$n%tion of a patient with an indwelling $"ina"y Foley %athete"& the n$"se meas$"es his ho$"ly $"ine o$tp$t She sho$ld notify the physi%ian if the $"ine o$tp$t is:


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a 'ess than +0 mlGho$" b 5. ml in 2 ho$"s % 90 ml in + ho$"s d 12 ml in . ho$"s Ce"tain s$bstan%es in%"ease the amo$nt of $"ine p"od$%ed !hese in%l$de: a Caffeine=%ontaining d"ins& s$%h as %offee and %ola b @eets % U"ina"y analgesi%s d aolin with pe%tin aope%tate # male patient who had s$"ge"y 2 days ago fo" head and ne% %an%e" is abo$t to mae his fi"st attempt to amb$late o$tside his "oom !he n$"se notes that he is steady on his feet and that his /ision was $naffe%ted by the s$"ge"y Hhi%h of the following n$"sing inte"/entions wo$ld be app"op"iateQ a ,n%o$"age the patient to wal in the hall alone b )is%o$"age the patient f"om waling in the hall fo" a few mo"e days % #%%ompany the patient fo" his wal d Cons$it a physi%al the"apist befo"e allowing the patient to amb$late # patient has e-a%e"bation of %h"oni% obst"$%ti/e p$lmona"y disease COP) manifested by sho"tness of b"eathW o"thopnea: thi%& tena%io$s se%"etionsW and a d"y ha%ing %o$gh #n app"op"iate n$"sing diagnosis wo$ld be: a Ineffe%ti/e ai"way %lea"an%e "elated to thi%& tena%io$s se%"etions b Ineffe%ti/e ai"way %lea"an%e "elated to d"y& ha%ing %o$gh % Ineffe%ti/e indi/id$al %oping to COP) d Pain "elated to immobili(ation of affe%ted leg <"s 'im begins to %"y as the n$"se dis%$sses hai" loss !he best "esponse wo$ld be: a )onKt wo""y ItKs only tempo"a"yT b Hhy a"e yo$ %"yingQ I didnKt get to the bad news yetT % Ao$" hai" is "eally p"ettyT d I now th is will be diffi%$lt fo" yo$& b$t yo$ " hai" wil l g"ow ba%  afte" the %ompl etion of %hemothe"aphyT #n additional 7itamin C is "e6$i"ed d$"ing all of the following pe"iods e-%ept: a Infan%y b Ao$ng ad$lthood % Childhood d P"egnan%y # p"es%"ibed amo$nt of o-ygen s needed fo" a patient with COP) to p"e/ent: a Ca"dia% a""est "elated to in%"eased pa"tial p"ess$"e of %a"bon dio-ide in a"te"ial blood PaCO 2 b Ci"%$lato"y o/e"load d$e to hype"/olemia % espi"ato"y e-%itement d Inhibition of the "espi"ato"y hypo-i% stim$l$s #fte" 1 wee of hospitali(ation& <" D"ay de/elops hypo alemia Hhi%h of the following is the most signifi%ant symptom of his diso"de"Q a 'etha"gy b In%"eased p$lse "ate and blood p"ess$"e % <$s%le w eaness d <$s%le i""itability Hhi%h of the following n$"sing inte"/entions p"omotes patient safetyQ a #sses the patientKs ability to amb$late and t"ansfe" f"om a bed to a %hai" b )emonst"ate the signal system to the patient % Che% to see that the patient is wea"ing his identifi%ation band d #ll of the abo/e St$dies ha/e shown that abo$t .0V of patients fall o$t of bed despite the $se of side "ailsW this has led to whi%h of the following %on%l$sionsQ a Side "ails a"e ineffe%ti/e b Side "ails sho$ld not be $sed % Side "ails a"e a dete""ent that p"e/ent a patient f"om falling o$t of bed d Side "ails a"e a "eminde" to a patient not to get o$t of bed ,-amples of patients s$ffe"ing f"om impai"ed awa"eness in%l$de all of the following e-%ept: a # semi%ons%io$s o" o/e" fatig$ed patient b # diso"iented o" %onf$sed patient % # patient who %annot %a"e fo" himself at home d # patient demonst"ating symptoms of d"$gs o" al%ohol withd"awal !he most %ommon inE$"y among elde"ly pe"sons is: a #the"os%leoti% %hanges in the blood /essels b In%"eased in%iden%e of gallbladde" disease % U"ina"y !"a%t Infe%tion


d ?ip f"a%t$"e . !he most %ommon psy%hogeni% diso"de" among elde"ly pe"son is: a )ep"ession b Sleep dist$"ban%es s$%h as bi(a""e d"eams % Inability to %on%ent"ate d )e%"eased app etite .5 Hhi%h of the following /as%$la" system %hanges "es$lts f"om agingQ a In%"eased pe"iphe"al "esistan%e of the blood /essels b )e%"eased blood flow % In%"eased wo" load of the left /ent"i%le d #ll of the abo/e .8 Hhi%h of the following is the most %ommon %a$se of dementia among elde"ly pe"sonsQ a Pa"insonKs dis ease b <$ltiple s%le"osis % #myot"ophi% late"al s%le"osis 'o$ De"higKs disease d #l(heime"Ks disease . !he n$"seKs most impo"tant legal "esponsibility afte" a patientKs death in a hospital is: a Obtaining a %onsent of an a$topsy b *otifying the %o"one" o" medi%al e-amine" % 'abeling the %o"pse app"op"iately d ,ns$"ing that the attending physi%ian iss$es the death %e"tifi%ation .9 @efo"e "igo" mo"tis o%%$"s& the n$"se is "esponsible fo": a P"o/iding a %omplete bath and d"essing %hange b Pla%ing one pillow $nde" the bodyKs head and sho$lde"s % emo/ing the bodyKs %lothing and w"apping the body in a sh"o$d d #llowing the body to "ela- no"mally 0 Hhen a patient in the te"mina l stages of l$ng %an%e" begin s to e-hibit loss of %ons%io$ sness& a maEo" n$"sing p"io"ity is to: a P"ote%t the patient f"om inE$"y b Inse"t an ai"way % ,le/ate the head of the bed d Hithd"aw all pain medi%ations


ANSERS a$% RATIONALES #r FUNDAMENTALS OF NURSING PART 2

1 )' Hhen a patient de/elops dyspnea and sho"tness of b"eath& the o"thopnei% position en%o$"ages

2

+

. 

5

8

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9

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11

12 1+

1.

1

ma-im$m %hest e-pansion and eeps the abdominal o"gans f"om p"essing against the diaph"agm& th$s imp"o/ing /entilation @ed "est and o-ygen by 7ent$"i mas at 2.V wo$ld imp"o/e o-ygenation of the tiss$es and %ells b$t m$st be o"de"ed by a physi%ian #llowing fo" "est pe"iods de%"eases the possibility of hypo-ia C' O"thopnea is diffi%$lty of b"eathing e-%ept in the $p"ight position !a%hypnea is "apid "espi"ation %ha"a%te"i(ed by 6$i%& shallow b"eaths ,$pnea is no"mal "espi"ation X 6$iet& "hythmi%& and witho$t effo"t C' # platelet %o$nt e/al$ates the n$mbe" of platelets in the %i"%$lating blood /ol$me !he n$"se is "esponsible fo" gi/ing the patient b"eafast at the s%hed$led time !he physi%ian is "esponsible fo" inst"$%ting the patient abo$t the test and fo" w"iting the o"de" fo" the test )'

15

18

1 19

20

21

22 2+

2. 2

25

28

2

29

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+1 +2

b"eathing o" %o$ghing& as well as in%"eased hea"t "ate& shallow "espi"ations stemming f"om pain $pon mo/ing the diaph"agm and "espi"ato"y m$s%les& and g$a"ding o" "igidity of the abdominal wall S$%h a patient is $nliely to display emotion& s$%h as %"ying )' !o assess fo" DI t"a%t bleeding when f"an blood is absent& the n$"se has two options: She %an test fo" o%%$lt blood in /omit$s& if p"esent& o" in stool X th"o$gh g$aia% ?emo%%$lt test # %omplete blood %o$nt does not p"o/ide immediate "es$lts and does not always immediately "efle%t blood loss Changes in /ital signs may be %a$se by fa%to"s othe" than blood loss #bdominal gi"th is $n"elated to blood loss D' @e%a$se pe"%$ssion and palpation %an affe%t bowel motility and th$s bowel so$nds& they sho$ld follow a$s%$ltation in abdominal assessmen t !ympani% pe"%$ssion& meas$"ement of abdominal gi"th& and inspe%tion a"e methods of assessing the abdomen #ssessing fo" distention& tende"ness and dis%olo"ation a"o$nd the $mbili%$s %an indi%ate /a"io$s bowel="elated %onditions& s$%h as %hole%ystitis& appendi%itis and pe"itonitis ?ype"a%ti/e so$nds indi%ate in%"eased bowel motilityW two o" th"ee so$nds pe" min$te indi%ate C' de%"eased bowel motility #bdominal %"amping with hype"a%ti/e& high pit%hed tinling bowel so$nds %an indi%ate a bowel obst"$%tion C' !he s$pine position also %alled the do"sal position& in whi%h the patient lies on his ba% with his fa%e $pwa"d& allows fo" easy a%%ess to the abdomen In the p"one position& the patient lies on his abdomen with his fa%e t$"ned to the side In the !"endelenb$"g position& the head of the bed is tilted downwa"d to +0 to .0 deg"ees so that the $ppe" body is lowe" than the legs In the late"al position& the patient lies on his side D' #ll of these positions a"e app"op"iate fo" a "e%tal e-amination In the gen$pe%to"al nee=%hest position& the patient neels and "ests his %hest on the table& fo"ming a 90 deg"ee angle between the to"so and $ppe" legs In SimsK position& the patient lies on his left side with the left a"m behind the body and his "ight leg fle-ed In the ho"i(ontal "e%$mbent position& the patient lies on his ba% with legs e-tended and hips "otated o$twa"d )' )$"ing a ombe"g test& whi%h e/al$ates fo" senso"y o" %e"ebella" ata-ia& the patient m$st stand with feet togethe" and a"ms "esting at the sidesYfi"st with eyes open& then with eyes %losed !he need to mo/e the feet apa"t to maintain this stan%e is an abno"mal finding A' !he p$lse p"ess$"e is the diffe"en%e between the systoli% and diastoli% blood p"ess$"e "eadings X in this %ase& . D' # slightly ele/ated tempe"at$"e in the immediate p"eope"ati/e o" post ope"ati/e pe"iod may "es$lt f"om the la% of fl$ids befo" e s$"ge"y "athe" than f"om infe%tion #n-iety will not %a$se an ele/ated tempe"at$"e ?ypothe"mia is an abno"mally low body tempe"at$"e D' !he 6$ality and effi%ien%y of the "espi"ato"y p"o%ess %an be dete"mined by app"aising the "ate& "hythm& depth& ease& so$nd& and symmet"y of "espi"ations D' Unde" no"mal %onditions& a healthy ad$lt b"eathes in a smooth $ninte""$pted patte"n 12 to 20 times a min$te !h$s& a "espi"ato"y "ate of +0 wo$ld be abno"mal # no"mal ad$lt body tempe"at$"e& as meas$"ed on an o"al the"momete"& "anges between 98R and 100RF +51R and +8RCW an a-illa"y tempe"at$"e is app"o-imately one deg"ee lowe" and a "e%tal tempe"at$"e& one deg"ee highe" !h$s& an a-illa"y tempe"at$"e of 995RF +85RC wo$ld be %onside"ed abno"mal !he "esting p$lse "ate in an ad$lt "anges f"om 50 to 100 beatsGmin$te& so a "ate of  is no"mal D' Pa"asympatheti% ne"/o$s system stim$lation of the hea"t de%"eases the hea"t "ate as well as the fo"%e of %ont"a%tion& "ate of imp$lse %ond$%tion and blood flow th"o$gh the %o"ona"y /essels Fe/e"& e-e"%ise& and sympatheti% stim$lation all in%"ease the hea"t "ate D' !he api%al p$lse the p$lse at the ape- of the hea"t is lo%ated on the mid%la/i%$la" line at the fo$"th& fifth& o" si-th inte"%ostal spa%e @ase line /ital signs in%l$de p$lse "ate& tempe"at$"e& "espi"ato"y "ate& and blood p"ess$"e @lood p"ess$"e is typi%ally assessed at the ante%$bital fossa& and "espi"ato"y "ate is assessed best by obse"/ing %hest mo/ement with ea%h inspi"ation and e-pi"ation C' @e%a$se the pedal p$lse %annot be dete%ted in 10V to 20V of the pop$lation& its absen%e is not ne%essa"ily a signifi%ant finding ?owe/e"& the p"esen%e o" absen%e of the pedal p$lse sho$ld be do%$mented $pon admission so that %hanges %an be identified d$"ing the hospital stay #bsen%e of the api%al& "adial& o" femo"al p$lse is abno"mal and sho$ld be in/estigated )' P"ess$"e $l%e"s a"e most liely to de/elop in patients with impai"ed mental stat$s& mobility& a%ti/ity le/el& n$t"ition& %i"%$lation and bladde" o" bowel %ont"ol #ge is also a fa%to" !h$s& the =yea" old in%ontinent patient who has impai"ed n$t"ition f"om gast"i% %an%e" and is %onfined to bed is at g"eate" "is A' #de6$ate hyd"ation thins and loosens p$lmona"y se%"etions and also helps to "epla%e fl$ids lost f"om ele/ated tempe"at$"e& diapho"esis& dehyd"ation and dyspnea ?igh= h$midity ai" and %hest physiothe"apy help li6$efy and mobili(e se%"etions A' Ch"oni% al%oholism %ommonly "es$lts in thiamine defi%ien%y and othe" symptoms of maln$t"ition C' # patient with dysphagia diffi%$lty swallowing "e6$i"es assistan%e with feeding Feeding himself is a long="ange e-pe%ted o$t%ome Soft foods& Fowle"Ks o" semi=Fowle"Ks position& and o"al hygiene befo"e eating sho$ld be pa"t of the feeding "egimen


++ A' # $"ine o$tp$t of less than +0mlGho$" indi%ates hypo/olemia o" olig$"ia& whi%h is "elated to idney f$n%tion and inade6$ate fl$id intae

+. A' Fl$ids %ontaining %affeine ha/e a di$"eti% effe%t @eets and $"ina"y analgesi%s& s$%h as py"idi$m& %an %olo" $"ine "ed aope%tate is an anti dia""heal medi%ation

+ C' # hospitali(ed s$"gi%al patient lea/ing his "oom fo" the fi"st time fea"s "eEe%tion and othe"s sta"ing at him& so he sho$ld not wal alone #%%ompanying him will offe" mo"al s$ppo"t& enabling him to fa%e the "est of the wo"ld Patients sho$ld begin amb$lation as soon as possible afte" s$"ge"y to de%"ease %ompli%ations and to "egain st"ength and %onfiden%e Haiting to %ons$lt a physi%al the"apist is $nne%essa"y +5 A' !hi%& tena%io$s se%"etions& a d"y& ha%ing %o$gh& o"thopnea& and sho"tness of b"eath a"e signs of ineffe%ti/e ai"way %lea"an%e Ineffe%ti/e ai"way %lea"an%e "elated to d"y& ha%ing %o$gh is in%o""e%t be%a$se the %o$gh is not the "eason fo" the ineffe%ti/e ai"way %lea"an%e Ineffe%ti/e indi/id$al %oping

+8

+

+9

.0

.1

.2

.+ .. .

.5 .8

.

.9

"elated COP) is w"ong the etiology not be a medi%al diagnosis COP)to and be%a$se nobe%a$se data indi%ate that fo" thea n$"sing patient diagnosis is %opingsho$ld ineffe%ti/ely Pain "elated to immobili(ation of affe%ted leg wo$ld be an app"op"iate n$"sing diagnosis fo" a patient with a leg f"a%t$"e D' I now this will be diffi%$ltT a%nowledges the p"oblem and s$ggests a "esol$tion to it )onKt wo""yT offe"s some "elief b$t doesnK t "e%ogni(e the patien tKs feelings I didnKt get to the bad news yetT wo$ld be inapp"op"iate at any time Ao$" hai" is "eally p"ettyT offe"s no %onsolation o" alte"nati/es to the patient )' #dditional 7itamin C is needed in g"owth pe"iods& s$%h as infan%y and %hildhood& and d$"ing p"egnan%y to s$pply demands fo" fetal g"owth and mate"nal tiss$es Othe" %onditions "e6$i"ing e-t"a /itamin C in%l$de wo$nd healing& fe/e"& infe%tion and st"ess D' )eli/e"y of mo"e than 2 lite"s of o-ygen pe" min$te to a patient with %h"oni% obst"$%ti/e p$lmona"y disease COP)& who is $s$ally in a state of %ompensated "espi"ato"y a%idosis "etaining %a"bon dio-ide CO2& %an inhibit the hypo-i% stim$l$s fo" "espi"ation #n in%"eased pa"tial p"ess$"e of %a"bon dio-ide in a"te"ial blood P#CO2 wo$ld not initially "es$lt in %a"dia% a""est Ci"%$lato"y o/e"load and "espi"ato"y e-%itement ha/e no "ele/an%e to the 6$estion C' P"esenting symptoms of hypoalemia  a se"$m potassi$m le/el below + m,6Glite" in%l$de m$s%le weaness& %h"oni% fatig$e& and %a"dia% dys"hythmias !he %ombined effe%ts of inade6$ate food intae and p"olonged dia""hea %an deplete the potassi$m sto"es of a patient with DI p"oblems D' #ssisting a patient with amb$lation and t"ansfe" f"om a bed to a %hai" allows the n$"se to e/al$ate the patientKs ability to %a""y o$t these f$n%tions safely )emonst"ating the signal system and p"o/iding an oppo"t$nity fo" a "et$"n demonst"ation ens$"es that the patient nows how to ope"ate the e6$ipment and en%o$"ages him to %all fo" assistan%e when needed Che%ing the patientKs identifi%ation band /e"ifies the patientKs identity and p"e/ents identifi%ation mistaes in d"$g administ"ation D' Sin%e abo$t .0V of patients fall o$t of bed despite the $se of side "ails& side "ails %annot be said to p"e/ent fallsW howe/e"& they do se"/e as a "eminde" that the patient sho$ld not get o$t of bed !he othe" answe"s a"e in%o""e%t inte"p"etations of the statisti%al data C' # patient who %annot %a"e fo" himself at home does not ne%essa"ily ha/e impai"ed awa"enessW he may simply ha/e some deg"ee of immobility D' ?ip f"a%t$"e& the most %ommon inE$"y among elde"ly pe"sons& $s$ally "es$lts f"om osteopo"osis !he othe" answe"s a"e diseases that %an o%%$" in the elde"ly f"om physiologi% %hanges A' Sleep dist$"ban%es& inability to %on%ent"ate and de%"eased appetite a"e symptoms of dep"ession& the most %ommon psy%hogeni% diso"de" among elde"ly pe"sons Othe" symptoms in%l$de diminished memo"y& apathy& disinte"est in appea"an%e& withd"awal& and i""itability )ep"ession typi%ally begins befo"e the onset of old age and $s$ally is %a$sed by psy%hoso%ial& geneti%& o" bio%hemi%al fa%to"s D' #ging de%"eases elasti%ity of the blood /essels& whi%h leads to in%"eased pe"iphe"al "esistan%e and de%"eased blood flow !hese %hanges& in t$"n& in%"ease the wo" load of the left /ent"i%le D' #l(heime"Ws disease& sometimes nown as senile dementia of the Alzheimer’s type or primary degenerative dementia& is an insidio$sW p"og"essi/e& i""e/e"sible& and degene"ati/e disease of the b"ain whose etiology is still $nnown Parkinson’s disease is a ne$"ologi% diso"de" %a$sed by lesions in the e-t"apy"amidial system and manifested by t"emo"s& m$s%le "igidity& hypoinesis& dysphagia& and dysphonia Multiple sclerosis, a p"og"essi/e& degene"ati/e disease in/ol/ing demyelination of the ne"/e fibe"s& $s$ally begins in yo$ng ad$lthood and is ma"ed by pe"iods of "emission and e-a%e"bation Amyotrophic lateral sclerosis& a disease ma"ed by p"og"essi/e degene"ation of the ne$"ons& e/ent$ally "es$lts in at"ophy of all the m$s%lesW in%l$ding those ne%essa"y fo" "espi"ation C' !he n$"se is legally "esponsible fo" labeling the %o"pse when death o%%$"s in the hospital She may be in/ol/ed in obtaining %onsent fo" an a$topsy o" notifying the %o"one" o" medi%al e-amine" of a patientKs deathW howe/e"& she is not legally "esponsible fo" pe"fo"ming these f$n%tions !he attending physi%ian may need info"mation f"om the n$"se to %omplete the death %e"tifi%ate& b$t he is "esponsible fo" iss$ing it )' !he n$"se m$st pla%e a pillow $nde" the de%"eased pe"sonKs head and sho$lde"s to p"e/ent blood f"om settling in the fa%e and dis%olo"ing it She is "e6$i"ed to bathe only soiled a"eas of the body sin%e the


mo"ti%ian will wash the enti"e body @efo"e w"apping the body in a sh"o$d& the n$"se pla%es a %lean gown on the body and %loses the eyes and mo$th 0 A' ,ns$"ing the patientKs safety is the most essential a%tion at this time !he othe" n$"sing a%tions may be ne%essa"y b$t a"e not a maEo" p"io"ity


1 Hhi%h element in the %i"%$la" %hain of infe%tion %an be eliminated by p"ese"/ing sin integ"ityQ a ?ost b ese"/oi" %

%

11

12

1+

1.

1

15

18

1

19

20

21

!he glo/es sho$ld be adE$sted by sliding the glo/ed finge"s $nde" the ste"ile %$ff and p$lling the glo/e o/e" the w"ist d !he inside of the glo/e is %onside"ed ste"ile Hhen "emo/ing a %ontaminated gown& the n$"se sho$ld be %a"ef$l that the fi"st thing she to$%hes is the: a Haist tie and ne% tie at the ba% of the gown b Haist tie in f"ont of the gown % C$ffs of the gown d Inside of the gown Hhi%h of the following n$"sing inte"/entions is %onside"ed the most effe%ti/e fo"m o" $ni/e"sal p"e%a$tionsQ a Cap all $sed needles befo"e "emo/ing them f"om thei" sy"inges b )is%a"d all $sed $n%apped needles and sy"inges in an impenet"able p"ote%ti/e %ontaine" % Hea" glo/es when administe"ing I< inEe%tions d Follow ente"i% p"e%a$tions #ll of the following meas$"es a"e "e%ommended to p"e/ent p"ess$"e $l%e"s e-%ept: a

22 !he %o""e%t method fo" dete"mining the /ast$s late"alis site fo" I< inEe%tion is to: a 'o%ate the $ppe" aspe%t of the $ppe" o$te" 6$ad"ant of the b$tto% abo$t  to  %m below the ilia% %"est b Palpate the lowe" edge of the a%"omion p"o%ess and the midpoint late"al aspe%t of the a"m % Palpate a 1T %i"%$la" a"ea ante"io" to the $mbili%$s d )i/ide the a"ea between the g"eate" femo"al t"o%hante" and the late"al femo"al %ondyle into thi"ds& and sele%t the middle thi"d on the ante"io" of the thigh 2+ !he mid=deltoid inEe%tion site is seldom $sed fo" I< inEe%tions be%a$se it: a Can a%%ommodate only 1 ml o" less of medi%ation b @"$ises too easily % Can be $sed only when the patient is lying down d )oes not "eadily pa"ente"al medi%ation 2. !he app"op"iate needle si(e fo" ins$lin inEe%tion is: a 1D& 1 [T long b 22D& 1T long % 22D& 1 [T long d 2D& GT long 2 !he app"op"iate needle ga$ge fo" int"ade"mal inEe%tion is: a 20D b 22D % 2D d 25D 25 Pa"ente"al peni%illin %an be administe"ed as an: a I< inEe%tion o" an I7 sol$tion b I7 o" an int"ade"mal inEe%tion % Int"ade"mal o" s$b%$taneo$s inEe%tion d I< o" a s$b%$taneo$s inEe%tion 28 !he physi%ian o"de"s g" 10 of aspi"in fo" a patient !he e6$i/alent dose in millig"ams is: a 05 mg b 10 mg

2

29

+0

+1

+2

++

+.

% 50 mg d 500 mg !he physi%ian o"de"s an I7 sol$tion of de-t"ose V in wate" at 100mlGho$" Hhat wo$ld the flow "ate be if the d"op fa%to" is 1 gtt  1 mlQ a  gttGmin$te b 1+ gttGmin$te % 2 gttGmin$te d 0 gttGmin$te Hhi%h of the following is a sign o" symptom of a hemolyti% "ea%tion to blood t"ansf$sionQ a ?emoglobin$"ia b Chest pain % U"ti%a"ia d )istended ne% /eins Hhi%h of the following %onditions may "e6$i"e fl$id "est"i%tionQ a Fe/e" b Ch"oni% Obst"$%ti/e P$lmona"y )isease % enal Fail$"e d )ehyd"ation #ll of the following a"e %ommon signs and symptoms of phlebitis e-%ept: a Pain o" dis%omfo"t at the I7 inse"tion site b ,dema and wa"mth at the I7 inse"tion site % # "ed st"ea e-iting the I7 inse"tion site d F"an bleeding at the inse"tion site !he best way of dete"mining whethe" a patient has lea"ned to insti ll ea" medi%ation p"ope"ly is fo" the n$"se to: a #s the patient if heGshe has $sed ea" d"ops befo"e b ?a/e the patient "epeat the n$"seKs inst"$%tions $sing he" own wo"ds % )emonst"ate the p"o%ed$"e to the patient and en%o$"age to as 6$estions d #s the patient to demonst"ate the p"o%ed$"e Hhi%h of the following types of medi%ations %an be administe"ed /ia gast"ostomy t$beQ a #ny o"al medi%ations b Caps$les whole %ontents a"e dissol/e in wate" % ,nte"i%=%oated tablets that a"e tho"o$ghly dissol/ed in wate" d

+

+5

+8

+

+9

a !ole"an%e b Idiosyn%"asy % Syne"gism d #lle"gy # patient has "et$" ned to his "oom afte" femo"al a"te"iog"aphy #ll of the following a"e app"op"iate n$"sing inte"/entions e-%ept: a #ssess femo"al& popliteal& and pedal p$lses e/e"y 1 min$tes fo" 2 ho$"s b Che% the p"ess$"e d"essing fo" sang$ineo$s d"ainage % #ssess a /ital signs e/e"y 1 min$tes fo" 2 ho$"s d O"de" a hemoglobin and hemato%"it %o$nt 1 ho$" afte" the a"te"iog"aphy !he n$"se e-plains to a patient that a %o$gh: a Is a p"ote%ti/e "esponse to %lea" the "espi"ato"y t"a%t of i""itants b Is p"ima"ily a /ol$nta"y a%tion % Is ind$%ed by the administ"ation of an antit$ssi/e d"$g d Can be inhibited by splintingT the abdomen #n infe%ted patient has %hills and begins shi/e"ing !he best n$"sing inte"/ention is to: a #pply i%ed al%ohol sponges b P"o/ide in%"eased %ool li6$ids % P"o/ide additional bed%lothes d P"o/ide in%"eased /entilation # %lini%al n$"se spe%ialist is a n$"se who has : a @een %e"tified by the *ational 'eag$e fo" *$"sing b e%ei/ed %"edentials f"om the Philippine *$"sesK #sso%iation % D"ad$ated f"om an asso%iate deg"ee p"og"am and is a "egiste"ed p"ofessional n$"se d Completed a maste"Ks deg"ee in the p"e s%"ibed %lini%al a"ea and is a "egis te"ed p"ofessional n$"se !he p$"pose of in%"easing $"ine a%idity th"o$gh dieta"y means is to: a )e%"ease b$"ning sensations b Change the $"ineKs %olo" % Change the $"ineKs %on%ent"ation d Inhibit the g"owth of mi%"oo"ganisms

.0 Clay %olo"ed stools indi%ate: a Uppe" DI bleeding b Impending %onstipation % #n effe%t of medi%ation d @ile obst"$%tion .1 In whi%h step of the n$"sing p"o%ess wo$ld the n$"se as a patient if the medi%ation she admin iste"ed "elie/ed his painQ a #ssessment b #nalysis % Planning d ,/al$ation .2 #ll of the following a"e good so$"%es of /itamin # e-%ept: a Hhite potatoes b Ca""ots % #p"i%ots d ,gg yols .+ Hhi%h of the following is a p"ima"y n$"sing inte"/ention ne%essa"y fo" all patients with a Foley Cathete" in pla%eQ a

.8

.

.9

0

b #pplying a topi%al antisepti% to the sin on the e/ening befo"e s$"ge"y % ?a/ing the patient tae a t$b bath on the mo"ning of s$"ge"y d ?a/ing the patient showe" with an antisepti% soap on the e/ening /befo"e and the mo"ning of s$"ge"y Hhen t"ansfe""ing a patient f"om a bed to a %hai"& the n$"se sho$ld $se whi% h m$s%les to a/oid ba% inE$"yQ a #bdominal m$s%les b @a% m$s%les % 'eg m$s%les d Uppe" a"m m$s%les !h"ombophlebitis typi%ally de/elops in patients with whi%h of the following %onditionsQ a In%"eases pa"tial th"omboplastin time b #%$te p$ls$s pa"ado-$s % #n impai"ed o" t"a$mati(ed blood /essel wall d Ch"oni% Obst"$%ti/e P$lmona"y )isease COP) In a "e%$mbent& immobili(ed patient& l$ng /entil ation %an be%ome alte"ed& leadin g to s$%h "espi"ato"y %ompli%ations as: a espi"ato"y a%idosis& ate%le%tasis& and hypostati% pne$monia b #ppne$sti% b"eathing& atypi%al pne$monia and "espi"ato"y alalosis % Cheyne=St"oes "espi"ations and spontaneo$s pne$motho"ad $ssmailKs "espi"ations and hypo/entilation Immobility impai"s bladde" elimination& "es$lting in s$%h diso"de"s as a In%"eased $"ine a%idity and "ela-ation of the pe"ineal m$s%les& %a$sing in%ontinen%e b U"ine "etention& bladde" distention& and infe%tion % )i$"esis& nat"i$"esis& and de%"eased $"ine spe%ifi% g"a/ity d )e%"eased %al%i$m and phosphate le/els in the $"ine

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +0

ANSERS a$% RATIONALES #r FUNDAMENTALS OF NURSING PART 3

1 D In the %i"%$la" %hain of infe%tion& pathogens m$st be able to lea/e thei" "ese"/oi" and be t"ansmitted to a s$s%eptible host th"o$gh a po"tal of ent"y& s$%h as b"oen sin

2 C espi"ato"y isolation& lie st"i%t isolation& "e6$i"es that the doo" to the doo" patientKs "oom "emain

+

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5 8

 9

10 11

12

1+

1.

%losed ?owe/e"& the patientKs "oom sho$ld be well /entilated& so opening the window o" t$"ning on the /ent"i%$la" is desi"able !he n$"se does not need to wea" glo/es fo" "espi"ato"y isolation& b$t good hand washing is impo"tant fo" all types of isolation A 'e$openia is a de%"eased n$mbe" of le$o%ytes white blood %ells& whi%h a"e impo"tant in "esisting infe%tion *one of the othe" sit$ations wo$ld p$t the patient at "is fo" %ont"a%ting an infe%tionW taing b"oad=spe%t"$m antibioti%s might a%t$ally "ed$%e the infe%tion "is A Soaps and dete"gents a"e $sed to help "emo/e ba%te"ia be%a$se of thei" ability to lowe" the s$"fa%e tension of wate" and a%t as em$lsifying agents ?ot wate" may lead to sin i""itation o" b$"ns A )epending on the deg"ee of e-pos$"e to pathogen s& hand washing may last f"om 10 se%onds to . min$tes #fte" "o$tine patient %onta%t & hand washing fo" +0 se%onds effe%ti/ely minimi(es the "is of pathogen t"ansmission ) !he $"ina"y system is no"mally f"ee of mi%"oo"ganisms e-%ept at the $"ina"y meat$s #ny p"o%ed$"e that in/ol/es ente"ing this system m$st $se s$"gi%ally asepti% meas$"es to maintain a ba%te"ia=f"ee state C #ll in/asi/e p"o%ed$"es& in%l$ding s$"ge"y& %athete" inse"tion& and administ"ation of pa"ente"al the"apy& "e6$i"e ste"ile te%hni6$e to maintain a ste"ile en/i"onment #ll e6$ipment m$st be ste"ile& and the n$"se and the physi%ian m$st wea" ste"ile glo/es and maintain s$"gi%al asepsis In the ope"ating "oom& the n$"se and physi%ian a"e "e6$i"ed to wea" ste"ile gowns& glo/es& mass& hai" %o/e"s& and shoe %o/e"s fo" all in/asi/e p"o%ed$"es St"i%t isolation "e6$i"es the $se of %lean glo/es& mass& gowns and e6$ipment to p"e/ent the t"ansmission of highly %omm$ni%able diseases by %onta%t o" by ai"bo"ne "o$tes !e"minal disinfe%tion is the disinfe%tion of all %ontaminated s$pplies and e6$ipment afte" a patient has been dis%ha"ged to p"epa"e them fo" "e$se by anothe" patient !he p$"pose of p"ote%ti/e "e/e"se isolation is to p"e/ent a pe"son with se"io$sly impai"ed "esistan%e f"om %oming into %onta%t who potentially pathogeni% o"ganisms C !he edges of a ste"ile field a"e %onside"ed %ontaminated Hhen ste"ile items a"e allowed to %ome in %onta%t with the edges of the field& the ste"ile items also be%ome %ontaminated ) ?ai" on o" within body a"eas& s$%h as the nose& t"aps and holds pa"ti%les that %ontain mi%"oo"ganisms Aawning and hi%%$pping do not p"e/ent mi%"oo"ganisms f"om ente"ing o" lea/ing the body apid eye mo/ement ma"s the stage of sleep d$"ing whi%h d"eaming o%%$"s D !he inside of the glo/e is always %onside"ed to be %lean& b$t not ste"ile A !he ba% of the gown is %onside"ed %lean& the f"ont is %ontaminated So& afte" "emo/ing glo/es and washing hands& the n$"se sho$ld $ntie the ba% of the gownW slowly mo/e ba%wa"d away f"om the gown& holding the inside of the gown and eeping the edges off the floo"W t$"n and fold the gown inside o$tW dis%a"d it in a %ontaminated linen %ontaine"W then wash he" hands again ) #%%o"ding to the Cente"s fo" )isease Cont"ol C)C& blood=to=blood %onta%t o%%$"s most %ommonly when a health %a"e wo"e" attempts to %ap a $sed needle !he"efo"e& $sed needles sho$ld ne/e" be "e%appedW instead they sho$ld be inse"ted in a spe%ially designed p$n%t$"e "esistant& labeled %ontaine" Hea"ing glo/es is not always ne%essa"y when administe"ing an I< inEe%tion ,nte"i% p"e%a$tions p"e/ent the t"ansfe" of pathogens /ia fe%es A *$"ses and othe" health %a"e p"ofessionals p"e/io$sly belie/ed that massaging a "eddened a"ea with lotion wo$ld p"omote /eno$s "et$"n and "ed$%e edema to the a"ea ?owe/e"& "esea"%h has shown that massage only in%"eases the lielihood of %ell$la" is%hemia and ne%"osis to the a"ea ) @efo"e a blood t"ansf$sion is pe"fo"med& the blood of the dono" and "e%ipient m$st be %he%ed fo" %ompatibility !his is done by blood typing a test that dete"mines a pe"sonKs blood type and %"oss= mat%hing a p"o%ed$"e that dete"mines the %ompatibility of the dono"Ks and "e%ipientKs blood afte" the blood types has been mat%hed If the blood spe%imens a"e in%ompatible& hemolysis and antigen=antibody "ea%tions will o%%$"


1 A Platelets a"e dis=shaped %ells that a"e essential fo" blood %oag$lation # platelet %o$nt dete"mines the n$mbe" of th"ombo%ytes in blood a/ailable fo" p"omoting hemostasis and assisting with blood %oag$lation afte" inE$"y It also is $sed to e/al$ate the patientKs potential fo" bleedingW howe/e"& this is not its p"ima"y p$"pose !he no"mal %o$nt "anges f"om 10&000 to +0&000Gmm + # %o$nt of 100&000Gmm+ o" less indi%ates a potential fo" bleedingW %o$nt of less than 20&000Gmm + is asso%iated with spontaneo$s bleeding 15 D 'e$o%ytosis is any t"ansient in%"ease in the n$mbe" of white blood %ells le$o% ytes in the blood *o"mal H@C %o$nts "ange f"om &000 to 100&000Gmm+ !h$s& a %o$nt of 2&000Gmm + indi%ates le$o%ytosis 18 A Fatig$e& m$s%le %"amping& and m$s%le weanesses a"e symptoms of hypoalemia an inade6$ate potassi$m le/el& whi%h is a potential side effe%t of di$"eti% the"apy !he physi%ian $s$ally o"de"s s$pplemental potassi$m to p"e/ent hypoalemia in patients "e%ei/ing di$"eti%s #no"e-ia is anothe" of hypoalemia swallowing fo" a %hest ;="ay ?owe/e"& if a %hest 1 symptom A P"egnan%y o" s$spe%ted)ysphagia p"egnan%ymeans is the diffi%$lty only %ont"aindi%ation

19 20

21

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25 28 2 29

+0

+1

;="ay is ne%essa"y& the patient %an wea" a lead ap"on to p"ote%t the pel/i% "egion f"om "adiation Bewel"y& metalli% obEe%ts& and b$ttons wo$ld inte"fe"e with the ;="ay and th$s sho$ld not be wo"n abo/e the waist # signed %onsent is not "e6$i"ed be%a$se a %hest ;="ay is not an in/asi/e e-amination ,ating& d"ining and medi%ations a"e allowed be%a$se the ;="ay is of the %hest& not the abdominal "egion A Obtaining a sp$t$m spe%imen ea"ly in this mo"ning ens$"es an ade6$ate s$pply of ba%te"ia fo" %$lt$"ing and de%"eases the "is of %ontamination f"om food o" medi%ation A Initial sensiti/ity to peni%illin is %ommonly manifested by a sin "ash& e/en in indi/id$als who ha/e not been alle"gi% to it p"e/io$sly @e%a$se of the dange" of anaphyla%ti% sho%& he n$"se sho$ld withhold the d"$g and notify the physi%ian& who may %hoose to s$bstit$te anothe" d"$g #dministe"ing an antihistamine is a dependent n$"sing inte"/ention that "e6$i"es a w"itten physi%ianKs o"de" #ltho$gh applying %o"n sta"%h to the "ash may "elie/e dis%omfo"t& it is not the n$"seKs top p"io"ity in s$%h a potentially life=th"eatening sit$ation D !he J=t"a% method is an I< inEe%tion te%hni6$e in whi%h the patientKs sin is p$lled in s$%h a way that the needle t"a% is sealed off afte" the inEe%tion !his p"o%ed$"e seals medi%ation deep into the m$s%le& the"eby minimi(ing sin staining and i""itation $bbing the inEe%tion site is %ont"aindi%ated be%a$se it may %a$se the medi%ation to e-t"a/asate into the sin D !he /ast$s late"alis& a long& thi% m$s%le that e-tends the f$ll length of the thigh& is /iewed by many %lini%ians as the site of %hoi%e fo" I< inEe%tions be%a$se it has "elati/ely few maEo" ne"/es and blood /essels !he middle thi"d of the m$s%le is "e%ommended as the inEe%tion site !he patient %an be in a s$pine o" sitting position fo" an inEe%tion into this site A !he mid=deltoid inEe%tion site %an a%%ommodate only 1 ml o" less of medi%ation be%a$se of its si(e and lo%ation on the deltoid m$s%le of the a"m& %lose to the b"a%hial a"te"y and "adial ne"/e D # 2D& GT needle is the "e%ommended si(e fo" ins$lin inEe%tion be%a$se ins$lin is administe"ed by the s$b%$taneo$s "o$te #n 1D& 1 [T needle is $s$ally $sed fo" I< inEe%tions in %hild"en& typi%ally in the /ast$s late"alis # 22D& 1 [T needle is $s$ally $sed fo" ad$lt I< inEe%tions& whi%h a"e typi%ally administe"ed in the /ast$s late"alis o" /ent"ogl$teal site D @e%a$se an int"ade"mal inEe%tion does not penet"ate deeply into the sin& a small=bo"e 2D needle is "e%ommended !his type of inEe%tion is $sed p"ima"ily to administe" antigens to e/al$ate "ea%tions fo" alle"gy o" sensiti/ity st$dies # 20D needle is $s$ally $sed fo" I< inEe%tions of oil=based medi%ationsW a 22D needle fo" I< inEe%tionsW and a 2D needle& fo" I< inEe%tionsW and a 2D needle& fo" s$b%$taneo$s ins$lin inEe%tions A Pa"ente"al peni%illin %an be administe"ed I< o" added to a sol$tion and gi/en I7 It %annot be administe"ed s$b%$taneo$sly o" int"ade"mally D g" 10 - 50mgGg" 1  500 mg C 100mlG50 min ; 1 gttG 1 ml  2 gttGmin$te A ?emoglobin$"ia& the abno"mal p"esen%e of hemoglobin in the $"ine& indi%ates a hemolyti% "ea%tion in%ompatibility of the dono"Ks and "e%ipientKs blood In this "ea%tion& antibodies in the "e%ipientKs plasma %ombine "apidly with dono" @CKsW the %ells a"e hemoly(ed in eithe" %i"%$lato"y o" "eti%$loendothelial system ?emolysis o%%$"s mo"e "apidly in #@O in%ompatibilities than in h in%ompatibilities Chest pain and $"ti%a"ia may be symptoms of impending anaphyla-is )istended ne% /eins a"e an indi%ation of hype"/olemia C In "eal fail$"e& the idney loses thei" ability to effe%ti/ely eliminate wastes and fl$ids @e%a$se of this& limiting the patientKs intae of o"al and I7 fl$ids may be ne%essa"y Fe/e"& %h"oni% obst"$%ti/e p$lmona"y disease& and dehyd"ation a"e %onditions fo" whi%h fl$ids sho$ld be en%o$"aged D Phlebitis& the inflammation of a /ein& %an be %a$sed by %hemi%al i""itants I7 sol$tions o" medi%ations& me%hani%al i""itants the needle o" %athete" $sed d$"ing /enip$n%t$"e o" %ann$lation& o" a lo%ali(ed alle"gi% "ea%tion to the needle o" %athete" Signs and symptoms of phlebitis in%l$de pain o" dis%omfo"t& edema and heat at the I7 inse"tion site& and a "ed st"ea going $p the a"m o" leg f"om the I7 inse"tion site


+2 D et$"n demonst"ation p"o/ides the most %e"tain e/iden%e fo" e/al$ating the effe%ti/eness of patient tea%hing

++ D Caps$les& ente"i%=%oated tablets& and most e-tended d$"ation o" s$stained "elease p"od$%ts sho$ld not be dissol/ed fo" $se in a gast"ostomy t$be !hey a"e pha"ma%e$ti%ally man$fa%t$"ed in these fo"ms fo" /alid "easons& and alte"ing them dest"oys thei" p$"pose !he n$"se sho$ld see an alte"nate physi%ianKs o"de" when an o"de"ed medi%ation is inapp"op"iate fo" deli/e"y by t$be +. D # d"$g=alle"gy is an ad/e"se "ea%tion "es$lting f"om an imm$nologi% "esponse following a p"e/io$s sensiti(ing e-pos$"e to the d"$g !he "ea%tion %an "ange f"om a "ash o" hi/es to anaphyla%ti% sho% Tolerance to a d"$g means that the patient e-pe"ien%es a de%"easing physiologi% "esponse to "epeated administ"ation of the d"$g in the same dosage Idiosyncrasy is an indi/id$alKs $ni6$e hype"sensiti/ity to a d"$g& food& o" othe" s$bstan%eW it appea"s to be geneti%ally dete"mined Synergism& is a d"$g inte"a%tion in whi%h the s$m of the d"$gKs %ombined effe%ts is g"eate" than that of thei" sepa"ate effe%ts  # othe" hemoglobin anda"e hemato%"it %o$nt wo$ld inte"/entions be o"de"ed byfo" the aphysi%ian if bleeding we"e s$spe%ted + D !he answe"s app"op"iate n$"sing patient who has $nde"gone femo"al a"te"iog"aphy

+5 A Co$ghing& a p"ote%ti/e "esponse that %lea"s the "espi"ato"y t"a%t of i""itants& $s$ally is in/ol$nta"yW

+8

+

+9 .0

.1 .2

.+

..

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.8 .

howe/e" it %an be /ol$nta"y& as when a patient is ta$ght to pe"fo"m %o$ghing e-e"%ises #n antit$ssi/e d"$g inhibits %o$ghing Splinting the abdomen s$ppo"ts the abdominal m$s%les when a patient %o$ghs C In an infe%ted patient& shi/e"ing "es$lts f"om the bodyKs attempt to in%"ease heat p"od$%tion and the p"od$%tion of ne$t"ophils and phago%ytoti% a%tion th"o$gh in%"eased seletal m$s%le tension and %ont"a%tions Initial /aso%onst"i%tion may %a$se sin to feel %old to the to$%h #pplying additional bed %lothes helps to e6$ali(e the body tempe"at$"e and stop the %hills #ttempts to %ool the body "es$lt in f$"the" shi/e"ing& in%"eased metabloism& and th$s in%"eased heat p"od$%tion D # %lini%al n$"se spe%ialist m$st ha/e %ompleted a maste"Ks deg"ee in a %lini%al spe%ialty and be a "egiste"ed p"ofessional n$"se !he *ational 'eag$e of *$"sing a%%"edits ed$%ational p"og"ams in n$"sing and p"o/ides a testing se"/i%e to e/al$ate st$dent n$"sing %ompeten%e b$t it does not %e"tify n$"ses !he #me"i%an *$"ses #sso%iation identifies "e6$i"ements fo" %e"tifi%ation and offe"s e-aminations fo" %e"tifi%ation in many a"eas of n$"sing& s$%h as medi%al s$"gi%al n$"sing !hese %e"tifi%ation %"edentialing demonst"ates that the n$"se has the nowledge and the ability to p"o/ide high 6$ality n$"sing %a"e in the a"ea of he" %e"tifi%ation # g"ad$ate of an asso%iate deg"ee p"og"am is not a %lini%al n$"se spe%ialist: howe/e"& she is p"epa"ed to p"o/ide bed side n$"sing with a high deg"ee of nowledge and sill She m$st s$%%essf$lly %omplete the li%ensing e-amination to be%ome a "egiste"ed p"ofessional n$"se D
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | ++

"es$lt of anti%oag$lant hepa"in the"apy #"te"ial blood diso"de"s s$%h as p$ls$s pa"ado-$s and l$ng diseases s$%h as COP) do not ne%essa"ily impede /eno$s "et$"n of inE$"e /essel walls .9 A @e%a$se of "est"i%ted "espi"ato"y mo/ement& a "e%$mbent& immobili(e patient is at pa"ti%$la" "is fo" "espi"ato"y a%idosis f"om poo" gas e-%hangeW atele%tasis f"om "ed$%ed s$"fa%tant and a%%$m$lated m$%$s in the b"on%hioles& and hypostati% pne$monia f"om ba%te"ial g"owth %a$sed by stasis of m$%$s se%"etions 0 ) !he immobili(ed patient %ommonly s$ffe"s f"om $"ine "etention %a$sed by de%"eased m$s%le tone in the pe"ine$m !his leads to bladde" distention and $"ine stagnation& whi%h p"o/ide an e-%ellent medi$m fo" ba%te"ial g"owth leading to infe%tion Immobility also "es$lts in mo"e alaline $"ine with e-%essi/e amo$nts of %al%i$m& sodi$m and phosphate& a g"ad$al de%"ease in $"ine p"od$%tion& and an in%"eased spe%ifi% g"a/ity

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +.

MATERNIT( NURSING Part 1

1 Hhen assessing the ade6$a%y of spe"m fo" %on %eption to o%%$"& whi%h of the foll owing is the most $sef $l %"ite"ionQ a Spe"m %o$nt b Spe"m motility % Spe"m mat$"ity d Semen /ol$me 2 # %o$ple who wants to %on%ei/e b$t has been $ns$%%essf$l d$"ing the last 2 yea"s has $nde"gone many diagnosti% p"o%ed$"es Hhen dis%$ssing the sit$ation with the n$"se& one pa"tne" states& He now se/e"al f"iends in o$" age g"o$p and all of them ha/e thei" own %hild al"eady& Hhy %anKt we ha/e oneQT Hhi%h of the following wo$ld be the most pe"tinent n$"sing diagnosis fo" this %o$pleQ a Fea" "elated to the $nnown b Pain "elated to n$me"o$s p"o%ed$"es % Ineffe%ti/e family %oping "elated to infe"tility d Self=esteem dist$"ban%e "elated to infe"tility + Hhi%h of the fol lowing $"ina"y symptoms does the p"eg nant woman most f"e6$ently e-pe"ien%e d$"ing the fi"st t"imeste"Q a )ys$"ia b F"e6$en%y % In%ontinen%e d @$"ning . ?ea"tb$"n and flat $len%e& %ommon in the se%ond t"imeste"& a"e most liely the "es$ lt of whi%h of the followingQ a In%"eased plasma ?CD le/els b )e%"eased intestinal motility % )e%"eased gast"i% a%idity d ,le/ated est"ogen le/els  On whi%h of the following a"eas wo$ld the n$"se e-pe%t to obse"/e %hloasmaQ a @"east& a"eola& and nipples b #bdomen& Chest& ne%& a"ms&and andthighs legs % b"east& d Chees& fo"ehead& and nose 5 # p"egnant %lient states that she waddlesT when she wals !he n$"seKs e-planation is based on whi%h of the following as the %a$seQ a !he la"ge si(e of the newbo"n b P"ess$"e on the pel/i% m$s%les % ela-ation of the pel/i% Eoints d ,-%essi/e weight gain 8 Hhi%h of the following "ep"esents the a/e"age amo$nt of weight gained d$"ing p"egnan%yQ a 12 to 22 lb b 1 to 2 lb % 2. to +0 lb d 2 to .0 lb  Hhen taling with a p"egnant %lient who is e-pe" ien%ing a%hing swollen& leg /eins& the n$"se wo$ld e-plain that this is most p"obably the "es$lt of whi%h of the followingQ a !h"ombophlebitis b P"egnan%y=ind$%ed hype"tension

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +

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% P"ess$"e on blood /essels f"om the enla"ging $te"$s d !he fo"%e of g"a/ity p$lling down on the $te"$s Ce"/i%al softening and $te"ine so$ffle a"e %lassified as whi%h of the followingQ a )iagnosti% signs b P"es$mpti/e signs % P"obable signs d Positi/e signs Hhi%h of the following wo$ld the n$"se identify as a p"es$mpti/e sign of p"egnan%yQ a ?ega" sign b *a$sea and /omiting % Sin pigmentation %hanges d Positi/e se"$m p"egnan%y test Hhi%h of the following %ommon emotional "ea%tions to p"egnan%y wo$ld the n$"se e-pe%t to o%%$" d$"ing the fi"st t"imeste"Q a Int"o/e"sion& ego%ent"ism& na"%issism b #wwa"dness& %l$msiness& and $natt"a%ti/eness % #n-iety& passi/ity& e-t"o/e"sion d #mbi/alen%e& fea"& fantasies )$"ing whi%h of the following wo$ld the fo%$s of %lasses be mainly on physiologi% %hanges& fetal de/elopment& se-$ality& d$"ing p"egnan%y& and n$t"itionQ a P"ep"egnant pe"iod b Fi"st t"imeste" % Se%ond t"imeste" d !hi"d t"imeste" Hhi%h of the following wo$ld be disad/antage of b"east feedingQ a In/ol$tion o%%$"s mo"e "apidly b !he in%iden%e of alle"gies in%"eases d$e to mate"nal antibodies % !he fathe" may "esent the infantKs demands on the mothe"Ks body d !he"e is a g"eate" %han%e fo" e""o" d$"ing p"epa"ation Hhi%h of the following wo$ld %a$se a false=positi/e "es$lt on a p"egnan%y testQ a !he test was pe"fo"med less than 10 days afte" an abo"tion b !he test was pe"fo"med too ea"ly o" too late in the p"egnan%y % !he $"ine sample was sto"ed too long at "oom tempe"at$"e d # spontaneo$s abo"tion o" a missed abo"tion is impending F? %an be a$s%$ltated with a fetos%ope as ea"ly as whi%h of the followingQ a  wees gestation b 10 wees gestation % 1 wees gestation d 20 wees gestation # %lient '


d In%"easing intensity with waling 21 )$"ing whi%h of the following stages of labo" wo$ld the n$"se assess %"owningTQ a Fi"st stage b Se%ond stage % !hi"d stage d Fo$"th stage 22 @a"bit$"ates a"e $s$ally not gi/en fo" pain "elief d$"ing a%ti/e labo" fo" whi%h of the following "easonsQ a !he neonatal effe%ts in%l$de hypotonia& hypothe"mia& gene"ali(ed d"owsiness& and "el$%tan%e to feed fo" the fi"st few days b !hese d"$gs "eadily %"oss the pla%ental ba""ie"& %a$sing dep"essi/e effe%ts in the newbo"n 2 to + ho$"s afte" int"am$s%$la" inEe%tion % !hey "apidly t"ansfe" a%"oss the pla%enta& and la% of an antagonist mae them gene"ally inapp"op"iate d$"ing labo" d #d/e"se "ea%tions may in%l$de mate"nal hypotension& alle"gi% o" to-i% "ea%ti on o" pa"tial o" total "espi"ato"y fail$"e 2+ Hhi%h of the following n$"sing inte"/entions wo$ld the n$"se pe"fo"m d$"ing the thi"d stage of labo"Q a Obtain a $"ine spe%imen and othe" labo"ato"y tests b #ssess $te"ine %ont"a%tions e/e"y +0 min$tes % Coa%h fo" effe%ti/e %lient p$shing d P"omote pa"ent=newbo"n inte"a%tion 2. Hhi%h of the following a%tions demonst"ates the n$"seKs $nde"standing abo$t the newbo"nKs the"mo"eg$lato"y abilityQ a Pla%ing the newbo"n $nde" a "adiant wa"me" b S$%tioning with a b$lb sy"inge % Obtaining an #pga" s%o"e d Inspe%ting the newbo"nKs $mbili%al %o"d 2 Immediately befo"e e-p$lsion& whi%h of the following %a"dinal mo/ements o%%$"Q a )es%ent b Fle-ion % ,-tension d ,-te"nal "otation 25 @efo"e bi"th& whi%h of the following st"$%t$"es %onne%ts the "ight and left a$"i%les of the hea"tQ a Umbili%al /ein b Fo"amen o/ale % )$%t$s a"te"ios$s d )$%t$s /enos$s 28 Hhi%h of the following when p"esent in the $"ine may %a$se a "eddish stain on the diape" of a newbo"nQ a <$%$s b U"i% a%id %"ystals % @ili"$bin d ,-%ess i"on 2 Hhen assessing the newbo"nKs hea"t "ate& whi%h of the following "anges wo$ ld be %onside"ed no"mal if the newbo"n we"e sleepingQ a 0 beats pe" min$te b 100 beats pe" min$te % 120 beats pe" min$te d 1.0 beats pe" min$te 29 Hhi%h of the following is t"$e "ega"ding the fontanels of the newbo"nQ a !he ante"io" is t"iang$la" shapedW the poste"io" is diamond shaped b !he poste"io" %loses at 1 monthsW the ante"io" %loses at  to 12 wees % !he ante"io" is la"ge in si(e when %ompa"ed to the poste"io" fontanel d !he ante"io" is b$lgingW the poste"io" appea"s s$nen +0 Hhi%h of the follow ing g"o$ps of newbo "n "efle-es belo w a"e p"esent at bi"th and "emain $n%hang ed th"o$gh ad$lthoodQ a @lin& %o$gh& "ooting& and gag b @lin& %o$gh& snee(e& gag % ooting& snee(e& swallowing& and %o$gh d Stepping& blin& %o$gh& and snee(e +1 Hhi%h of the following des%"ibes the @abinsi "efle-Q a !he newbo"nKs toes will hype"e-tend and fan apa"t f"om do"sifle-ion of the big toe wh en one side of foot is st"oed $pwa"d f"om the ball of the heel and a%"oss the ball of the foot b !he newbo"n abd$%ts and fle-es all e-t"emities and may begin to %"y when e-posed to s$dden mo/ement o" lo$d noise % !he newbo"n t$"ns th e head in the di"e% tion of stim$l$s& opens the mo$ th& and begins to s$% when %hee& lip& o" %o"ne" of mo$th is to$%hed


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d !he newbo"n will att empt to %"awl fo"wa"d with both a" ms and leg s when he is pla%e d on his abdomen on a flat s$"fa%e Hhi%h of the following statements best des%"ibes hype"emesis g"a/ida"$mQ a Se/e"e anemi a leading to ele%t"olyte& metab oli%& and n$t"itional imbalan%es in the absen%e of othe" medi%al p"oblems b Se/e"e na$sea and /omiting leading to ele%t"olyte& metaboli%& and n$t"itional imbalan%es in the absen%e of othe" medi%al p"oblems % 'oss of appetite and %ontin$o$s /omiting that %ommonly "es$lts in dehyd"ation and $ltimately de%"easing mate"nal n$t"ients d Se/e"e na$sea and dia""hea that %an %a$se gast"ointestinal i""itation and possibly inte"nal bleeding Hhi%h of the following wo$ld the n$"se identify as a %lassi% sign of PI?Q a ,dema of the feet and anles b ,dema of the hands and fa%e % Height gain of 1 lbGwee d ,a"ly mo"ning heada%he In whi%h of the following types of spontan eo$s abo"tions wo$ld the n$"se asses s da" b"own /aginal dis%ha"ge and a negati/e p"egnan%y testsQ a !h"eatened b Imminent %
d Soft and nontende" abdomen +8 Hhi%h of the following is des%"ibed as p"emat$"e sepa"ation of a no"mally implanted pla%enta d$"ing the se%ond half of p"egnan%y& $s$ally with se/e"e hemo""hageQ a Pla%enta p"e/ia b ,%topi% p"egnan%y % In%ompetent %e"/id #b"$ptio pla%entae + Hhi%h of the follo wing may happen if the $te"$s be%omes o/e"stim$lated by o-yto%in d$"ing the ind$%tion of labo"Q a Hea %ont"a%tion p"olonged to mo"e than 80 se%onds b !etani% %ont"a%tions p"olonged to mo"e than 90 se%onds % In%"eased pain with b"ight "ed /aginal bleeding d In%"eased "estlessness and an-iety +9 Hhen p"epa"ing a %lient fo" %esa"ean deli/e"y& whi%h of the following ey %on%epts sho$ld be %onside"ed when implementing n$"sing %a"eQ a Inst"$%t the mothe"Ks s$ppo"t pe"son to "emain in the family lo$nge $ntil afte" the deli/e"y b #""ange fo" a staff membe" of the anesthesia depa"tment to e-plain what to e-pe%t postope"ati/ely %
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +

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b Chills& fe/e"& malaise& o%%$""ing 2 wees afte" deli/e"y % <$s%le pain the p"esen%e of ?omans sign& and swelling in the affe%ted limb d Chills& fe/e"& stiffness& and pain o%%$""ing 10 to 1. days afte" deli/e"y Hhi%h of the following a"e the most %ommonly assessed findings in %ystitisQ a F"e6$en%y& $"gen%y& dehyd"ation& na$sea& %hills& and flan pain b *o%t$"ia& f"e6$en%y& $"gen%y dys$"ia& hemat$"ia& fe/e" and s$p"ap$bi% pain % )ehyd"ation& hype"tension& dys$"ia& s$p"ap$bi% pain& %hills& and fe/e" d ?igh fe/e"& %hills& flan pain na$sea& /omiting& dys$"ia& and f"e6$en%y Hhi%h of the following best "efle%ts the f"e6$en%y of "epo"ted postpa"t$m bl$esTQ a @etween 10V and .0V of all new mothe"s "epo"t some fo"m of postpa"t$m bl$es b @etween +0V and 0V of all new mothe"s "epo"t some fo"m of postpa"t$m bl$es % @etween 0V and 0V of all new mothe"s "epo"t some fo"m of postpa"t$m bl$es d @etween 2V and 80V of all new mothe"s "epo"t some fo"m of postpa"t$m bl$es Fo" the %lient who is $sing o"al %ont"a%epti/es& the n$"se info"ms the %lient abo$t the need to tae the pill at the same time ea%h day to a%%omplish whi%h of the followingQ a )e%"ease the in%iden%e of na$sea b

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% P"omis%$o$s yo$ng ad$lt d Postpa"t$m %lient # %lient in he" thi"d t"imeste " tells the n$"se& IKm %onstip ated all the time\T Hhi%h of the followi ng sho$ld the n$"se "e%ommendQ a )aily enemas b 'a-ati/es % In%"eased fibe" intae d )e%"eased fl$id intae Hhi%h of the following wo$ld the n$"se $se as the basis fo" the tea%hing plan when %a"ing fo" a p"egnant teenage" %on%e"ned abo$t gaining too m$%h weight d$"ing p"egnan%yQ a 10 po$nds pe" t"imeste" b 1 po$nd pe" wee fo" .0 wees % [ po$nd pe" wee fo" .0 wees d # total gain of 2 to +0 po$nds !he %lient tells the n$"se that he" last menst"$al pe"iod sta"ted on Ban$a"y 1. and ended on Ban$a"y 20 Using *ageleKs "$le& the n$"se dete"mines he" ,)) to be whi%h of the followingQ a Septembe" 28 b O%tobe" 21 % *o/embe" 8 d )e%embe" 28 Hhen taing an obstet"i%al histo"y on a p"egnant %lien t who states& I had a son bo"n at + wees gestation& a da$ghte" bo"n at +0 wees gestation and I lost a baby at abo$t  wees&T the n$"se sho$ld "e%o"d he" obstet"i%al histo"y as whi%h of the followingQ a D2 !2 P0 #0 '2 b D+ !1 P1 #0 '2 % D+ !2 P0 #0 '2 d D. !2 P1 #1 '2 Hhen p"epa"ing to listen to the fetal hea"t "ate at 12 weesK gestat ion& the n$"se wo$ld $se whi%h of the followingQ a Stethos%ope pla%ed midline at the $ mbili%$s b )opple" pla%ed midline at the s$p"ap$bi% "egion % Fetos%ope pla%ed midway between the $mbili%$s and the -iphoid p"o%ess d ,-te"nal ele%t"oni% fetal monito" pla%ed at the $mbili%$s Hhen de/eloping a plan of %a"e fo" a %lient newly diagnosed with gestational diabetes& whi%h of the following inst"$%tions wo$ld be the p"io"ityQ a )ieta"y intae b
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .0

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a !ell he" to b"east feed mo"e f"e6$ently b #dministe" a na"%oti% befo"e b"east feeding % ,n%o$"age he" to wea" a n$"sing b"assie"e d Use soap and wate" to %lean the nipples !he n$"s e assesses the /ital signs of a %lient& . ho$"sK post pa"t$m that a"e as follo ws: @P 90G50W tempe"at$"e 100.]FW p$lse 100 wea& th"eadyW  20 pe" min$te Hhi%h of the following sho$ld the n$"se do fi"stQ a epo"t the tempe"at$"e to the physi%ian b e%he% the blood p"ess$"e with anothe" %$ff % #ssess the $te"$s fo" fi"mness and position d )ete"mine the amo$nt of lo%hia !he n$"se assesse s the postpa"t$m /aginal dis%ha"ge lo%hia on fo$" %lients Hhi%h of the following assessments wo$ld wa""ant notifi%ation of the physi%ianQ a # da" "ed dis%ha"ge on a 2=d ay postpa"t$m %lient b # pin to b"ownish dis%ha"ge on a %lient who is  days postpa"t$m % #lmost %olo"less to %"eamy dis%ha"ge on a %lient 2 wees afte" deli/e"y d # b"ight "ed dis%ha"ge  days afte" deli/e"y # postpa"t$m %lient has a tempe"at$"e of 101.]F & with a $te"$s that is tende" when palpated & "emains $n$s$ally la"ge& and not des%ending as no"mally e-pe%ted Hhi%h of the following sho$ld the n$"se assess ne-tQ a 'o%hia b @"easts % In%ision d U"ine Hhi%h of the follo wing is the p"io" ity fo%$s of n$"sing p"a%ti%e with the %$""en t ea"ly postpa"t$m dis%ha"geQ a P"omoting %omfo"t and "esto"ation of health b ,-plo"ing the emotional stat$s of the family % Fa%ilitating safe and effe%ti/e self=and newbo"n %a"e d !ea%hing abo$t the impo"tan%e of family planning

80 Hhi%h of the following a%tions wo$ld be least effe%ti/e in maintaining a ne$t"al the"mal en/i"onment fo"

81

82

8+

8.

8

the newbo"nQ a Pla%ing infant $nde" "adiant wa"me" afte" bathing b Co/e"ing the s%ale with a wa"med blanet p"io" to weighing % Pla%ing %"ib %lose to n$"se"y window fo" family /iewing d Co/e"ing the infantKs head with a nit sto%inette # newbo"n who has an asymme t"i%al

d ?e %an ha/e a t$b bath ea%h dayT 85 # newbo"n weighing +000 g"ams and feeding e/e"y . ho$"s needs 120 %alo"iesGg of body weight e/e"y 2. ho$"s fo" p"ope" g"owth and de/elopment ?ow many o$n%es of 20 %alGo( fo"m$la sho$ld this newbo"n "e%ei/e at ea%h feeding to meet n$t"itional needsQ a 2 o$n%es b + o$n%es % . o$n%es d 5 o$n%es 88 !he postte"m neonate with me%oni$m=stained amnioti% fl$id needs %a"e designed to espe%ially monito" fo" whi%h of the followingQ a espi"ato"y p"oblems b Dast"ointestinal p"oblems % Integ$menta"y p"oblems d ,limination p"oblems 8 Hhen meas$"ing a %lientKs f$ndal heigh t& whi%h of the following te%hni6$es denotes the %o""e%t method of meas$"ement $sed by the n$"seQ a F"om the -iphoid p"o%ess to the $mbili%$s b F"om the symphysis p$bis to the -iphoid p"o%ess % F"om the symphysis p$bis to the f$nd$s d F"om the f$nd$s to the $mbili%$s 89 # %lient with se/e"e p"ee%lampsia is admitted with of @P 150G110& p"otein$"ia& and se/e"e pitting edema Hhi%h of the following wo$ld be most impo"tant to in%l$de in the %lientKs plan of %a"eQ a )aily weights b Sei($"e p"e%a$tions % ight late"al positioning d St"ess "ed$%tion 0 # postpa"t$m p"imipa"a ass the n$"se& Hhen %an we ha/e se-$al inte"%o$"se againQT Hhi%h of the following wo$ld be the n$"seKs best "esponseQ a #nytime yo$ both want toT b #s soon as %hoose a %ont"a%epti/e methodT

1

2

+

.



5

% Hhen the dis%ha"ge has stopped and the in%ision is healedT d #fte" yo$" 5 wees e-aminationT Hhen p"epa"ing to administe" the /itamin  inEe%tion to a neonate& the n$"se wo$ld sele%t whi%h of the following sites as app"op"iate fo" the inEe%tionQ a )eltoid m$s%le b #nte"io" femo"is m$s%le % 7ast$s late"alis m$s%le d Dl$te$s ma-im$s m$s%le Hhen pe"fo"ming a pel/i% e-am ination& the n$"se obse "/es a "ed swollen a"ea on the "ight side of the /aginal o"ifi%e !he n$"se wo$ld do%$ment this as enla"gement of whi%h of the followingQ a Clito"is b Pa"otid gland % SeneKs gland d @a"tholinKs gland !o diffe"entiate as a female& the ho"monal stim$lation of the emb"yo that m$st o%%$" in/o l/es whi%h of the followingQ a In%"ease in mate"nal est"ogen se%"etion b )e%"ease in mate"nal and"ogen se%"etion % Se%"etion of and"ogen by the fetal gonad d Se%"etion of est"ogen by the fetal gonad # %lient at  weesK gestation %alls %omplaining of slight na$sea in the mo"ning ho$ "s Hhi%h of the following %lient inte"/entions sho$ld the n$"se 6$estionQ a !aing 1 teaspoon of bi%a"bonate of soda in an =o$n%e glass of wate" b ,ating a few low=sodi$m %"a%e"s befo"e getting o$t of bed % #/oiding the intae of li6$ids in the mo"ning ho$"s d ,ating si- small meals a day instead of thee la"ge meals !he n$"se do%$ments positi/e ballottement in the %lientKs p"enatal "e%o"d !he n$"se $nde"stands that this indi%ates whi%h of the followingQ a Palpable %ont"a%tions on the abdomen b Passi/e mo/ement of the $nengaged fet$s % Fetal i%ing felt by the %lient d ,nla"gement and softening of the $te"$s )$"ing a pel/i% e-am the n$"se notes a p$"ple=bl$e tinge of the %e"/i- !he n$"se do%$ments this as whi%h of the followingQ a @"a-ton=?i%s sign


8



9

90

91

92

9+

9.

9

95

98

b Chadwi%Ks sign % DoodellKs sign d <%)onaldKs sign )$"ing a p"enatal %lass& the n$"se e-plains the "ationale fo" b"eathin g te%hni6$es d$"ing p"epa"ation fo" labo" based on the $nde"standing that b"eathing te%hni6$es a"e most impo"tant in a%hie/ing whi%h of the followingQ a ,liminate pain and gi/e the e-pe%tant pa"ents something to do b ed$%e the "is of fetal dist"ess by in%"easing $te"opla%ental pe"f$sion % Fa%ilitate "ela-ation& possibly "ed$%ing the pe"%eption of pain d ,liminate pain so that less analgesia and anesthesia a"e needed #fte" . ho$"s of a%ti/e labo"& the n$"se notes that the %ont"a%tions of a p"imig"a/ida %lient a"e not st"ong eno$gh to dilate the %e"/i- Hhi%h of the following wo$ld the n$"se anti%ipate doingQ a Obtaining an o"de" to begin I7 o-yto%in inf$sion b #dministe"ing a light sedati/e to allow the patient to "est fo" se/e"al ho$" % P"epa"ing fo" a %esa"ean se%tion fo" fail$"e to p"og"ess d In%"easing the en%o$"agement to the patient when p$shing begins # m$ltig"a/ida at + weesK gestation is admitted with painless& b"ight "ed bleeding and mild %ont"a%tions e/e"y 8 to 10 min$tes Hhi%h of the following assessments sho$ld be a/oidedQ a $i%ening b Ophthalmia neonato"$m % Pi%a d P"olapsed $mbili%al %o"d Hhen des%"ibing di(ygoti% twin s to a %o$ple& on whi%h of the foll owing wo$ld the n$"se base the e-planationQ a !wo o/a fe"tili(ed by sepa"ate spe"m b Sha"ing of a %ommon pla%enta % ,a%h o/a with the same genotype d Sha"ing of a %ommon %ho"ion Hhi%h of the following "efe"s to the single %ell that "ep"od$%es itself afte" %on%eptionQ a Ch"omosome b @lasto%yst % Jygote d !"ophoblast In the late 190s& %ons$me"s and health %a"e p"ofessionals began %hallenging the "o$tine $se of analgesi%s and anestheti%s d$"ing %hildbi"th Hhi%h of the following was an o$tg"owth of this %on%eptQ a 'abo"& deli/e"y& "e%o/e"y& postpa"t$m ')P

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .+

b *$"se=midwife"y % Clini%al n$"se spe%ialist d P"epa"ed %hildbi"th 9 # %lient has a midpel/ i% %ont"a%t$"e f"om a p"e/io$s pel/i% inE$"y d$e to a moto" /ehi%l e a%%ident as a teenage" !he n$"se is awa"e that this %o$ld p"e/ent a fet$s f"om passing th"o$gh o" a"o$nd whi%h st"$%t$"e d$"ing %hildbi"thQ a Symphysis p$bis b Sa%"al p"omonto"y % Is%hial spines d P$bi% a"%h 99 Hhen tea%hing a g"o$p of adoles% ents abo$t /a"iations in the length of the menst"$al %y%l e& the n$"se $nde"stands that the $nde"lying me%hanism is d$e to /a"iations in whi%h of the following phasesQ a
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | ..

ANSERS a$% RATIONALES #r MATERNIT( NURSING Part 1

1 )' #ltho$gh all of the fa%to"s listed a"e impo"tant& spe"m motility is the most signifi%ant %"ite"ion when assessing male infe"tility Spe"m %o$nt& spe"m mat$"ity& and semen /ol$me a"e all signifi%ant& b$t they a"e not as signifi%ant spe"m motility 2 D @ased on the pa"tne"Ks statement& the %o$ple is /e"bali(ing feelings of inade6$a%y and negati/e feelings abo$t themsel/es and thei" %apabilities !h$s& the n$"sing diagnosis of self=esteem dist$"ban%e is most app"op"iate Fea"& pain& and ineffe%ti/e family %oping also may be p"esent b$t as se%onda"y n$"sing diagnoses + ) P"ess$"e and i""itation of the bladde" by the g"owing $te"$s d$"ing the fi"st t"imeste" is "esponsible fo" %a$sing $"ina"y f"e6$en%y )ys$"ia& in%ontinen%e& and b$"ning a"e symptoms asso%iated with $"ina"y t"a%t infe%tions . C )$"ing the se%ond t"imeste"& the "ed$%tion in gast"i% a%idity in %onE$n%tion with p"ess$"e f"om the g"owing $te"$s and smooth m$s%le "ela-ation& %an %a$se hea"tb$"n and flat$len%e ?CD le/els in%"ease in

 5

8



9

the fi"st& not the se%ond& t"imeste" )e%"ease intestinal motility wo$ld most liely be the %a$se of %onstipation and bloating ,st"ogen le/els de%"ease in the se%ond t"imeste" D Chloasma& also %alled the mas of p"egnan%y& is an i""eg$la" hype"pigmented a"ea fo$nd on the fa%e It is not seen on the b"easts& a"eola& nipples& %hest& ne%& a"ms& legs& abdomen& o" thighs C )$"ing p"egnan%y& ho"monal %hanges %a$se "ela-ation of the pel/i% Eoints& "es$lting in the typi%al waddlingT gait Changes in post$"e a"e "elated to the g"owing fet$s P"ess$"e on the s$""o$nding m$s%les %a$sing dis%omfo"t is d$e to the g"owing $te"$s Height gain has no effe%t on gait C !he a/e"age amo$nt of weight gained d$"ing p"egnan%y is 2. to +0 lb !his weight gain %onsists of the following: fet$s X 8 lbW pla%enta and memb"ane X 1 lbW amnioti% fl$id X 2 lbW $te"$s X 2 lbW b"easts X + lbW and in%"eased blood /ol$me X 2 to . lbW e-t"a/as%$la" fl$id and fat X . to 9 lb # gain of 12 to 22 lb is ins$ffi%ient& whe"eas a weight gain of 1 to 2 lb is ma"ginal # weight gain of 2 to .0 lb is %onside"ed e-%essi/e C' P"ess$"e of the g"owing $te"$s on blood /essels "es$lts in an in%"eased "is fo" /eno$s stasis in the lowe" e-t"emities S$bse6$ently& edema and /a"i%ose /ein fo"mation may o%%$" !h"ombophlebitis is an inflammation of the /eins d$e to th"omb$s fo"mation P"egnan%y=ind$%ed hype"tension is not asso%iated with these symptoms D"a/ity plays only a mino" "ole with these symptoms C' Ce"/i%al softening Doodell sign and $te"ine so$ffl_ a"e two p"obable signs of p"egnan%y P"obable

signs a"e obEe%ti/e findings that st"ongly s$ggest p"egnan%y Othe" p"obable signs in%l$de ?ega" sign& whi%h is softening of the lowe" $te"ine segmentW Pisa%e sign& whi%h is enla"gement and softening of the $te"$sW se"$m labo"ato"y testsW %hanges in sin pigmentationW and $lt"asoni% e/iden%e of a gestational sa% P"es$mpti/e signs a"e s$bEe%ti/e signs and in%l$de ameno""heaW na$sea and /omitingW $"ina"y f"e6$en%yW b"east tende"ness and %hangesW e-%essi/e fatig$eW $te"ine enla"gementW and 6$i%ening 10 )' P"es$mpti/e signs of p"egnan%y a"e s$bEe%ti/e signs Of the signs listed& only na$sea and /omiting a"e p"es$mpti/e signs ?ega" sign& sin pigmentation %hanges& and a positi/e se"$m p"egnan%y test a"e %onside"ed p"obably signs& whi%h a"e st"ongly s$ggesti/e of p"egnan%y 11 D' )$"ing the fi"st t"imeste"& %ommon emotional "ea%tions in%l$d e ambi/alen%e& fea"& fantasies& o" an-iety !he se%ond t"imeste" is a pe"iod of well=being a%%ompanied by the in%"eased need to lea"n abo$t fetal g"owth and de/elopment Common emotional "ea%tions d$"ing this t"imeste" in%l$de na"%issism& passi/ity& o" int"o/e"sion #t times the woman may seem ego%ent"i% and self=%ente"ed )$"ing the thi"d t"imeste"& the woman typi%ally feels awwa"d& %l$msy& and $natt"a%ti/e& often be%oming mo"e int"o/e"ted o" "efle%ti/e of he" own %hildhood 12 ) Fi"st=t"imeste" %lasses %ommonly fo%$s on s$%h iss$es as ea"ly physiologi% %hanges& fetal de/elopment& se-$ality d$"ing p"egnan%y& and n$t"ition Some ea"ly %lasses may in%l$de p"egnant %o$ples Se%ond and thi"d t"imeste" %lasses may fo%$s on p"epa"ation fo" bi"th& pa"enting& and newbo"n %a"e

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .

1+ C Hith b"east feeding& the fathe"Ks body is not %apable of p"o/iding the mil fo" the newbo"n& whi%h may inte"fe"e with feeding the newbo"n& p"o/iding fewe" %han%es fo" bonding& o" he may be Eealo$s of the infantKs demands on his wifeKs time and body @"east feeding is ad/antageo$s be%a$se $te"ine in/ol$tion o%%$"s mo"e "apidly& th$s minimi(ing blood loss !he p"esen%e of mate"nal antibodies in b"east mil helps de%"ease the in%iden%e of alle"gies in the newbo"n # g"eate" %han%e fo" e""o" is asso%iated with bottle feeding *o p"epa"ation is "e6$i"ed fo" b"east feeding 1. A # false=positi/e "ea%tion %an o%%$" if the p"egnan%y test is pe"fo"med less than 10 days afte" an abo"tion Pe"fo"ming the tests too ea"ly o" too late in the p"egnan%y& sto"ing the $"ine sample too long at "oom tempe"at$"e& o" ha/ing a spontaneo$s o" missed abo"tion impending %an all p"od$%e false=negati/e "es$lts 1 D !he F? %an be a$s%$ltated with a fetos%ope at abo$t 20 weeKs gesta tion F? $s$al ly is a$s%$latated at the midline s$p"ap$bi% "egion with )opple" $lt"aso$nd t"ansd$%e" at 10 to 12 weeKs F?& %annot be hea"d ea"lie" than%lientKs 10 weesK 15 gestation C' !o dete"mine the ,)) when any the date of the '
18

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19

20

21

22

2+

2.

2

25

28 2

the '

29 C !he ante"io" fontanel is la"ge" in si(e than the poste"io" fontanel #dditionally& the ante"io" fontanel& whi%h is diamond shaped& %loses at 1 months& whe"eas the poste"io" fontanel& whi%h is t"iang$la" shaped& %loses at  to 12 wees *eith e" fontanel sho$ld appea " b$lging& whi%h may indi% ate in%"e ased int"a%"anial p"ess$"e& o" s$nen& whi%h may indi%ate dehyd"ation +0 ) @lin& %o$gh& snee(e& swallowing and gag "efle-es a"e all p"esent at bi"th and "emain $n%hanged th"o$gh ad$lthood efle-es s$%h as "ooting and stepping s$bside within the fi"st yea" +1 A Hith the babinsi "efle-& the newbo"nKs toes hype"e-tend and fan apa"t f"om do"sifle-ion of the big toe when one side of foot is st"oed $pwa"d fo"m the heel and a%"oss the ball of the foot Hith the sta"tle "efle-& the newbo"n abd$%ts and fle-es all e-t"emities and may begin to %"y when e-posed to s$dden mo/ement of lo$d noise Hith the "ooting and s$%ing "efle-& the newbo"n t$"ns his head in the di"e%tion of stim$l$s& opens the mo$th& and begins to s$% when the %hees& lip& o" %o"ne" of mo$th is to$%hed Hith the %"awl "efle-& the newbo"n will attempt to %"awl fo"wa"d with both a"ms and legs when he is his abdomen a flat s$"fa%eg"a/ida"$m in%l$des se/e"e na$sea and /omiting& leading to +2 pla%ed ) !heondes%"iption ofonhype"emesis

++

+.

+ +5

+8

+

+9

.0 .1

.2

ele%t"olyte& metaboli%& and n$t"itional imbalan%es in the absen%e of othe" medi%al p"oblems ?ype"emesis is not a fo"m of anemia 'oss of appetite may o%%$" se%onda"y to the na$sea and /omiting of hype"emesis& whi%h& if it %ontin$es& %an deplete the n$t"ients t"anspo"ted to the fet$s )ia""hea does not o%%$" with hype"emesis )' ,dema of the hands and fa%e is a %lassi% sign of PI?

.+ A' Hith $te"ine "$pt$"e& the %lient is at "is fo" hypo/olemi% sho% !he"efo"e& the p"io"ity is to p"e/ent and limit hypo/olemi% sho% Immediate steps sho$ld in%l$de gi/ing o-ygen& "epla%ing lost fl$ids& p"o/iding d"$g the"apy as needed& e/al$ating fetal "esponses and p"epa"ing fo" s$"ge"y Obtaining blood spe%imens& instit$ting %omplete bed "est& and inse"ting a $"ina"y %athete" a"e ne%essa"y in p"epa"ation fo" s$"ge"y to "emedy the "$pt$"e .. )' !he immediate p"io"ity is to minimi(e p"ess$"e on the %o"d !h$s the n$"seKs initial a%tion in/ol/es pla%ing the %lient on bed "est and then pla%ing the %lient in a nee=%hest position o" lowe"ing the head of the bed& and ele/ating the mate"nal hips on a pillow to minimi(e the p"ess$"e on the %o"d
.8

.

.9

0 1

2

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.



p"ima"y p"edisposing fa%to" ,pidemi% and endemi% infe%tions a"e p"obable so$"%es of infe%tion fo" mastitis !empo"a"y $"ina"y "etention d$e to de%"eased pe"%eption of the $"ge to /oid is a %ont"ib$to"y fa%to" to the de/elopment of $"ina"y t"a%t infe%tion& not mastitis D' !h"ombophlebitis "efe"s to an inflammation of the /as%$la" endotheli$m with %lot fo"mation on the wall of the /essel @lood %omponents %ombining to fo"m an agg"egate body des%"ibe a th"omb$s o" th"ombosis Clots lodging in the p$lmona"y /as%$lat$"e "efe"s to p$lmona"y embolismW in the femo"al /ein& femo"al th"ombophlebitis C' Classi% symptoms of )7! in%l$de m$s%le pain& the p"esen%e of ?omans sign& and swelling of the affe%ted limb
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .

5

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de%"easing the amo$nt of wate" that is abso"bed #s a "es$lt& stool is softe" and easie" to pass ,nemas %o$ld p"e%ipitate p"ete"m labo" andGo" ele%t"olyte loss and sho$ld be a/oided 'a-ati/es may %a$se p"ete"m labo" by stim$lating pe"istalsis and may inte"fe"e with the abso"ption of n$t"ients Use fo" mo"e than 1 wee %an also lead to la-ati/e dependen%y 'i6$id in the diet helps p"o/ide a semisolid& soft %onsisten%y to the stool ,ight to ten glasses of fl$id pe" day a"e essential to maintain hyd"ation and p"omote stool e/a%$ation D !o ens$"e ade6$ate fetal g"owth and de/elopment d$"ing the .0 wees of a p"egnan%y& a total weight gain 2 to +0 po$nds is "e%ommended: 1 po$nds in the fi"st 10 weesW 9 po$nds by +0 weesW and 28 po$nds by .0 wees !he p"egnant woman sho$ld gain less weight in the fi"st and se%ond t"imeste" than in the thi"d )$"ing the fi"st t"imeste"& the %lient sho$ld only gain 1 po$nds in the fi"st 10 wees& not 1 po$nd pe" wee # weight gain of [ po$nd pe" wee wo$ld be 20 po$nds fo" the total p"egnan%y& less than the "e%ommended amo$nt ) !o %al%$late the ,)) by *ageleKs "$le& add 8 days to the fi"st day of the last menst"$al pe"iod and %o$nt ba% + months& %hanging the yea" app"op"iately !o obtain a date of Septembe" 28& 8 days ha/e been added to the last day of the '

50 A' #ltho$gh all of the %hoi%es a"e impo"tant in the management of diabetes& diet the"apy is the mainstay of the t"eatment plan and sho$ld always be the p"io"ity Homen diagnosed with gestational diabetes gene"ally need only diet the"apy witho$t medi%ation to %ont"ol thei" blood s$ga" le/els ,-e"%ise& is impo"tant fo" all p"egnant women and espe%ially fo" diabeti% women& be%a$se it b$"ns $p gl$%ose& th$s de%"easing blood s$ga" ?owe/e"& dieta"y intae& not e-e"%ise& is the p"io"ity #ll p"egnant women with diabetes sho$ld ha/e pe"iodi% monito"ing of se"$m gl$%ose ?owe/e"& those with gestational diabetes gene"ally do not need daily gl$%ose monito"ing !he standa"d of %a"e "e%ommends a fasting and 2=ho$" postp"andial blood s$ga" le/el e/e"y 2 wees 51 C' #fte" 20 weesK gestation& when the"e is a "apid weight gain& p"ee%lampsia sho$ld be s$spe%ted& whi%h may be %a$sed by fl$id "etention manifested by edema& espe%ially of the hands and fa%e !he th"ee %lassi% signs of p"ee%lampsia a"e hype"tension& edema& and p"otein$"ia #ltho$gh $"ine is %he%ed fo" gl$%ose at ea%h %lini% /isit& this is not the p"io"ity )ep"ession may %a$se eithe" ano"e-ia o" e-%essi/e food intae& leading to e-%essi/e weight gain o" loss !his is not& howe/e"& the p"io"ity %onside"ation at this time Height gain tho$ght to be %a$sed by e-%essi/e food intae wo$ld "e6$i"e a 2.=ho$" diet "e%all ?owe/e"& e-%essi/e intae wo$ld not be the p"ima"y %onside"ation fo" this %lient at this time 52 )' C"amping and /aginal bleeding %o$pled with %e"/i%al dilation signi fies that te"mination of the p"egnan%y is ine/itable and %annot be p"e/ented !h$s& the n$"se wo$ld do%$ment an imminent abo"tion In a th"eatened abo"tion& %"amping and /aginal bleeding a"e p"esent& b$t the"e is no %e"/i%al dilation !he symptoms may s$bside o" p"og"ess to abo"tion In a %omplete abo"tion all the p"od$%ts of %on%eption a"e e-pelled # missed abo"tion is ea"ly fetal int"a$te"ine death witho$t e-p$lsion of the p"od$%ts of %on%eption 5+ )' Fo" the %lient with an e%topi% p"egnan%y& lowe" abdominal pain& $s$ally $nilate"al& is the p"ima"y symptom !h$s& pain is the p"io"ity #ltho$gh the potential fo" infe%tion is always p"esent& the "is is low in e%topi% p"egnan%y be%a$se pathogeni% mi%"oo"g anisms ha/e not been int"od$%ed f"om e-te"nal so$"%es !he %lient may ha/e a limited nowledge of the pathology and t"eatment of the %ondition and will most liely e-pe"ien%e g"ie/ing& b$t this is not the p"io"ity at this time 5. D' @efo"e $te"ine assessment is pe"fo"med& it is essential that the woman empty he" bladde" # f$ll bladde" will inte"fe"e with the a%%$"a%y of the assessment by ele/ating the $te"$s and displa%ing to the side of the midline 7ital sign assessment is not ne%essa"y $nless an abno"mality in $te"ine assessment is identified Ute"ine assessment sho$ld not %a$se a%$te pain that "e6$i"es administ"ation of analgesia #mb$lating the %lient is an essential %omponent of postpa"t$m %a"e& b$t is not ne%es sa"y p"io" to assessment of the $te"$s 5 A' Feeding mo"e f"e6$ently& abo$t e/e"y 2 ho$"s& will de%"ease the infantKs f"anti%& /igo"o$s s$%ing f"om h$nge" and will de%"ease b"east engo"gement& soften the b"east& and p"omote ease of %o""e%t lat%hing=on


fo" feeding *a"%oti%s administe"ed p"io" to b"east feeding a"e passed th"o$gh the b"east mil to the infant& %a$sing e-%essi/e sleepiness *ipple so"eness is not se/e"e eno$gh to wa""ant na"%oti% analgesia #ll postpa"t$m %lients& espe%ially la%tating mothe"s& sho$ld wea" a s$ppo"ti/e b"assie"e with wide %otton st"aps !his does not& howe/e"& p"e/ent o" "ed$%e nipple so"eness Soaps a"e d"ying to the sin of the nipples and sho$ld not be $sed on the b"easts of la%tating mothe"s )"y nipple sin p"edisposes to %"a%s and fiss$"es& whi%h %an be%ome so"e and painf$l 55 D' # wea& th"eady p$lse ele/ated to 100 @P< may indi%ate impending hemo""hagi% sho% #n in%"eased p$lse is a %ompensato"y me%hanism of the body in "esponse to de%"eased fl$id /ol$me !h$s& the n$"se sho$ld %he% the amo$nt of lo%hia p"esent !empe"at$"es $p to 100.F in the fi"st 2. ho$"s afte" bi"th a"e "elated to the dehyd"ating effe%ts of labo" and a"e %onside"ed no"mal #ltho$gh "e%he%ing the blood p"ess$"e may be a %o""e%t %hoi%e of a%tion& it is not the fi"st a%tion that sho$ld be implemented in light of the othe" data !he data indi%ate a potential impending hemo""hage #ssessing the $te"$s fo" fi"mness and position in "elation to the $mbili%$s and midline is impo"tant& b$t the n$"se sho$ld %he% the e-tent of /aginal bleeding fi"st !hen it wo$ld be app"op"iate to %he% the $te"$s& whi%h may be a possible %a$se of the hemo""hage 58 D' #ny b"ight "ed /aginal dis%ha"ge wo$ld be %onside"ed abno"mal& b$t espe%ially  days afte" deli/e"y& when the lo%hia is typi%ally pin to b"ownish 'o%hia "$b"a& a da" "ed dis%ha"ge& is p"esent fo" 2 to + days afte" deli/e"y @"ight "ed /aginal bleeding at this time s$ggests late postpa"t$m hemo""hage& whi%h o%%$"s afte" the fi"st 2. ho$"s following deli/e"y and is gene"ally %a$sed by "etained pla%ental f"agments o" bleeding diso"de"s 'o%hia "$b"a is the no"mal da" "ed dis%ha"ge o%%$""ing in the fi"st 2 to + days afte" deli/e"y& %ontaining epithelial %ells& e"yth"o%yes& le$o%ytes and de%id$a 'o%hia se"osa is a pin to b"ownish se"osang$ineo$s dis%ha"ge o%%$""ing f"om + to 10 days afte" deli/e"y that %ontains de%id$a& e"yth"o%ytes& le$o%ytes& %e"/i%al m$%$s& and mi%"oo"ganisms 'o%hia alba is an almost %olo"less to yellowish dis%ha"ge o%%$""ing f"om 10 days to + wees afte" deli/e"y and %ontaining le$o%ytes& de%id$a& epithelial %ells& fat& %e"/i%al m$%$s& %holeste"ol %"ystals& and ba%te"ia 5 A' !he data s$ggests an infe%tion of the endomet"ial lining of the $te"$s !he lo%hia may be de%"eased o" %opio$s& da" b"own in appea"an%e& and fo$l smelling& p"o/iding f$"the" e/iden%e of a possible infe%tion #ll the %lientKs data indi%ate a $te"ine p"oblem& not a b"east p"oblem !ypi%ally& t"ansient fe/e"& $s$ally 101]F& may be p"esent with b"east engo"gement Symptoms of mastitis in%l$de infl$en(a=lie manifestations 'o%ali(ed infe%tio n of an episiotomy o" C=se%tion in%ision "a"ely %a$ses systemi% symptoms& and $te"ine in/ol$tion wo$ld not be affe%ted !he %lient data do not in%l$de dys$"ia& f"e6$en%y& o" $"gen%y& symptoms of $"ina"y t"a%t infe%tions& whi%h wo$ld ne%essitate assessing the %lientKs $"ine 59 C' @e%a$se of ea"ly postpa"t$m dis%ha"ge and limited time fo" tea%hing& the n$"seKs p"io"ity is to fa%ilitate the safe and effe%ti/e %a"e of the %lient and newbo"n #ltho$gh p"omoting %omfo"t and "esto"ation of health& e-plo"ing the familyKs emotional stat$s& and tea%hing abo$t family planning a"e impo"tant in postpa"t$mGnewbo"n n$"sing %a"e& they a"e not the p"io"ity fo%$s in the limited time p"esented by ea"ly post=pa"t$m dis%ha"ge 80 C' ?eat loss by "adiation o%%$"s when the infantKs %"ib is pla%ed too nea" %old walls o" windows !h$s pla%ing the newbo"nKs %"ib %lose to the /iewing window wo$ld be least effe%ti/e @ody heat is lost th"o$gh e/apo"ation d$"ing bathing Pla%ing the infant $nde" the "adiant wa"me" afte" bathing will assist the infant to be "ewa"med Co/e"ing the s%ale with a wa"med blanet p"io" to weighing p"e/ents heat loss th"o$gh %ond$%tion # nit %ap p"e/ents heat loss f"om the head a la"ge head& a la"ge body s$"fa%e a"ea of the newbo"nKs body 81 )' # f"a%t$"ed %la/i%le wo$ld p"e/ent the no"mal
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 0

notified and o-ygen is not needed !he data do not indi%ate the p"esen%e of %hoing& gagging o" %o$ghing& whi%h a"e signs of e-%essi/e se%"etions S$%tioning is not ne%essa"y 8 )' #ppli%ation of 80V isop"opyl al%ohol to the %o"d minimi(es mi%"oo"ganisms ge"mi%idal and p"omotes d"ying !he %o"d sho$ld be ept d"y $ntil it falls off and the st$mp has healed #ntibioti% ointment sho$ld only be $sed to t"eat an infe%tion& not as a p"ophyla-is Infants sho$ld not be s$bme"ged in a t$b of wate" $ntil the %o"d falls off and the st$mp has %ompletely healed 85 )' !o dete"mine the amo$nt of fo"m$la needed& do the following mathemati%al %al%$lation + g - 120 %alGg pe" day  +50 %alo"iesGday feeding 6 . ho$"s  5 feedings pe" day  50 %alo"ies pe" feeding: 50 %alo"ies pe" feedingW 50 %alo"ies pe" feeding with fo"m$la 20 %alGo(  + o$n%es pe" feeding @ased on the %al%$lation 2& . o" 5 o$n%es a"e in%o""e%t 88 A' Int"a$te"ine ano-ia may %a$se "ela-ation of the anal sphin%te" and emptying of me%oni$m into the amnioti% fl$id #t bi"th some of the me%oni$m fl$id may be aspi"ated& %a$sing me%hani%al obst"$%tion o"

8

89

0

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2

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%hemi%al pne$monitis !he infantit isis not at in%"easedste"ile "is fo"and gast"ointestinal ,/en me%oni$m= tho$gh the sin is stained with me%oni$m& noninfe%tio$s noni""itatingp"oblems !he postte"m stained infant is not at additional "is fo" bowel o" $"ina"y p"oblems C' !he n$"se sho$ld $se a nonelasti%& fle-ible& pape" meas$"ing tape& pla%ing the (e"o point on the s$pe"io" bo"de" of the symphysis p$bis and st"et%hing the tape a%"oss the abdomen at the midline to the top of the f$nd$s !he -iphoid and $mbili%$s a"e not app"op"iate landma"s to $se when meas$"ing the height of the f$nd$s <%)onaldKs meas$"ement )' Homen hospitali(ed with se/e"e p"ee%lampsia need de%"eased C*S stim$lation to p"e/ent a sei($"e Sei($"e p"e%a$tions p"o/ide en/i"onmental safety sho$ld a sei($"e o%%$" @e%a$se of edema& daily weight is impo"tant b$t not the p"io"ity P"e%lampsia %a$ses /asospasm and the"efo"e %an "ed$%e $te"o=pla%ental pe"f$sion !he %lient sho$ld be pla%ed on he" left side to ma-imi(e blood flow& "ed$%e blood p"ess$"e& and p"omote di$"esis Inte"/entions to "ed$%e st"ess and an-iety a"e /e"y impo"tant to fa%ilitate %oping and a sense of %ont"ol& b$t sei($"e p"e%a$tions a"e the p"io"ity C' Cessation of the lo%hial dis%ha"ge signifies healing of the endomet"i$m is of hemo""hage and infe%tion a"e minimal + wees afte" a no"mal /aginal deli/e"y !elling the %lient anytime is inapp"op"iate be%a$se this "esponse does not p"o/ide the %lient with the spe%ifi% info"mation she is "e6$esting Choi%e of a %ont"a%epti/e method is impo"tant& b$t not the spe%ifi% %"ite"ia fo" safe "es$mption of se-$al a%ti/ity C$lt$"ally& the 5=weesK e-amination has been $sed as the time f"ame fo" "es$ming se-$al a%ti/ity& b$t it may be "es$med ea"lie" C !he middle thi"d of the /ast$s late"alis is the p"efe""ed inEe%tion site fo" /itamin  administ"ation be%a$se it is f"ee of blood /essels and ne"/es and is la"ge eno$gh to abso"b the medi%ation !he deltoid m$s%le of a newbo"n is not la"ge eno$gh fo" a newbo"n I< inEe%tion InEe%tions into this m$s%le in a small %hild might %a$se damage to the "adial ne"/e !he ante"io" femo"is m$s%le is the ne-t safest m$s%le to $se in a newbo"n b$t is not the safest @e%a$se of the p"o-imity of the s%iati% ne"/e& the gl$te$s ma-im$s m$s%le sho$ld not be $ntil the %hild has been waling 2 yea"s D @a"tholinKs glands a"e the glands on eithe" side of the /aginal o"ifi%e !he %lito"is is female e"e%tile tiss$e fo$nd in the pe"ineal a"ea abo/e the $"eth"a !he pa"otid glands a"e open into the mo$th SeneKs glands open into the poste"io" wall of the female $"ina"y meat$s D !he fetal gonad m$st se%"ete est"ogen fo" the emb"yo to diffe"entiate as a female #n in%"ease in mate"nal est"ogen se%"etion does not effe%t diffe"entiation of the emb"yo& and mate"nal est"ogen se%"etion o%%$"s in e/e"y p"egnan%y
 ) @allottement indi%ates passi/e mo/ement of the $nengaged fet$s @allottement is not a %ont"a%tion Fetal i%ing felt by the %lient "ep"esents 6$i%ening ,nla"gement and softening of the $te"$s is nown as Pisa%eKs sign 5 ) Chadwi%Ks sign "efe"s to the p$"ple=bl$e tinge of the %e"/i- @"a-ton ?i%s %ont"a%tions a"e painless %ont"a%tions beginning a"o$nd the . th month DoodellKs sign indi%ates softening of the %e"/i- Fle-ibility of the $te"$s against the %e"/i- is nown as <%)onaldKs sign 8 C @"eathing te%hni6$es %an "aise the pain th"eshold and "ed$%e the pe"%eption of pain !hey also p"omote "ela-ation @"eathing te%hni6$es do not eliminate pain& b$t they %an "ed$%e it Positioning& not b"eathing& in%"eases $te"opla%ental pe"f$sion  A !he %lientKs labo" is hypotoni% !he n$"se sho$ld %all the physi%al and obtain an o"de" fo" an inf$sion of o-yto%in& whi%h will assist the $te"$s to %onta%t mo"e fo"%ef$lly in an attempt to dilate the %e"/i- #dministe"ing light sedati/e wo$ld be done fo" hype"toni% $te"ine %ont"a%tions P"epa"ing fo" %esa"ean se%tion is $nne%essa"y at this time O-yto%in wo$ld in%"ease the $te"ine %ont"a%tions and hopef$lly p"og"ess labo" befo"e a %esa"ean wo$ld be ne%essa"y It is too ea"ly to anti%ipate %lient p$shing with %ont"a%tions


9 D !he signs indi%ate pla%enta p"e/ia and /aginal e-am to dete"mine %e"/i%al dilation wo$ld not be done be%a$se it %o$ld %a$se hemo""hage #ssessing mate"nal /ital signs %an help dete"mine mate"nal physiologi% stat$s Fetal hea"t "ate is impo"tant to assess fetal well=being and sho$ld be done
9+ C' !he g"eenish tint is d$e to the p"esen%e of me%oni$m 'an$go is the soft& downy hai" on the sho$lde"s

9.

9 95

98

and ba% of the fet$s ?yd"amnios "ep"esents e-%essi/e amnioti% fl$id 7e"ni- is the white& %heesy s$bstan%e %o/e"ing the fet$s D' In a b"ee%h position& be%a$se of the spa%e between the p"esenting pa"t and the %e"/i-& p"olapse of the $mbili%al %o"d is %ommon >$i%ening is the womanKs fi"st pe"%eption of fetal mo/ement Ophthalmia neonato"$m $s$ally "es$lts f"om mate"nal gono""hea and is %onE$n%ti/itis Pi%a "efe"s to the o"al intae of nonfood s$bstan%es A' )i(ygoti% f"ate"nal twins in/ol/e two o/a fe"tili(ed by sepa"ate spe"m
9 C' !he is%hial spines a"e lo%ated in the mid=pel/i% "egion and %o$ld be na""owed d$e to the p"e/io$s pel/i% inE$"y !he symphysis p$bis& sa%"al p"omonto"y& and p$bi% a"%h a"e not pa"t of the mid=pel/is

99 )' 7a"iations in the length of the menst"$al %y%le a"e d$e to /a"iations in the p"olife"ati/e phase !he menst"$al& se%"eto"y and is%hemi% phases do not %ont"ib$te to this /a"iation

100 ) !estoste"one is p"od$%ed by the 'eyding %ells in the seminife"o$s t$b$les Folli%le=stim$lating ho"mone and le$tein(ing ho"mone a"e "eleased by the ante"io" pit$ita"y gland !he hypothalam$s is "esponsible fo" "eleasing gonadot"opin="eleasing ho"mone


MATERNIT( NURSING Part 2

1 S$ppose
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +

% S%hool=age stage d 'a$n%hing stage 8 Hhile she is in the hospital& Ca"m ela maes the foll owing statements Hhi%h is the best e-amp le of ste"eotypingQ a
On physi%al e-amination&
11
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .

15 oseann& 18 yea"s old& wants to t"y female %ondoms as he" "ep"od$%ti/e life plannin g method Hhi%h inst"$%tion wo$ld yo$ gi/e he"Q a !he ho"mone the %ondom "eleases may %a$se mild weight gain b She sho$ld inse"t the %ondom befo"e any penile penet"ation % She sho$ld %oat the %ondom with a spe"mi%ide befo"e $se d Female %ondoms& $nlie male %ondoms& %an be "e$sed 18 oseann& 18 yea"s old& ass yo$ how a t$bal ligation p"e/ents p"egnan%y Hhi%h wo$ld be the best answe"Q a Spe"m %an no longe" "ea%h the o/a be%a$se fallopian t$bes a"e blo%ed b Spe"m %an not ente" the $te"$s be%a$se the %e"/i%al ent"an%e is blo%ed % P"ostaglandins "eleased f"om the %$t fallopian t$bes %an ill spe"m d !he o/a"y no longe" "eleases o/a as the"e is no whe"e fo" them to go 1 a b % d

!he #tien(as a"e a %o$ple $nde"going testing fo" infe"tility Infe"tility is said to e-ist when: # %o$ple has been t"ying to %on%ei/e fo" 1 yea" # woman has no %hild"en # woman has no $te"$s # %o$ple has wanted a %hild fo" 5 months

19 a b % d

D$adal$pe #tien(a is diagnosed as ha/ing endomet"iosis !his %ondition inte"fe"es with fe"tility be%a$se: !he o/a"ies stop p"od$%ing ade6$ate est"ogen !he $te"ine %e"/i- be%omes inflamed and swollen P"ess$"e on the pit$ita"y leads to de%"eased FS? le/els ,ndomet"ial implants %an blo% the fallopian t$bes

20 D$adal$pe #tien(a is s%hed$led to ha/e a hyste"osalpingog"am Hhi%h of the following inst"$%tions wo$ld yo$ gi/e he" "ega"ding this p"o%ed$"eQ a She may feel some mild %"amping when the dye is inse"ted b !he sonog"am of the $te"$s will "e/eal any t$mo"s p"esent % She will not be able to %on%ei/e fo" th"ee months afte" the p"o%ed$"e d
Bean S$a"e( is p"egnant with he" fi"st %hild ?e" phenotype "efe"s to: ?e" %on%ept of he"self as male o" female Hhethe" she has .5 %h"omosomes o" not ?e" a%t$al geneti% %omposition ?e" o$twa"d appea"an%e

2. a b % d

Bean S$a"e( is a balan%ed t"anslo%ation %a""ie" fo" )own synd"ome !his te"m means that: #ll of he" %hild"en will be bo"n with some aspe%ts of )own synd"ome #ll of he" female and none of he" male %hild"en will ha/e )own synd"ome She has a g"eate" than a/e"age %han%e a %hild will ha/e )own synd"ome It is impossible fo" any of he" %hild"en to be bo"n with )own synd"ome

2 Bean S$a"e( was told at a geneti% %o$nseling session tat she is a balan%ed t"anslo%ation %a""ie" fo" )own synd"ome Hhat wo$ld be yo$" best a%tion "ega"ding this info"mationQ a @e %e"tain all of he" family $nde"stand what this means b )is%$ss the %ost of /a"io$s abo"tion te%hni6$es with Bean % @e s$"e Bean nows she sho$ld not ha/e any mo"e %hild"en d #s Bean is she has any 6$estions that yo$ %o$ld answe" fo" he"

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 

25 Bean S$a"e(Ks %hild is bo"n with )own Synd"ome  Hhat is a %ommon physi%al feat$"e of newbo"n with this diso"de"Q a Spasti% and stiff m$s%les b 'oose sin at ba% of ne% % # white lo% of fo"ehead hai" d H"inles on soles of the feet 28 i(alyn ass how m$%h longe" he" do%to " will "efe" to the baby inside he" as an emb"yo Hhat wo$ ld be yo$" best e-planationQ a !his te"m is $sed d$"ing the time befo"e fe"tili(ation b ?e" baby will be a fet$s as soon as the pla%enta fo"ms c# #fte" the 20th wee of p"egnan%y& the baby is %alled (ygote d F"om the time of implantation $ntil  to  wees& the baby is an emb"yo 2 i(alyn is wo""ied that he" baby will be bo"n with %ongenital hea"t disease Hhat assessment of a fet$s at bi"th is impo"tant to help dete%t %ongenital hea"t defe%tsQ a #ssessing whethe" the Hha"tonKs Eelly if the %o"d has a p? highe" than 82 b #ssessing whethe" the $mbili%al %o"d has two a"te"ies and one /ein %

+ @e"nadetteKs do%to" told he" she had a positi/e Chadwi%Ks sign She ass yo$ what this means& and yo$ tell he" that: a ?e" abdomen is soft and tende" b ?e" $te"$s has tipped fo"wa"d % Ce"/i%al m$%$s is %lea" and sti%y d ?e" /agina has da"ened in %olo" +5 @e"nadette o/e"hea"d he" do%to" say that ins$lin is not as effe%ti/e d$"ing p"egnan%y as $s$al !hat made he" wo""y that she is de/eloping diabetes& lie he" a$nt ?ow wo$ld yo$ e-plain how de%"eased ins$lin effe%ti/eness safeg$a"ds the fet$sQ a )e%"eased effe%ti/eness p"e/ents the fet$s f"om being hypogly%emi% b If ins$lin is ineffe%ti/e it %annot %"oss the pla%enta and ha"m the fet$s % !he lessened a%tion p"e/ents the fet$s f"om gaining too m$%h weight d !he mothe"& not the fet$s& is g$a"ded by this de%"eased ins$lin a%tion +8 i(a C$a feels well  She ass yo$ why she needs to %ome fo" p"enat al %a"e !he best "eason fo" he" to "e%ei/e "eg$la" %a"e is: a )is%o/e"ing alle"gies %an help eliminate ea"ly bi"th b It helps do%$ment how many p"egnan%ies o%%$" ea%h yea" % It p"o/ides time fo" ed$%ation abo$t p"egnan%y and bi"th d It dete"mines whethe" p"egnan%ies today a"e planned o" not + a b % d

Hhy is it impo"tant to as i(a abo$t past s$"ge"y on a p"egnan%y health histo"yQ !o test he" "e%ent and long=te"m memo"y #dhesions f"om s$"ge"y %o$ld limit $te"ine g"owth !o assess she %o$ld be alle"gi% to any medi%ation !o dete"mine if she has effe%ti/e heath ins$"an%e

+9 i(a "epo"ts that the palms of he" hands a"e alwa ys it%hy Ao$ noti%e s%"at %hes on them when yo$ do a physi%al e-am Hhat is the most liely %a$se of this finding d$"ing p"egnan%yQ a b % d

She m$st ha/e be%ome alle"gi% to dishwashing soap She has an alle"gy to he" fet$s and will p"obably abo"t ?e" weight gain has st"et%hed the sin o/e" he" hands !his is a %ommon "ea%tion to in%"easing est"ogen le/els

.0 i(a has not had a pel/i% e-am sin%e she was in highs%hool Hhat ad/i%e wo$ld yo$ gi/e he" to help he" "ela- d$"ing he" fi"st p"enatal pel/i% e-amQ a ?a/e he" tae a deep b"eath and hold it d$"ing the e-am b !ell he" to bea" down slightly as the spe%$l$m is inse"ted % Singing o$t lo$d helps& be%a$se this p$shes down the diaph"agm d She sho$ld b"eathe slowly and e/enly d$"ing the e-am .1 i(a has pel/i% meas$"ements taen Hhat si(e sho$ld the is%hial t$be"osity diamete" be to be %onside"ed ade6$ateQ a 5%m b !wi%e the width of the %onE$gate diamete" % 11 %m d ?alf the width of the symphysis p$bis Sit$ation: One of the n$"sing "oles in %a"ing fo" the p"egnant family is p"omoting fetal and mate"nal health .2 Hhi%h statement by 7anna )elgado wo$ ld ale"t yo$ that she needs mo"e tea%h ing abo$t safe p"a%ti% es d$"ing p"egnan%yQ a I tae eithe" a showe" o" t$b bath& be%a$se I now both a"e safeT b I wash my b"easts with %lea" wate"& not with soap dailyT % IKm glad I donKt ha/e to as my boyf"iend to $se %ondoms anymo"eT d IKm wea"ing low=heeled shoes to t"y and a/oid ba%a%heT .+ 7anna des%"ibes he" typi%al day to yo$ Hhat wo$ld ale"t yo$ that she may need f$"the" p"egnan%y ad/i%eQ a I Eog "athe" than wal e/e"y time I %an fo" e-e"%iseT b I always go to sleep on my side& not on my ba%T % I pa% my l$n%h in the mo"ning when IKm not so ti"edT d I wal a"o$nd my des e/e"y ho$" to p"e/ent /a"i%ositiesT


.. a b % d

7anna tells yo$ that she is de/eloping painf$l hemo""hoids #d/i%e yo$ wo$ld gi/e he" wo$ld be: !ae a tablespoon of mine"al oil with ea%h of yo$" meals Omit fibe" f"om yo$" diet !his will p"e/ent %onstipation 'ie on yo$" stoma%h daily to d"ain blood f"om the "e%tal /eins Hit%h ha(el pads feel %ool against swollen hemo""hoids

. 7anna has anle edema by the end of ea%h day Hhi%h statement by he" wo$ld "e/eal that she $nde"stands what %a$ses thisQ a I now this is a beginning %ompli%ationW IKll %all my do%to" tonightT b I $nde"stand this is f"om eating too m$%h saltW IKll "est"i%t that mo"eT % IKll "est in a SimsK position to tae p"ess$"e off lowe" e-t"emity /einsT d IKll wal fo" half an ho$" e/e"y day to "elie/e thisW IKll t"y waling mo"eT

ANSERS #r MATERNIT( NURSING Part 1

@CC@@ C@C@) )#@)C @##)# @#)C) @)@#C #@@)) #C@)) CC#)C

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 

PEDIATRIC NURSING

1 Hhile pe"fo "ming physi%al asse ssment of a 12 month=old& the n$"s e notes that the infantKs ante"io" fontanelle is still slightly open Hhi%h of the following is the n$"seKs most app"op"iate a%tionQ a *otify the physi%ian immediately be%a$se the"e is a p"oblem b Pe"fo"m an intensi/e ne$"ologi% e-amination % Pe"fo"m an intensi/e de/elopmental e-amination d )o nothing be%a$se this is a no"mal finding fo" the age 2 Hhen tea%hing a mothe" abo$t int"od$%ing solid foods to he" %hi ld& whi%h of the fol lowing indi%ates the ea"liest age at whi%h this sho$ld be doneQ a 1 month b 2 months % + months d . months + !he infant of a s$bstan%e=ab$sing mothe" is at "is fo" de/e loping a sense of whi%h of the fol lowingQ a

8 If pa"ents eep a toddle" dependent in a"eas whe"e he is %ap able of $sing sills& the toddle will de/elop a sense of whi%h of the followingQ a
1+

1.

1

15

18

1

a 'a"ge blo%s b )"ess=$p %lothes % Hooden p$((le d @ig wheels Hhi%h of the followin g a%ti/ities& when /oi%ed by the pa"ents follow ing a tea%hing session abo$t the %ha"a%te"isti%s of s%hool=age %ogniti/e de/elopment wo$ld indi%ate the need fo" additional tea%hingQ a Colle%ting baseball %a"ds and ma"bles b O"de"ing dolls a%%o"ding to si(e % Conside"ing simple p"oblem=sol/ing options d )e/eloping plans fo" the f$t$"e # hospitali(ed s%hoolage" states: IKm not af"aid of this pla%e& IKm not af"aid of anythingT !his statement is most liely an e-ample of whi%h of the followingQ a eg"ession b ep"ession % ea%tion fo"mation d ationali(ation #fte" tea%hing a g"o$p of pa"ents abo$t a%%ident p"e/ention fo" s%hoolage"s& whi%h of the following statements by the g"o$p wo$ld indi%ate the need fo" mo"e tea%hingQ a S%hoolage"s a"e mo"e a%ti/e and ad/ent$"o$s than a"e yo$nge" %hild"enT b S%hoolage"s a"e mo"e s$s%eptible to home ha(a"ds than a"e yo$nge" %hild"enT % S%hoolage"s a"e $nable to $nde"stand potential dange"s a"o$nd themT d S%hoola"ge"s a"e less s$bEe%t to pa"ental %ont"ol than a"e yo$nge" %hild"enT Hhi%h of the following sills is the most signifi%ant one lea"ned d$"ing the s%hoolage pe"iodQ a Colle%ting b O"de"ing % eading d So"ting # %hild age 8 was $nable to "e%ei/e the measles& m$mps& and "$bella << /a%%ine at the "e%ommended s%hed$led time Hhen wo$ld the n$"se e-pe%t to administe" << /a%%ineQ a In a month f"om now b In a yea" f"om now % #t age 10 d #t age 1+ !he adoles%entKs inability to de/elop a sense of who he is and what he %an be%ome "es$lts in a sense of whi%h of the followingQ


19

20

21

22

2+

2.

2

25

28

2

a Shame b D$ilt % Infe"io"ity d ole diff$sion Hhi%h of the following wo$ld be most app"op"iate fo" a n$"se to $se when des%"ibing mena"%he to a 1+= yea"=oldQ a # femaleKs fi"st menst"$ation o" menst"$al pe"iodsT b !he fi"st yea" of menst"$ation o" pe"iodT % !he enti"e menst"$al %y%le o" f"om one pe"iodT to anothe" d !he onset of $te"ine mat$"ation o" pea g"owth # 1.=yea"=old boy has a%ne and a%%o"ding to his pa"ents& dominates the bath"oom by $sing the mi""o" all the time Hhi%h of the following "ema"s by the n$"se wo$ld be least helpf$l in taling to the boy and his pa"entsQ a !his is p"obably the only %on%e"n he has abo$t his body So donKt wo""y abo$t it o" the time he spends on itT b !eenage"s a"e an-io$s abo$t how thei" pee"s pe"%ei/e them So they spend a lot of time g"oomingT % # teen may de/elop a poo" self=image when e-pe"ien%ing a%ne )o yo$ feel this way sometimesQT d Ao$ appea" to be eeping yo$" fa%e well washed Ho$ld yo$ feel %omfo"table dis%$ssing yo$" %leansing methodQT Hhi%h of the following sho$ld the n$"se s$spe%t when noting that a +=yea"=old is engagin g in e-pli%it se-$al beha/io" d$"ing doll playQ a !he %hild is e-hibiting no"mal p"e=s%hool %$"iosity b !he %hild is a%ting o$t pe"sonal e-pe"ien%es % !he %hild does not now how to play with dolls d !he %hild is p"obably de/elopmentally delayed Hhi%h of the followi ng statements by the pa"ents of a %hild with s%hool phobi a wo$ld indi%at e the need fo" f$"the" tea%hingQ a HeKll eep him at home $ntil phobia s$bsidesT b HeKll wo" with his tea%he"s and %o$nselo"s at s%hoolT % HeKll t"y to en%o$"age him to tal abo$t his p"oblemT d HeKll dis%$ss possible sol$tions with him and his %o$nselo"T Hhen de/eloping a tea%hing plan fo" a g"o$p of high s%hool st$dents abo$t teenage p"egnan%y& the n$"se wo$ld eep in mind whi%h of the followingQ a !he in%iden%e of teenage p"egnan%ies is in%"easing b

29

+0

+1

+2

++

+.

+

+5

+8

+

+9

b ,n%o$"aging ade6$ate intae of i"on="i%h foods % #ssisting with %oping with %h"oni% illness d #dministe"ing medi%ations /ia I< inEe%tions Hhi%h of the follow ing info"mation& when /oi%ed by the mothe"& wo$l d indi%ate to the n$"se that she $nde"stands home %a"e inst"$%tions following the administ"ation of a diphthe"ia& tetan$s& and pe"t$ssis inEe%tionQ a

.0

.1

.2

.+

..

.

.5

.8

.

.9

0

a Slow to feed self b 'a% of spee%h %

b Pain patte"n % Family histo"y d #bdominal palpation

ANSERS a$% RATIONALES #r PEDIATRIC NURSING

1 D' !he ante"io" fontanelle typi%ally %loses anywhe"e between 12 to 1 months of age !h$s& assessing the ante"io" fontanelle as still being slightly open is a no"mal finding "e6$i"ing no f$"the" a%tion @e%a$se it is

2

+

.



no"mal finding fo" this age& notifying he physi%ian o" pe"fo"ming additional e-aminations a"e inapp"op"iate D' Solid foods a"e not "e%ommended befo"e age . to 5 months be%a$se of the s$%ing "efle- and the immat$"ity of the gast"ointestinal t"a%t and imm$ne system !he"efo"e& the ea"liest age at whi%h to int"od$%e foods is . months #ny time ea"lie" wo$ld be inapp"op"iate A' #%%o"ding to ,"ison& infants need to ha/e thei" needs met %onsistently and effe%ti/ely to de/elop a sense of t"$st #n infant whose needs a"e %onsistently $nmet o" who e-pe"ien%es signifi%ant delays in ha/ing them met& s$%h as in the %ase of the infant of a s$bstan%e=ab$sing mothe"& will de/elop a sense of $n%e"tainty& leading to mist"$st of %a"egi/e"s and the en/i"onment !oddle"s de/elop a sense of shame when thei" a$tonomy needs a"e not met %onsistently P"es%hoole"s de/elop a sense of g$ilt when thei" sense of initiati/e is thwa"ted S%hoolage"s de/elop a sense of infe"io"ity when they do not de/elop a sense of ind$st"y D' # b$sy bo- fa%ilitates the fine moto" de/elopment that o%%$"s between . and 5 months @alloons a"e %ont"aindi%ated be%a$se small %hild"en may aspi"ate balloons @e%a$se the b$tton eyes of a teddy bea" may deta%h and be aspi"ated& this toy is $nsafe fo" %hild"en yo$nge" than + yea"s # =month=old is too yo$ng to $se a p$sh=p$ll toy )' Infants need to ha/e thei" se%$"ity needs met by being held and %$ddled #t 2 months of age& they a"e

$nable to mae the %onne%tion between %"ying and attention !his asso%iation does not o%%$" $ntil late infan%y o" ea"ly toddle"hood 'etting the infant %"y fo" a time befo"e pi%ing $p the infant o" lea/ing the infant alone to %"y he"self to sleep inte"fe"es with meeting the infantKs need fo" se%$"ity at this /e"y yo$ng age Infants %"y fo" many "easons #ss$ming that the %hild s h$ng"y may %a$se o/e"feeding p"oblems s$%h as obesity 5 )' Unde"de/eloped abdominal m$s%$lat$"e gi/es the toddle" a %ha"a%te"isti%ally p"ot"$ding abdomen )$"ing toddle"hood& food intae de%"eases& not in%"eases !oddle"s a"e %ha"a%te"isti%ally bowlegged be%a$se the leg m$s%les m$st bea" the weight of the "elati/ely la"ge t"$n !oddle" g"owth patte"ns o%%$" in a steplie& not linea" patte"n 8 )' #%%o"ding to ,"ison& toddle"s e-pe"ien%e a sense of shame when they a"e not allowed to de/elop app"op"iate independen%e and a$tonomy Infants de/elop mist"$st when thei" needs a"e not %onsistently g"atified P"es%hoole"s de/elop g$ilt when thei" initiati/e needs a"e not met while s%hoolage"s de/elop a sense of infe"io"ity when thei" ind$st"y needs a"e not met  C' Ao$ng toddle"s a"e still senso"imoto" lea"ne"s and they enEoy the e-pe"ien%e of feeling diffe"ent te-t$"es !h$s& finge" paints wo$ld be an app"op"iate toy %hoi%e <$ltiple=pie%e toys& s$%h as p$((le& a"e too diffi%$lt to manip$late and may be ha(a"do$s if the pie%es a"e small eno$gh to be aspi"ated

%a"s also ha/e a high potential fo" aspi"ation Comi% boos a"e on too high a le/el fo" toddle"s #ltho$gh they may enEoy looing at some of the pi%t$"es& toddle"s a"e mo"e liely to "ip a %omi% boo apa"t 9 D' !he %hild m$st be able to sate the need to go to the bath"oom to initiate toilet t"aining Us$ally& a %hild needs to be d"y fo" only 2 ho$"s& not . ho$"s !he %hild also m$st be able to sit& wal& and s6$at # new sibling wo$ld most liely hinde" toilet t"aining 10 A' !oddle"s be%ome pi%y eate"s& e-pe"ien%ing food Eags and eating la"ge amo$nts one day and /e"y little the ne-t # toddle"Ks food gags e-p"ess a p"efe"en%e fo" the "it$alism of eating one type of food fo" se/e"al days at a time !oddle"s typi%ally enEoy so%iali(ation and limiting othe"s at meal time !oddle"s p"efe" to feed themsel/es and th$s a"e too yo$ng to ha/e table manne"s # toddle"Ks appetite and need fo" %alo"ies& p"otein& and fl$id de%"ease d$e to the d"amati% slowing of g"owth "ate 11 D' P"es%hoole"s %ommonly ha/e fea"s of the da"& being left alone espe%ially at bedtime& and ghosts& whi%h may affe%t the %hildKs going to bed at night >$iet play and time with pa"ents is a positi/e bedtime

12

1+

1.

1

15

18

1

"o$tine p"o/ides se%$"ity and also thewill %hild fo" sleep !he%hild %hildassho$ld sleep in his own bed !elling that the %hild abo$t lo%ing him in "eadies his "oom /iewed by the a th"eat #dditionally& a lo%ed doo" is f"ightening and potentially ha(a"do$s 7igo"o$s a%ti/ity at bedtime sti"s $p the %hild and maes mo"e diffi%$lt to fall asleep )' )"ess=$p %lothes enhan%e imaginati/e play and imagination& allowing p"es%hoole"s to engage in "i%h fantasy play @$ilding blo%s and wooden p$((les a"e app"op"iate fo" en%o$"aging fine moto" de/elopment @ig wheels and t"i%y%les en%o$"age g"oss moto" de/elopment D' !he s%hool=aged %hild is in the stage of %on%"ete ope"ations& ma"ed by ind$%ti/e "easoning& logi%al ope"ations& and "e/e"sible %on%"ete tho$ght !he ability to %onside" the f$t$"e "e6$i"es fo"mal tho$ght ope"ations& whi%h a"e not de/eloped $ntil adoles%en%e Colle%ting baseball %a"ds and ma"bles& o"de"ing dolls by si(e& and simple p"oblem=sol/ing options a"e e-amples of the %on%"ete ope"ational thining of the s%hoolage" C' ea%tion fo"mation is the s%hoolage"Ks typi%al defensi/e "esponse when hospitali(ed In "ea%tion fo"mation& e-p"ession of $na%%eptable tho$ghts o" beha/io"s is p"e/ented o" o/e""idden by the e-agge"ated e-p"ession of opposite tho$ghts o" types of beha/io"s eg"ession is seen in toddle"s and p"esh%oole"s when they "et"eat o" "et$"n to an ea"lie" le/el of de/elopment ep"ession "efe"s to the in/ol$nta"y blo%ing of $npleasant feelings and e-pe"ien%es f"om oneKs awa"eness ationali(ation is the attempt to mae e-%$ses to E$stify $na%%eptable feelings o" beha/io"s C' !he s%hoolage"Ks %ogniti/e le/el is s$ffi%iently de/eloped to enable good $nde"standing of and adhe"en%e to "$les !h$s& s%hoolage"s sho$ld be able to $nde"stand the potential dange"s a"o$nd them Hith g"owth %omes g"eate" f"eedom and %hild"en be%ome mo"e ad/ent$"o$s and da"ing !he s%hool=aged %hild is also still p"one to a%%idents and home ha(a"ds& espe%ially be%a$se of in%"eased moto" abilities and independen%e Pl$s the home ha(a"ds diffe" f"om othe" age g"o$ps !hese ha(a"ds& whi%h a"e potentially lethal b$t tempting& may in%l$de fi"ea"ms& al%ohol& and medi%ations S%hool=age %hild"en begin to inte"nali(e thei" own %ont"ols and need less o$tside di"e%tion Pl$s the %hild is away f"om home mo"e often Some pa"ental o" %a"egi/e" assistan%e is still needed to answe" 6$estions and p"o/ide g$idan%e fo" de%isions and "esponsibilities C' !he most signifi%ant sill lea"ned d$"ing the s%hool=age pe"iod is "eading )$"ing this time the %hild de/elops fo"mal ad$lt a"ti%$lation patte"ns and lea"ns that wo"ds %an be a""anged in st"$%t$"e Colle%ti/e& o"de"ing& and so"ting& altho$gh impo"tant& a"e not most signifi%ant sills lea"ned C' @ased on the "e%ommendations of the #me"i%an #%ademy of Family Physi%ians and the #me"i%an #%ademy of Pediat"i%s& the << /a%%ine sho$ld be gi/en at the age of 10 if the %hild did not "e%ei/e it between the ages of . to 5 yea"s as "e%ommended Imm$ni(ation fo" diphthe"ia and tetan$s is "e6$i"ed at age 1+ D' #%%o"ding to ,"ison& "ole diff$sion de/elops when the adoles%ent does not de/elop a sense of identity

and a sense o" whe"e he fits in !oddle"s de/elop a sense of shame when they do not a%hie/e a$tonomy P"es%hoole"s de/elop a sense of g$ilt when they do not de/elop a sense of initiati/e S%hool=age %hild"en de/elop a sense of infe"io"ity when they do not de/elop a sense of ind$st"y 19 A'

22 A' !he pa"ents need mo"e tea%hing if they state that they will eep the %hild home $ntil the phobia

2+

2.

2

25 28

2

29

+0

+1

s$bsides )oing so "einfo"%es the %hildKs feelings of wo"thlessness and dependen%y !he %hild sho$ld attend s%hool e/en d$"ing "esol$tion of the p"oblem #llowing the %hild to /e"bali(e helps the %hild to /entilate feelings and may help to $n%o/e" %a$ses and sol$tions Collabo"ation with the tea%he"s and %o$nselo"s at s%hool may lead to $n%o/e"ing the %a$se of the phobia and to the de/elopment of sol$tions !he %hild sho$ld pa"ti%ipate and play an a%ti/e "ole in de/eloping possible sol$tions C' !he adoles%ent who be%omes p"egnant typi%ally denies the p"egnan%y ea"ly on ,a"ly "e%ognition by a pa"ent o" health %a"e p"o/ide" may be %"$%ial to timely initiation of p"enatal %a"e !he in%iden%e of adoles%ent p"egnan%y has de%lined sin%e 1991& yet mo"bidity "emains high
when the mothe" wo$ld i% a %hai" o" bang the doo" sh$t ep"ession is the s$bme"ging of painf$l ideas into the $n%ons%io$s Psy%hosis is a state of being o$t of to$%h with "eality +2 A' Child"en with %ongenital hea"t disease a"e mo"e p"one to "espi"ato"y infe%tions @leeding tenden%ies& f"e6$ent /omiting& and dia""hea and sei($"e diso"de"s a"e not asso%iated with %ongenital hea"t disease ++ D' !he %hild is e-hibiting %lassi% signs of epiglottitis& always a pediat"i% eme"gen%y !he physi%ian m$st be notified immediately and the n$"se m$st be p"epa"ed fo" an eme"gen%y int$bation o" t"a%heostomy F$"the" assessment with a$s%$ltating l$ngs and pla%ing the %hild in a mist tent wastes /al$able time !he sit$ation is a possible life=th"eatening eme"gen%y ?a/ing the %hild lie down wo$ld %a$se additional dist"ess and may "es$lt in "espi"ato"y a""est !h"oat e-amination may "es$lt in la"yngospasm that %o$ld be fatal +. A' In females& the $"eth"a is sho"te" than in males !his de%"eases the distan%e fo" o"ganisms to t"a/el& the"eby in%"easing the %han%e of the %hild de/eloping a $"ina"y t"a%t infe%tion F"e6$ent emptying of the bladde" wo$ld help to de%"ease $"ina"y t"a%t infe%tions by a/oiding sphin%te" st"ess In%"eased fl$id intae enables the bladde" to be %lea"ed mo"e f"e6$ently& th$s helping to p"e/ent $"ina"y t"a%t infe%tions !he intae of a%idi% E$i%es helps to eep the $"ine p? a%idi% and th$s de%"ease the %han%e of flo"a de/elopment


+ )' Compa"tment synd"ome is an eme"gent sit$ation and the physi%ian needs to be notified immediately so that inte"/entions %an be initiated to "elie/e the in%"easing p"ess$"e and "esto"e %i"%$lation #%etaminophen !ylenol will be ineffe%ti/e sin%e the pain is "elated to the in%"easing p"ess$"e and tiss$e is%hemia !he %ast& not t"a%tion& is being $sed in this sit$ation fo" immobili(ation& so "eleasing the t"a%tion wo$ld be inapp"op"iate In this sit$ation& spe%ifi% a%tion not %ontin$ed monito"ing is indi%ated +5 D' !he /a"i%ella (oste" /a%%ine 7J7 is a li/e /a%%ine gi/en afte" age 12 months !he fi"st dose of hepatitis @ /a%%ine is gi/en at bi"th to 2 months& then at 1 to . months& and then again at 5 to 1 months )taP is "o$tinely gi/en at 2& .& 5& and 1 to 1 months and a booste" at . to 5 yea"s +8 C' @e%a$se the =month=old is "efining his g"oss moto" sills& being able to sit $ns$ppo"ted and also imp"o/ing his fine moto" sills& p"obably %apable of maing hand=to=hand t"ansfe"s& la"ge blo%s wo$ld be the most app"op"iate toy sele%tion P$sh=p$ll toys wo$ld be mo"e app"op"iate fo" the 10 to 12=month= old as he o" she begins to %"$ise the en/i"onment attles and mobiles a"e mo"e app"op"iate fo" infants in 1 to + month age "ange
+9

.0

.1

.2

.+

..

.

.5

.8

.

.9

0

of initiati/e )$"ing this pe"iod& the %hild %ommonly e-pe"ien%es mo"e fea"s than at any othe" time One %ommon fea" is fea" of the body m$tilation& espe%ially asso%iated with painf$l e-pe"ien%es !he p"es%hool %hild $ses simple& not %omple-& "easoning& engages in asso%iati/e& not %ompetiti/e& play inte"a%ti/e and %oope"ati/e play with sha"ing& and is able to tole"ate longe" pe"iods of delayed g"atifi%ation A' 0 to 80 !ypi%ally& the %hild is not noted as being "eta"ded& b$t e-hibits slowness in pe"fo"ming tass& s$%h as self=feeding& waling& and taing 'ittle o" no spee%h& ma"ed moto" delays& and gait disabilities wo$ld be seen in mo"e se/e"e fo"ms mental "eta"dation ) )own synd"ome is %ha"a%te"i(ed by the following a t"ans/e"se palma" %"ease simian %"ease& sepa"ated sagittal s$t$"e& obli6$e palpeb"al fiss$"es& small nose& dep"essed nasal b"idge& high=a"%hed palate& e-%ess and la- sin& wide spa%ing and planta" %"ease between the se%ond and big toes& hype"e-tensible and la- Eoints& la"ge p"ot"$ding tong$e& and m$s%le weaness A' @e%a$se of the defe%t& the %hild will be $nable to f"om the mo$th ade6$ately a"o$nd nipple& the"eby "e6$i"ing spe%ial de/i%es to allow fo" feeding and s$%ing g"atifi%a tion espi"ato"y stat$s may be %omp"omised if the %hild is fed imp"ope"ly o" d$"ing postope"ati/e pe"iod& 'o%omotion wo$ld be a p"oblem fo" the olde" infant be%a$se of the $se of "est"aints DI f$n%tioning is not %omp"omised in the %hild with a %left lip )' Postope"ati/ely %hild"en with %left palate sho$ld be pla%ed on thei" abdomens to fa%ilitate d"ainage If the %hild is pla%ed in the s$pine position& he o" she may aspi"ate Using an infant seat does not fa%ilitate d"ainage Side=lying does not fa%ilitate d"ainage as well as the p"one position C' P"oEe%tile /omiting is a ey symptom of pylo"i% stenosis eg$"gitation is seen mo"e %ommonly with D, Steato""hea o%%$"s in malabso"ption diso"de"s s$%h as %elia% disease C$""ant EellyT stools a"e %ha"a%te"isti% of int$ss$s%eption D' D, is the ba%flow of gast"i% %ontents into the esophag$s "es$lting f"om "ela-ation o" in%ompeten%e of the lowe" esophageal %a"dia% sphin%te" *o alte"ation in the o"al m$%o$s memb"anes o%%$"s with this diso"de" Fl$id /ol$me defi%it& "is fo" aspi"ation& and alte"ed n$t"ition a"e app"op"iate n$"sing diagnoses A' !hi%ened feedings a"e $sed with D, to stop the /omiting !he"efo"e& the n$"se wo$ld monito" the %hildKs /omiting to e/al$ate the effe%ti/eness of $sing the thi%ened feedings *o "elationship e-ists between feedings and %ha"a%te"isti%s of stools and $te"ine If feedings a"e ineffe%ti/e& this sho$ld be noted befo"e the"e is any %hange in the %hildKs weight C' Child"en with %elia% disease %annot tole"ate o" digest gl$ten !he"efo"e& be%a$se of its gl$ten %ontent& wheat and wheat=%ontaining p"od$%ts m$st be a/oided i%e& mil& and %hi%en do not %ontain gl$ten and need not be a/oided C' ,pisodes of %elia% %"ises a"e p"e%ipitated by infe%tions& ingestion of gl$ten& p"olonged fasting& o" e-pos$"e to anti%holine"gi% d"$gs Celia% %"isis is typi%ally %ha"a%te"i(ed by se/e"e wate"y dia""hea espi"ato"y dist"ess is $nliely in a "o$tine $ppe" "espi"ato"y infe%tion I""itability& "athe" than letha"gy& is mo"e liely @e%a$se of the fl$id loss asso%iated with the se/e"e wate"y dia""hea& the %hildKs weight is mo"e liely to be de%"eased A' Fo" the %hild with ?i"s%hsp"$ng disease& fe/e" and e-plosi/e dia""hea indi%ate ente"o%olitis& a life= th"eatening sit$ation !he"efo"e& the physi%ian sho$ld be notified immediately Dene"ally& be%a$se of the intestinal obst"$%tion and inade6$ate p"op$lsi/e intestinal mo/ement& antidia""heals a"e not $sed to t"eat ?i"s%hsp"$ng disease !he %hild is a%$tely ill and "e6$i"es inte"/ention& with monito"ing mo"e f"e6$ently than e/e"y +0 min$tes ?i"s%hsp"$ng disease typi%ally p"esents with %h"oni% %onstipation A Fail$"e to pass me%oni$m within the fi"st 2. ho$"s afte" bi"th may be an indi%ation of ?i"s%hsp"$ng disease& a %ongenital anomaly "es$lt ing in me%hani%al obst"$%tion d$e to inade6$ate motility in an intestinal segment Fail$"e to pass me%oni$m is not asso%iated with %elia% disease& int$ss$s%eption& o" abdominal wall defe%t C @e%a$se int$ss$s%eption is not belie/ed to ha/e a familial tenden%y& obtaining a family histo"y wo$ld p"o/ide the least amo$nt of info"mation Stool inspe%tion& pain patte"n& and abdominal palpation wo$ld "e/eal possible indi%ato"s of int$ss$s%eption C$""ent& Eelly=lie stools %ontaining blood and m$%$s a"e an


indi%ation of int$ss$s%eption #%$te& episodi% abdominal pain is %ha"a%te"isti%s of int$ss$s%eption # sa$sage=shaped mass may be palpated in the "ight $ppe" 6$ad"ant


COMMUNIT( HEALTH NURSING Part 1

SI!U#!IO* : ,pidemiology and 7ital statisti%s is a /e"y impo"tant tool that a n$"se %o$ld $se in %ont"olling the sp"ead of disease in the %omm$nity and at the same time& s$"/eying the impa%t of the disease on the pop$lation and p"e/ent itKs f$t$"e o%%$""en%e 1 It is %on%e"ned with the st$dy of fa%to"s that infl$en%e the o%%$""en%e and dist"ib$tion of diseases& defe%ts& disability o" death whi%h o%%$"s in g"o$ps o" agg"egation of indi/id$als A' E*i%!6i#+# @ )emog"aphi%s C 7ital Statisti%s ) ?ealth Statisti%s

2 Hhi%h of the following is the ba%bone in disease p"e/entionQ A' E*i%!6i#+# @ )emog"aphi%s C 7ital Statisti%s ) ?ealth Statisti%s

C #%tion esea"%h ) #pplied esea"%h . #n o$tb"ea of measles has been "epo"ted in Comm$nity # #s a n$"se& whi%h of the following is yo$" fi"st a%tion fo" an ,pidemiologi%al in/estigationQ # Classify if the o$tb"ea of measles is epidemi% o" E$st spo"adi% @ epo"t the in%iden%e into the ?U C )ete"mine the fi"st day when the o$tb"ea o%%$""ed D' I%!$ti i it is t/! %is!as! -/i"/ it is r!*#rt!% t# 7!  #fte" the epidemiologi%al in/estigation p"od$%ed final %on%l$sions& whi%h of the following is yo$" initial step in yo$" ope"ational p"o%ed$"e d$"ing disease o$tb"eaQ

+ Hhi%h of the following type of "esea"%h %o$ld show how %omm$nity e-pe%tations %an "es$lt in the a%t$al p"o/ision of se"/i%esQ

A' C##r%i$at! *!rs#$$!+ r#6 M0$i"i*a+ t# t/! Nati#$a+ +!8!+ @ Colle%t pe"tinent labo"ato"y spe%imen to %onfi"m disease %a$sation C Imm$ni(e nea"by %omm$nities with
# @asi% esea"%h )' O*!rati#$a+ R!s!ar"/

5 !he main %on%e"n of a p$bli% health n$"se is the p"e/ention of disease& p"olonging of life and


p"omoting physi%al health and effi%ien%y th"o$gh whi%h of the followingQ # Use of epidemiologi%al tools and /ital health statisti%s @ )ete"mine the sp"ead and o%%$""en%e of the disease C Politi%al empowe"ment and So%io ,%onomi% #ssistan%e D' Ora$i9!% C#660$it E#rts 8 In o"de" to %ont"ol a disease effe%ti/ely& whi%h of the following m$st fi"st be nownQ 1 !he %onditions s$""o$nding its o%%$""en%e 2 Fa%to"s that do not fa/o" its de/elopment + !he %ondition that do not s$""o$nd its o%%$""en%e . Fa%to"s that fa/o"s its de/elopment # 1 and + )' 1 a$% 4 C 2 and + ) 2 and .  #ll of the following a"e $ses of epidemiology e-%ept: # !o st$dy the histo"y of health pop$lation and the "ise and fall of disease @ !o diagnose the health of the %omm$nity and the %ondition of the people C' T# *r#8i%! s066ar %ata #$ /!a+t/ s!r8i"! %!+i8!r ) !o identify g"o$ps needing spe%ial attention 9 @efo"e "epo"ting the fa%t of p"esen%e of an epidemi%& whi%h of the following is of most impo"tan%e to dete"mineQ A' Ar! t/! a"ts "#6*+!t!: @ Is the disease "ealQ C Is the disease tangibleQ ) Is it epidemi% o" endemi%Q

# .&1&+&&2&5 )' 4,1,5,;,3,2 C &.&5&2&1&+ ) &.&5&1&2&+ , 1&2&+&.&&5 11 In the o%%$""en%e of S#S and othe" pandemi%s& whi%h of the following is the most /ital "ole of a n$"se in epidemiologyQ # ?ealth p"omotion @ )isease p"e/ention C' S0r8!i++a$"! ) Casefinding 12
10 #n $nnown epidemi% has E$st been "epo"ted in @a"angay )eb$deb$ People said that affe%ted pe"son demonst"ates hemo""hagi% type of fe/e" Ao$ a"e designated now to plan fo" epidemiologi%al in/estigation #""ange the se6$en%e of e/ents in a%%o"dan%e with the %o""e%t o$tline plan fo" epidemiologi%al in/estigation

A' La7#rat#r Dia$#sis @ S$"/eillan%e of disease o%%$""en%e C Follow $p %ases and %onta%ts ) efe" %ases to hospitals if ne%essa"y , Isolate %ases of %omm$ni%able disease

1 epo"t the p"esen%e of deng$e 2 S$mma"i(e data and %on%l$de the final pi%t$"e of epidemi% + elate the o%%$""en%e to the pop$lation g"o$p& fa%ilities& food s$pply and %a""ie"s . )ete"mine if the disease is fa%t$al o" "eal  )ete"mine any $n$s$al p"e/alen%e of the disease and its nat$"eW is it epidemi%& spo"adi%& endemi% o" pandemi%Q 5 )ete"mine onset and the geog"aphi%al limitation of the disease

# O"ientation and demonst"ation of methodology to be employed @ #"ea assignments of team membe"s C Che% teamKs e6$ipments and pa"aphe"nalia D' A"ti8! "as! i$%i$ a$% S0r8!i++a$"!

1. #ll of the following a"e pe"fo"med in team o"gani(ation e-%ept

1 Hhi%h of the following is the final o$tp$t of data "epo"ting in epidemiologi%al ope"ational p"o%ed$"eQ A' R!"#66!$%ati#$


@ ,/al$ation C Final epo"t ) P"elimina"y "epo"t

C @"ing 'estat to the nea"est pediat"i% %lini% D' Ca++ a Ta
15 !he offi%e in %ha"ge with "egiste"ing /ital fa%ts in the Philippines is none othe" than the

2+ )eeEay wo$ld s$spe%t whi%h diso"de"Q

# PCSO @ P#DCO C )O? D' NSO

# !"isomy 21 @ !$"ne"s Synd"ome C' Cri D0 C/at ) linefelte"s Synd"ome

18 !he following a"e possible so$"%es of )ata e-%ept:

2. )eeEay %o$ld e-pe%t whi%h of the following %ongenital anomaly that wo$ld a%%ompany this diso"de"Q

A' E<*!ri!$"! @ Cens$s C S$"/eys ) esea"%h

A' AVSD @ P)# C !OF ) !OD7

1 !his "efe"s to systemati% st$dy of /ital e/ents s$%h as bi"ths& illnesses& ma""iages& di/o"%es and deaths

25 Hhi%h p"esidential de%"ee o"de"s "epo"ting of bi"ths within +0 days afte" its o%%$""en%eQ

# ,pidemiology @ )emog"aphi%s C' Vita+ Statisti"s ) ?ealth Statisti%s

A' ;51 @ .1 C 995 ) 2

19 In %ase of %le"i%al e""o"s in yo$" bi"th

2 !hese "ates a"e "efe""ed to the total li/ing pop$lation& It m$st be p"es$med that the total

%e"tifi%ate& Hhe"e sho$ld yo$ go to ha/e it %o""e%tedQ

pop$lation was e-posed to the "is of o%%$""en%e of the e/ent

# *SO @ Co$"t of #ppeals C <$ni%ipal !"ial Co$"t D' L#"a+ Ci8i+ R!istrar

# ate @ atio C' Cr0%!=G!$!ra+ Rat!s ) Spe%ifi% ate

20 #%asia E$st ga/e bi"th to 'estat& # healthy baby boy Hho a"e going to "epo"t the bi"th of @aby 'estatQ

25 !hese a"e $sed to des%"ibe the "elationship between two n$me"i%al 6$antities o" meas$"es of e/ents witho$t taing pa"ti%$la" %onside"ations to the time o" pla%e

# *$"se @
22 )eeEay& !he bi"th attendant noti%ed that 'estat has low set of ea"s&
# ate )' Rati#s C C"$deGDene"al ate ) Spe%ifi% ate 28 !his is the most sensiti/e inde- in dete"mining the gene"al health %ondition of a %omm$nity sin%e it "efle%ts the %hanges in the en/i"onment and medi%al %onditions of a %omm$nity # C"$de death "ate )' I$a$t 6#rta+it rat! C

@ Pne$monia C )ia""hea ) ?I7G#I)S 29 In the Philippines& what is the most %ommon %a$se of death of infants a%%o"ding to the latest s$"/eyQ # Pne$monia @ )ia""hea C' Ot/!r *!ri$ata+ "#$%iti#$ ) espi"ato"y %ondition of fet$s and newbo"n +0 !he maEo" %a$se of mo"tality f"om 1999 $p to 2002 in the Philippines a"e

following data in yea" 2005 1 B$ly 1 pop$lation : 2.&+15 2 'i/ebi"ths : 2&29 + )eaths f"om mate"nal %a$se : 1 . )eath f"om C7) : +&029  )eaths $nde" 1 yea" of age : 2+ 5 Fetal deaths :  8 )eaths $nde" 2 days :   )eath d$e to "abies : . 9 egiste"ed %ases of "abies : . 10 People with pne$monia : 89 11 People e-posed with pne$monia : 2&9+ 12 !otal n$mbe" of deaths f"om all %a$ses : 10&99

A' Dis!as!s # t/! /!art @ )iseases of the /as%$la" system C Pne$monias ) !$be"%$losis

!he following 6$estions "efe" to these data

+1 #li%ia& a 9 yea" old %hild ased yo$  Hhat is the %ommon %a$se of death in my age g"o$p he"e in the PhilippinesQ  !he n$"se is %o""e%t if he will answe"

# 90G100&000 @ 9G100 C 90G1000 D' >=1???

# Pne$monia is the top leading %a$se of death in %hild"en age  to 9 @
+5 Hhat is the %a$se spe%ifi% death "ate f"om %a"dio/as%$la" diseasesQ

C' Pr#7a7i+it -is!, (#0 6i/t %i! %0! t# a""i%!$ts ) )iseases of the "espi"ato"y system is the most %ommon %a$se of death in %hild"en

)' 11>1=1??,??? C 28G100&000 ) 11G1000

+2 In %hild"en 1 to . yea"s old& whi%h is the most %ommon %a$se of deathQ # )ia""hea @ #%%idents C' P$!06#$ia ) )iseases of the hea"t

+ Hhat is the %"$de bi"th "ate of @a"angay Pinoy@S*Q

# 28G100

+8 Hhat is the
+ Hhat is the fetal death "ateQ ++ Ho"ing in the %omm$nity as a P?* fo" almost 10 yea"s& #ida new the fl$%t$ation in /ital statisti%s She new that the most %ommon %a$se of mo"bidity among the Filipinos is # )iseases of the hea"t @ )ia""hea C' P$!06#$ia ) 7as%$la" system diseases +. *$"se #ida also new that most mate"nal deaths a"e %a$sed by

A' 3'4>=1??? @ 100.G1000 C +1.G1000 ) +1.G100&000

+9 Hhat is the atta% "ate of pne$moniaQ # +0.G1000 @ 81G1000 C +22G100 D' 3'?4=1??

# ?emo""hage )' Ot/!r C#6*+i"ati#$s r!+at!% t# *r!$a$" #""0rri$ i$ t/! "#0rs! # +a7#r, %!+i8!r a$% *0!r*!ri06 C ?ype"tension %ompli%ating p"egnan%y& %hildbi"th and p$e"pe"i$m ) #bo"tion

.0 )ete"mine the Case fatality "atio of "abies in this @a"angay

SI!U#!IO* : @a"angay Pinoy@S* has the

.1 !he following a"e all f$n%tions of the n$"se

# 1G100 )' 1??@ C 1V ) 100G1000


in /ital statisti%s& whi%h of the following is notQ A' C#$s#+i%at! Data @ Colle%ts )ata C #naly(e )ata ) !ab$late )ata

.2 !he following a"e *otifiable diseases that needs to ha/e a tally sheet in data "epo"ting& Hhi%h one is notQ # ?ype"tension @ @"on%hiolitis C Chemi%al Poisoning D' A""i%!$ts .+ Hhi%h of the following "e6$i"es "epo"ting within 2. ho$"sQ # *eonatal tetan$s )' M!as+!s C ?ype"tension ) !etan$s .. Hhi%h #%t de%la"ed that all %omm$ni%able disease be "epo"ted to the nea"est health stationQ # 102 @ 191 C' 353

@ !he disease is $s$ally %a$sed by %ontaminated food C' T/!r! is a ra%0a+ i$"r!as! # "as!s ) ,pidemi% is $s$ally s$dden .9 !he only
) 558

,-%ept

. In the ?U !eam& Hhi%h p"ofessional is di"e%tly "esponsible in %a"ing a si% pe"son who is homebo$ndQ

A' T# "#6*+!t! t/! "+i$i"a+ *i"t0r! # "/r#$i" %is!as! a$% %!s"ri7! t/!ir $at0ra+ /ist#r @ !o p"o/ide standa"di(ed& fa%ility le/el data base whi%h %an be a%%essed fo" mo"e in depth st$dies C !o minimi(e "e%o"ding and "epo"ting b$"den allowing mo"e time fo" patient %a"e and p"omoti/e a%ti/ities ) !o ens$"e that data "epo"ted a"e $sef$l and a%%$"ate and a"e disseminated in a timely and easy to $se fashion

A' Mi%-i! @ *$"se C @?H ) Physi%ian

.5 )$"ing epidemi%s& whi%h of the following epidemiologi%al f$n%tion will yo$ ha/e to pe"fo"m fi"stQ # !ea%hing the %omm$nity on disease p"e/ention @ #ssessment on s$spe%ted %ases C
2 Hhat is the f$ndamental blo% o" fo$ndation of the field health se"/i%e info"mation systemQ A' Fa6i+ tr!at6!$t r!"#r% @ !a"get Client list C epo"ting fo"ms ) O$tp$t "e%o"d

.8 Hhi%h of the following is a POI*! SOUC, epidemi%Q

+ Hhat is the p"ima"y ad/antage of ha/ing a ta"get %lient listQ

# )eng$e ?F @
A' N0rs!s $!!% $#t t# # 7a"B t# FTR t# 6#$it#r tr!at6!$t a$% s!r8i"!s t# 7!$!i"iari!s t/0s sa8i$ ti6! a$% !#rt @ ?elp monito" se"/i%e "ende"ed to %lients in gene"al C Fa%ilitate monito"ing and s$pe"/ision of se"/i%es ) Fa%ilitates easie" "epo"ting

. #ll b$t one is a %ha"a%te"isti% of a point so$"%e epidemi%& whi%h one is notQ # !he sp"ead of the disease is %a$sed by a %ommon /ehi%le

. Hhi%h of the following is $sed to monito"


pa"ti%$la" g"o$ps that a"e 6$alified as eligible to a %e"tain p"og"am of the )O?Q # Family t"eatment "e%o"d )' Tar!t C+i!$t +ist C epo"ting fo"ms ) O$tp$t "e%o"d

52 In p"epa"ing the mate"nal death "epo"t& whi%h of the following %o""e%tly %odes this o%%$""en%eQ # F?SISG,=1 )' FHSIS=E2 C F?SISG,=+ ) F?SISG<=1

 In $sing the tally sheet& what is the "e%ommended f"e6$en%y in tallying a%ti/ities and se"/i%esQ

5+ Hhe"e sho$ld *$"se @$de b"ing the "epo"ting fo"ms if he is in the @?U Fa%ilityQ

A' Dai+ @ Heely C $a"te"ly

# $"al health offi%e @ F?SIS
5 Hhen is the %o$nting of the tally sheet doneQ

5. #fte" b"inging the "epo"ting fo"ms in the "ight fa%ility fo" p"o%essing& *$"se @$de new that the o$tp$t "epo"ts a"e solely p"od$%ed by what offi%eQ

# #t the end of the day @ #t the end of the wee C' At t/! !$% # t/! 6#$t/ ) #t the end of the yea" 8 !a"get %lient list will be t"ansmitted to the ne-t fa%ility in the fo"m of

# $"al health offi%e @ F?SIS
# Family t"eatment "e%o"d @ !a"get Client list C' R!*#rti$ #r6s

5
) O$tp$t "e%o"d

is se/e"ely malno$"ished and anemi% Hhat "e%o"d sho$ld yo$ get fi"st to do%$ment these findingsQ

 #ll b$t one of the following a"e eligible ta"get %lient list # 'ep"osy %ases @ !@ %ases C P"enatal %a"e D' Diarr/!a "as!s 9 !his is the only me%hanism th"o$gh whi%h data a"e "o$tinely t"ansmitted f"om on%e fa%ility to anothe" # Family t"eatment "e%o"d @ !a"get Client list C' R!*#rti$ #r6s ) O$tp$t "e%o"d

A' Fa6i+ tr!at6!$t r!"#r% @ !a"get Client list C epo"ting fo"ms ) O$tp$t "e%o"d

55 !he info"mation abo$t
50 F?SISG>=+ O" the "epo"t fo" en/i"onmental health a%ti/ities is p"epa"ed how f"e6$entlyQ

58 #nothe" ent"y is to be made fo"
# )aily @ Heely C' 0art!r+ ) Aea"ly

# !C' ,ligible Pop$lation @ !C' Family Planning C' TCL N0triti#$ ) !C' P"e *atal

51 *$"se @$de is p"epa"ing the "epo"ting fo"m fo" weely notifiable diseases ?e new that he will %ode the "epo"t fo"m as

5 !he n$"se $ses the F?SIS e%o"d system in%o""e%tly when she fo$nd o$t that

# F?SISG,=1 @ F?SISG,=2 C F?SISG,=+ D' FHSIS=M1

# She go to the indi/id$al o" F! fo" ent"y %onfi"mation in the !allyGepo"t S$mma"y )' S/! r!!r t# #t/!r s#0r"!s #r "#6*+!ti$ 6#$t/+ a$% 0art!r+ r!*#rts C She "e%o"ds dia""hea in the !ally sheetGepo"t


fo"m with a %ode F?SISG<=1 ) She "e%o"ds a Child who ha/e f"e6$ent dia""hea in !C' : Unde" Fi/e 59 !he @?S Is the lowest le/el of "epo"ting $nit in F?SIS # @?S %an be %onside"ed a "epo"ting $nit if all of the following a"e met e-%ept # It "ende"s se"/i%e to + ba"angays @ !he"e is a midwife the "eg$la"ly "ende"s se"/i%e to the a"ea C !he @?S ?a/e no mothe" @?S D' It s/#0+% 7! a sat!++it! )HS 80 )ata s$bmitted to the P?O is p"o%essed $sing what type of te%hnologyQ # Inte"net )' Mi"r#"#6*0t!r C S$pe"%omp$te" ) Se"/e" Inte"lin Conne%tions

as leade"s 8 Hhi%h of the following dwelling pla%e sho$ld the *$"se %hoose when integ"ating with the peopleQ # # simple ho$se in the bo"de" of @a"angay @a"itan and San Pablo @ # simple ho$se with fen%ing and gate lo%ated in the %ente" of @a"angay @a"itan C # modest dwelling pla%e whe"e people will not hesitate to ente" D' A 6#%!st %-!++i$ *+a"! -/!r! *!#*+! -i++ $#t /!sitat! t# !$t!r +#"at!% i$ t/! "!$t!r # t/! "#660$it 85 In %hoosing a leade" in the %omm$nity d$"ing the O"gani(ational phase& Hhi%h among these people will yo$ %hooseQ

SI!U#!IO* : Comm$nity o"gani(ing is a p"o%ess by whi%h people& health se"/i%es and agen%ies of the %omm$nity a"e b"o$ght togethe" to a%t and sol/e thei" own p"oblems

#
81
88 Hhi%h type of leade"ship style sho$ld the leade"s of the %omm$nity p"a%ti%eQ

# Di/e good ad/i%e to
# #$to%"ati% )' D!6#"rati" C 'aisse( Fai"e ) Cons$ltati/e

82 #s a newly appointed P?* inst"$%ted to o"gani(e @a"angay @a"itan& Hhi%h of the following is yo$" initial step in o"gani(ing the %omm$nity fo" initial a%tionQ

8 Setting $p Committee on ,d$%ation and !"aining is in what phase of COP#Q

A' St0% t/! )ara$a H!a+t/ statisti"s a$% r!"#r%s @
8+ P"epa"ato"y phase is the fi"st phase in o"gani(ing the %omm$nity Hhi%h of the following is the initial step in the p"epa"ato"y phaseQ A' Ar!a s!+!"ti#$ @ Comm$nity p"ofiling C ,nt"y in the %omm$nity ) Integ"ation with the people

8. the most impo"tant fa%to" in dete"mining the p"ope" a"ea fo" %omm$nity o"gani(ing is that this a"ea sho$ld # @e al"eady adopted by anothe" o"gani(ation @ @e able to finan%e the p"oEe%ts C' Ha8! *r#7+!6s a$% $!!%s assista$"! ) ?a/e people with e-pe"tise to be de/eloped

# P"epa"ato"y )' Ora$i9ati#$a+ C ,d$%ation and !"aining ) Inte"se%to"al Collabo"ation , Phase o$t 89 Comm$nity diagnosis is done to %ome $p with a p"ofile of lo%al health sit$ation that will se"/e as basis of health p"og"ams and se"/i%es !his is done in what phase of COP#Q # P"epa"ato"y @ O"gani(ational C' E%0"ati#$ a$% Trai$i$ ) Inte"se%to"al Collabo"ation , Phase o$t 0 !he people named the %omm$nity health wo"e"s based on the %olle%ti/e de%ision in a%%o"dan%e with the set %"ite"ia @efo"e they %an be t"ained by the *$"se& !he *$"se m$st fi"st #

1 *$"se @$de w"ote a lette" to PCSO asing them fo" assistan%e in thei" feeding p"og"ams fo" the %omm$nityKs n$t"ition and health p"oEe%ts PCSO then app"o/ed the "e6$est and ga/e @$de 0&000 Pesos and a t"$%load of "i%e& f"$its and /egetables Hhi%h phase of COP# did @$de $tili(edQ # P"epa"ato"y @ O"gani(ational C ,d$%ation and !"aining D' I$t!rs!"t#ra+ C#++a7#rati#$ , Phase o$t 2 Ideally& ?ow many yea"s sho$ld the *$"se stay in the %omm$nity befo"e he %an phase o$t and be ass$"ed of a Self eliant %omm$nityQ A' 5 !ars @ 10 yea"s C 1 yea" ) 5 months

+
C D"o$nd Ho" )
SI!U#!IO* : ?ealth ed$%ation is the p"o%ess whe"eby nowledge& attit$de and p"a%ti%e of people a"e %hanged to imp"o/e indi/id$al& family and %omm$nity health 91 Hhi%h of the following is the %o""e%t se6$en%e in health ed$%ationQ 1 Info"mation 2 Comm$ni%ation + ,d$%ation A' 1,2,3 @ +&2&1 C 1&+&2 ) +&1&2

92 !he health stat$s of the people is g"eatly affe%ted and dete"mined by whi%h of the


followingQ # @eha/io"al fa%to"s )' S#"i#!"#$#6i" a"t#rs C Politi%al fa%to"s ) Psy%hologi%al fa%to"s

inst"$%tions )' M#ti8ati#$ t# 7! s6*t#6 r!! C #bility of the patient to $nde"stand tea%hing inst"$%tion ) 'ang$age $sed by the n$"se

9+ *$"se @$de is %ond$%ting a health tea%hing to #gnesia& 0 yea" old b"east %an%e" s$"/i/o" needing "ehabilitati/e meas$"es ?e nows that health ed$%ation is effe%ti/e when

98 #n impo"tant sill that a p"imig"a/ida has to a%6$i"e is the ability to bathe he" newbo"n baby and %lean he" b"east if she de%ides to b"eastfeed he" baby& Hhi%h of the following lea"ning domain will yo$ %lassify the abo/e goalsQ

# #gnesia "e%ites the p"o%ed$"e and inst"$%tions

A' Ps"/#6#t#r

pe"fe%tly )' A$!sia.s 7!/a8i#r a$% #0t+##B i$ +i! -as "/a$!% *#siti8!+ C #gnesia ga/e feedba% to @$de saying that she $nde"stood the inst"$%tion ) #gnesia "e6$ested a w"itten inst"$%tion f"om @$de

@ Cogniti/e C #ffe%ti/e ) #ttit$dinal

9. Hhi%h of the following is t"$e abo$t health ed$%ationQ # It helps people attain thei" health th"o$gh the n$"seKs sole effo"ts @ It sho$ld not be fle-ible C It is a fast and m$sh"oom lie p"o%ess D' It is a s+#- a$% "#$ti$0#0s *r#"!ss 9 Hhi%h of the following fa%to"s least infl$en%e the lea"ning "eadiness of an ad$lt lea"ne"Q A' T/! i$%i8i%0a+s sta! # %!8!+#*6!$t @ #bility to %on%ent"ate on info"mation to be lea"ned C !he indi/id$alKs psy%hoso%ial adaptation to his illness ) !he inte"nal imp$lses that d"i/e the pe"son to tae a%tion

95 Hhi%h of the following is the most impo"tant %ondition fo" diabeti% patients to lea"n how to %ont"ol thei" dietQ # Use of pamphlets and othe" mate"ials d$"ing

9 Hhen yo$ p"epa"e yo$" tea%hing plan fo" a g"o$p of hype"tensi/e patients& yo$ fi"st fo"m$late yo$" lea"ning obEe%ti/es Hhi%h of the following steps in the n$"sing p"o%ess %o""esponds to the w"iting of the lea"ning obEe%ti/esQ A' P+a$$i$ @ Implementing C ,/al$ation C #ssessment

99 ose& 0 yea"s old and newly diagnosed diabeti% patient m$st lea"n how to inEe%t ins$lin Hhi%h of the following physi%al att"ib$te is not in anyway "elated to he" ability to administe" ins$linQ # St"ength @ Coo"dination C )e-te"ity D' M0s"+! )0i+t 100 #ppea"an%e and disposition of %lients a"e best obse"/ed initially d$"ing whi%h of the following sit$ationQ # !aing 7GS )' I$t!r8i!C Implementation of the initial %a"e ) #%t$al Physi%al e-amination


COMMUNIT( HEALTH NURSING Part 2

1 Hhi%h is the p"ima"y goal of %omm$nity health n$"singQ # !o s$ppo"t and s$pplement the effo"ts of the medi%al p"ofession in the p"omotion of health and p"e/ention of illness @ !o enhan%e the %apa%ity of indi/id$als& families and %omm$nities to %ope with thei" health needs C !o in%"ease the p"od$%ti/ity of the people by p"o/iding them with se"/i%es that will in%"ease thei" le/el of health ) !o %ont"ib$te to national de/elopment th"o$gh p"omotion of family welfa"e& fo%$sing pa"ti%$la"ly on mothe"s and %hild"en A$s-!r ) T# !$/a$"! t/! "a*a"it # i$%i8i%0a+s, a6i+i!s a$% "#660$iti!s t# "#*! -it/ t/!ir /!a+t/ $!!%s !o %ont"ib$te to national de/elopment th"o$gh p"omotion of family welfa"e& fo%$sing pa"ti%$la"ly on mothe"s and %hild"en

2 C?* is a %omm$nity=based p"a%ti%e Hhi%h best e-plains this statementQ # !he se"/i%e is p"o/ided in the nat$"al en/i"onment of people @ !he n$"se has to %ond$%t %omm$nity diagnosis to dete"mine n$"sing needs and p"oblems C !he se"/i%es a"e based on the a/ailable "eso$"%es within the %omm$nity

) P"io"ity setting is based on the magnit$de of the health p"oblems identified A$s-!r ) T/! $0rs! /as t# "#$%0"t "#660$it %ia$#sis t# %!t!r6i$! $0rsi$ $!!%s a$% *r#7+!6s' Comm$nity=based p"a%ti%e means p"o/iding %a"e to people in thei" own nat$"al en/i"onments: the home& s%hool and wo"pla%e& fo" e-ample

+ Pop$lation=fo%$sed n$"sing p"a%ti%e "e6$i"es whi%h of the following p"o%essesQ # Comm$nity o"gani(ing @ *$"sing p"o%ess C Comm$nity diagnosis ) ,pidemiologi% p"o%ess A$s-!r C C#660$it %ia$#sis Pop$lation=fo%$sed n$"sing %a"e means p"o/iding %a"e based on the g"eate" need of the maEo"ity of the pop$lation !he g"eate" need is identified th"o$gh %omm$nity diagnosis

. # 10. is also nown as the O%%$pational ?ealth #%t #side f"om n$mbe" of employees& what othe" fa%to" m$st be %onside"ed in dete"mining the o%%$pational health p"i/ileges to whi%h the wo"e"s will be entitledQ # !ype of o%%$pation: ag"i%$lt$"al& %omme"%ial& ind$st"ial


@ 'o%ation of the wo"pla%e in "elation to health fa%ilities C Classifi%ation of the b$siness ente"p"ise based on net p"ofit ) Se- and age %omposition of employees A$s-!r ) L#"ati#$ # t/! -#rB*+a"! i$ r!+ati#$ t# /!a+t/ a"i+iti!s @ased on # 10.& an o%%$pational n$"se m$st be employed when the"e a"e +0 to 100 employees and the wo"pla%e is mo"e than 1 m away f"om the nea"est health %ente"

 # b$siness fi"m m$st employ an o%%$pational health n$"se when it has at least how many employeesQ # 21 @ 101 C 201 ) +01

A$s-!r ) T/! stat!6!$t is a+s! *!#*+! *a i$%ir!"t+ #r *07+i" /!a+t/ s!r8i"!s' Comm$nity health se"/i%es& in%l$ding p$bli% health se"/i%es& a"e p"e=paid se"/i%es& tho$gh ta-ation& fo" e-ample

9 #%%o"ding to C,Hinslow& whi%h of the following is the goal of P$bli% ?ealthQ # Fo" people to attain thei" bi"th"ights of health and longe/ity @ Fo" p"omotion of health and p"e/ention of disease C Fo" people to ha/e a%%ess to basi% health se"/i%es ) Fo" people to be o"gani(ed in thei" health effo"ts

A$s-!r ) 1?1 #gain& this is based on # 10.

A$s-!r A F#r *!#*+! t# attai$ t/!ir 7irt/ri/ts # /!a+t/ a$% +#$!8it #%%o"ding to Hinslow& all p$bli% health effo"ts a"e fo" people to "eali(e thei" bi"th"ights of health and longe/ity

5 Hhen the o%%$pational health n$"se employs e"gonomi% p"in%iples& she is pe"fo"ming whi%h of he" "olesQ # ?ealth %a"e p"o/ide" @ ?ealth ed$%ato" C ?ealth %a"e %oo"dinato"

10 He say that a Filipino has attained longe/ity when he is able to "ea%h the a/e"age lifespan of Filipinos Hhat othe" statisti% may be $sed to dete"mine attainment of longe/ityQ # #ge=spe%ifi% mo"tality "ate @ P"opo"tionate mo"tality "ate

) ,n/i"onmental manage"

C Swa"oopKs inde) Case fatality "ate

A$s-!r D E$8ir#$6!$ta+ 6a$a!r ,"gonomi%s is imp"o/ing effi%ien%y of wo"e"s by imp"o/ing the wo"e"Ks en/i"onment th"o$gh app"op"iately designed f$"nit$"e& fo" e-ample

8 # ga"ment fa%to"y does not ha/e an o%%$pational n$"se Hho shall p"o/ide the o%%$pational health needs of the fa%to"y wo"e"sQ # O%%$pational health n$"se at the P"o/in%ial ?ealth Offi%e @ Physi%ian employed by the fa%to"y C P$bli% health n$"se of the ?U of thei" m$ni%ipality ) $"al sanita"y inspe%to" of the ?U of thei" m$ni%ipality A$s-!r C P07+i" /!a+t/ $0rs! # t/! RHU # t/!ir 60$i"i*a+it Ao$K"e "ight\ !his 6$estion is based on #10.

 P$bli% health se"/i%es a"e gi/en f"ee of %ha"geT Is this statement t"$e o" falseQ # !he statement is t"$eW it is the "esponsibility of go/e"nment to p"o/ide basi% se"/i%es @ !he statement is falseW people pay indi"e%tly fo" p$bli% health se"/i%es C !he statement may be t"$e o" false& depending on the spe%ifi% se"/i%e "e6$i"ed ) !he statement may be t"$e o" false& depending on poli%ies of the go/e"nment %on%e"ned

A$s-!r C S-ar##*.s i$%!< Swa"oopKs inde- is the pe"%entage of the deaths aged 0 yea"s o" olde" Its in/e"se "ep"esents the pe"%entage of $ntimely deaths those who died yo$nge" than 0 yea"s

11 Hhi%h of the following is the most p"ominent feat$"e of p$bli% health n$"singQ # It in/ol/es p"o/iding home %a"e to si% people who a"e not %onfined in the hospital @ Se"/i%es a"e p"o/ided f"ee of %ha"ge to people within the %at%hment a"ea C !he p$bli% health n$"se f$n%tions as pa"t of a team p"o/iding a p$bli% health n$"sing se"/i%es ) P$bli% health n$"sing fo%$ses on p"e/enti/e& not %$"ati/e& se"/i%es A$s-!r D P07+i" /!a+t/ $0rsi$ #"0s!s #$ *r!8!$ti8!, $#t "0rati8!, s!r8i"!s' !he %at%hment a"ea in P?* %onsists of a "esidential %omm$nity& many of whom a"e well indi/id$als who ha/e g"eate" need fo" p"e/enti/e "athe" than %$"ati/e se"/i%es

12 #%%o"ding to

) !he wo"th and dignity of man A$s-!r D T/! -#rt/ a$% %i$it # 6a$ !his is a di"e%t 6$ote f"om )"
1+ Hhi%h of the following is the mission of the )epa"tment of ?ealthQ # ?ealth fo" all Filipinos @ ,ns$"e the a%%essibility and 6$ality of health %a"e C Imp"o/e the gene"al health stat$s of the pop$lation ) ?ealth in the hands of the Filipino people by the yea" 2020 A$s-!r ) E$s0r! t/! a""!ssi7i+it a$% 0a+it # /!a+t/ "ar! none

1. egion I7 ?ospital is %lassified as what le/el of fa%ilityQ # P"ima"y @ Se%onda"y C Inte"mediate ) !e"tia"y A$s-!r D T!rtiar egional hospitals a"e te"tia"y fa%ilities be%a$se they se"/e as t"aining hospitals fo" the "egion

1 Hhi%h is t"$e of p"ima"y fa%ilitiesQ # !hey a"e $s$ally go/e"nment="$n @ !hei" se"/i%es a"e p"o/ided on an o$t=patient basis C !hey a"e t"aining fa%ilities fo" health p"ofessionals ) # %omm$nity hospital is an e-ample of this le/el of health fa%ilities A$s-!r ) T/!ir s!r8i"!s ar! *r#8i%!% #$ a$ #0t*ati!$t 7asis' P"ima"y fa%ilities go/e"nment and non= go/e"nment fa%ilities that p"o/ide basi% o$t= patient se"/i%es

15 Hhi%h is an e-ample of the s%hool n$"seKs health %a"e p"o/ide" f$n%tionsQ # e6$esting fo" @CD f"om the ?U fo" s%hool ent"ant imm$ni(ation @ Cond$%ting "andom %lass"oom inspe%tion d$"ing a measles epidemi% C !aing "emedial a%tion on an a%%ident ha(a"d in the s%hool playg"o$nd ) Obse"/ing pla%es in the s%hool whe"e p$pils spend thei" f"ee time A$s-!r ) C#$%0"ti$ ra$%#6 "+assr##6 i$s*!"ti#$ %0ri$ a 6!as+!s !*i%!6i" andom %lass"oom inspe%tion is assessment of p$pilsGst$dents and tea%he"s fo" signs of a health p"oblem p"e/alent in the %omm$nity

18 Hhen the n$"se dete"mines whethe" "eso$"%es we"e ma-imi(ed in implementing

'igtas !igdas& she is e/al$ating # ,ffe%ti/eness @ ,ffi%ien%y C #de6$a%y ) #pp"op"iateness A$s-!r ) Ei"i!$" ,ffi%ien%y is dete"mining whethe" the goals we"e attained at the least possible %ost

1 Ao$ a"e a new @S* g"ad$ate Ao$ want to be%ome a P$bli% ?ealth *$"se Hhe"e will yo$ applyQ # )epa"tment of ?ealth @ P"o/in%ial ?ealth Offi%e C egional ?ealth Offi%e ) $"al ?ealth Unit A$s-!r D R0ra+ H!a+t/ U$it # 8150 de/ol/ed basi% health se"/i%es to lo%al go/e"nment $nits 'DUKs  !he p$bli% health n$"se is an employee of the 'DU

19 # 8150 mandates de/ol$tion of basi% se"/i%es f"om the national go/e"nment to lo%al go/e"nment $nits Hhi%h of the following is the maEo" goal of de/ol$tionQ # !o st"engthen lo%al go/e"nment $nits @ !o allow g"eate" a$tonomy to lo%al go/e"nment $nits C !o empowe" the people and p"omote thei" self="elian%e ) !o mae basi% se"/i%es mo"e a%%essible to the people A$s-!r C T# !6*#-!r t/! *!#*+! a$% *r#6#t! t/!ir s!+r!+ia$"! People empowe"ment is the basi% moti/ation behind de/ol$tion of basi% se"/i%es to 'DUKs

20 Hho is the Chai"man of the <$ni%ipal ?ealth @oa"dQ #
21 Hhi%h le/el of health fa%ility is the $s$al point of ent"y of a %lient into the health %a"e deli/e"y systemQ # P"ima"y @ Se%onda"y C Inte"mediate ) !e"tia"y A$s-!r A Pri6ar !he ent"y of a pe"son into the health %a"e deli/e"y system is $s$ally th"o$gh a %ons$ltation in o$t=patient se"/i%es

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 0

22 !he p$bli% health n$"se is the s$pe"/iso" of "$"al health midwi/es Hhi%h of the following is a s$pe"/iso"y f$n%tion of the p$bli% health n$"seQ # efe""ing %ases o" patients to the midwife @ P"o/iding te%hni%al g$idan%e to the midwife C P"o/iding n$"sing %a"e to %ases "efe""ed by the midwife ) Fo"m$lating and implementing t"aining p"og"ams fo" midwi/es

# #%t +8+ @ # +8+ C # 10. ) # 102

A$s-!r ) Pr#8i%i$ t!"/$i"a+ 0i%a$"! t# t/! 6i%-i! !he n$"se p"o/ides te%hni%al g$idan%e to the midwife in the %a"e of %lients& pa"ti%$la"ly in the implementation of management g$idelines& as in Integ"ated
2+ One of the pa"ti%ipants in a hilot t"aining %lass ased yo$ to whom she sho$ld "efe" a patient in labo" who de/elops a %ompli%ation Ao$ will answe"& to the # P$bli% ?ealth *$"se @ $"al ?ealth
28 #%%o"ding to F"eeman and ?ein"i%h& %omm$nity health n$"sing is a de/elopmental se"/i%e Hhi%h of the following best ill$st"ates this statementQ # !he %omm$nity health n$"se %ontin$o$sly de/elops himself pe"sonally and p"ofessionally @ ?ealth ed$%ation and %omm$nity o"gani(ing a"e ne%essa"y in p"o/iding %omm$nity health se"/i%es C Comm$nity health n$"sing is intended p"ima"ily fo" health p"omotion and p"e/ention and t"eatment of disease ) !he goal of %omm$nity health n$"sing is to p"o/ide n$"sing se"/i%es to people in thei" own pla%es of "esiden%e

A$s-!r C M0$i"i*a+ H!a+t/ Oi"!r # p$bli% health n$"se and "$"al health midwife %an p"o/ide %a"e d$"ing no"mal %hildbi"th #

A$s-!r ) H!a+t/ !%0"ati#$ a$% "#660$it #ra$i9i$ ar! $!"!ssar i$ *r#8i%i$ "#660$it /!a+t/ s!r8i"!s'

physi%ian sho$ld attend to a woman with a %ompli%ation d$"ing labo"

!he %omm$nity health n$"se de/elops the health %apability of people th"o$gh health ed$%ation and %omm$nity o"gani(ing a%ti/ities

2. Ao$ a"e the p$bli% health n$"se in a m$ni%ipality with a total pop$lation of abo$t 20&000 !he"e a"e + "$"al health midwi/es among the ?U pe"sonnel ?ow many mo"e midwife items will the ?U needQ # 1 @ 2 C + ) !he ?U does not need any mo"e midwife item A$s-!r A 1 ,a%h "$"al health midwife is gi/en a pop$lation assignment of abo$t &000

2 If the ?U needs additional midwife items& yo$ will s$bmit the "e6$est fo" additional midwife items fo" app"o/al to the # $"al ?ealth Unit @ )ist"i%t ?ealth Offi%e C P"o/in%ial ?ealth Offi%e ) <$ni%ipal ?ealth @oa"d A$s-!r D M0$i"i*a+ H!a+t/ )#ar% #s mandated by # 8150& basi% health se"/i%es ha/e been de/ol/ed f"om the national go/e"nment to lo%al go/e"nment $nits

25 #s an epidemiologist& the n$"se is "esponsible fo" "epo"ting %ases of notifiable diseases Hhat law mandates "epo"ting of %ases of notifiable diseasesQ

A$s-!r A A"t 353 #%t +8+& the 'aw on epo"ting of Comm$ni%able )iseases& ena%ted in 1929& mandated the "epo"ting of diseases listed in the law to the nea"est health station

2 Hhi%h disease was de%la"ed th"o$gh P"esidential P"o%lamation *o . as a ta"get fo" e"adi%ation in the PhilippinesQ # Poliomyelitis @
29 !he p$bli% health n$"se is "esponsible fo" p"esenting the m$ni%ipal health statisti%s $sing g"aphs and tables !o %ompa"e the f"e6$en%y of the leading %a$ses of mo"tality in the m$ni%ipality& whi%h g"aph will yo$ p"epa"eQ # 'ine @ @a" C Pie ) S%atte" diag"am A$s-!r ) )ar # ba" g"aph is $sed to p"esent %ompa"ison of /al$es& a line g"aph fo" t"ends o/e" time o" age& a pie g"aph fo" pop$lation %omposition o" dist"ib$tion& and a s%atte" diag"am fo" %o""elation of two /a"iables

+0 Hhi%h step in %omm$nity o"gani(ing in/ol/es t"aining of potential leade"s in the


%omm$nityQ # Integ"ation @ Comm$nity o"gani(ation C Comm$nity st$dy ) Co"e g"o$p fo"mation A$s-!r D C#r! r#0* #r6ati#$ In %o"e g"o$p fo"mation& the n$"se is able to t"ansfe" the te%hnology of %omm$nity o"gani(ing to the potential o" info"mal %omm$nity leade"s th"o$gh a t"aining p"og"am

+1 In whi%h step a"e plans fo"m$lated fo" sol/ing %omm$nity p"oblemsQ #
+2 !he p$bli% health n$"se taes an a%ti/e "ole in %omm$nity pa"ti%ipation Hhat is the p"ima"y goal of %omm$nity o"gani(ingQ

+. !e"tia"y p"e/ention is needed in whi%h stage of the nat$"al histo"y of diseaseQ # P"e=pathogenesis @ Pathogenesis C P"od"omal ) !e"minal A$s-!r D T!r6i$a+ !e"tia"y p"e/ention in/ol/es "ehabilitation& p"e/ention of pe"manent disability and disability limitation app"op"iate fo" %on/ales%ents& the disabled& %ompli%ated %ases and the te"minally ill those in the te"minal stage of a disease

+ Isolation of a %hild with measles belongs to what le/el of p"e/entionQ # P"ima"y @ Se%onda"y C Inte"mediate ) !e"tia"y A$s-!r A Pri6ar !he p$"pose of isolating a %lient with a %omm$ni%able disease is to p"ote%t those who a"e not si% spe%ifi% disease p"e/ention

+5 On the othe" hand& Ope"ation !imbang is  p"e/ention # P"ima"y @ Se%onda"y

# !o ed$%ate the people "ega"ding %omm$nity health p"oblems @ !o mobili(e the people to "esol/e %omm$nity health p"oblems C !o ma-imi(e the %omm$nityKs "eso$"%es in dealing with health p"oblems ) !o ma-imi(e the %omm$nityKs "eso$"%es in dealing with health p"oblems

C Inte"mediate ) !e"tia"y

A$s-!r D T# 6a
+8 Hhi%h type of family=n$"se %onta%t will p"o/ide yo$ with the best oppo"t$nity to obse"/e family dynami%sQ # Clini% %ons$ltation @ D"o$p %onfe"en%e C ?ome /isit ) H"itten %omm$ni%ation

++ #n indi%ato" of s$%%ess in %omm$nity o"gani(ing is when people a"e able to # Pa"ti%ipate in %omm$nity a%ti/ities fo" the sol$tion of a %omm$nity p"oblem @ Implement a%ti/ities fo" the sol$tion of the %omm$nity p"oblem C Plan a%ti/ities fo" the sol$tion of the %omm$nity p"oblem ) Identify the health p"oblem as a %ommon %on%e"n

A$s-!r C H#6! 8isit )ynami%s of family "elationships %an best be obse"/ed in the familyKs nat$"al en/i"onment& whi%h is the home

A$s-!r A Parti"i*at! i$ "#660$it a"ti8iti!s #r t/! s#+0ti#$ # a "#660$it *r#7+!6 Pa"ti%ipation in %omm$nity a%ti/ities in "esol/ing a %omm$nity p"oblem may be in any of the p"o%esses mentioned in the othe" %hoi%es

A$s-!r ) S!"#$%ar Ope"ation !imbang is done to identify membe"s of the s$s%eptible pop$lation who a"e malno$"ished Its p$"pose is ea"ly diagnosis and& s$bse6$ently& p"ompt t"eatment

+ !he typology of family n$"sing p"oblems is $sed in the statement of n$"sing diagnosis in the %a"e of families !he yo$ngest %hild of the de los eyes family has been diagnosed as mentally "eta"ded !his is %lassified as a # ?ealth th"eat @ ?ealth defi%it C Fo"eseeable %"isis ) St"ess point A$s-!r ) H!a+t/ %!i"it Fail$"e of a family membe" to de/elop


a%%o"ding to what is e-pe%ted& as in mental "eta"dation& is a health defi%it +9 !he de los eyes %o$ple ha/e a 5=yea" old %hild ente"ing s%hool fo" the fi"st time !he de los eyes family has a # ?ealth th"eat @ ?ealth defi%it C Fo"eseeable %"isis ) St"ess point A$s-!r C F#r!s!!a7+! "risis ,nt"y of the 5=yea" old into s%hool is an anti%ipated pe"iod of $n$s$al demand on the family

.0 Hhi%h of the following is an ad/antage of a home /isitQ # It allows the n$"se to p"o/ide n$"sing %a"e to a g"eate" n$mbe" of people @ It p"o/ides an oppo"t$nity to do fi"st hand app"aisal of the home sit$ation C It allows sha"ing of e-pe"ien%es among people with simila" health p"oblems ) It de/elops the familyKs initiati/e in p"o/iding fo" health needs of its membe"s A$s-!r ) It *r#8i%!s a$ #**#rt0$it t# %# irst /a$% a**raisa+ # t/! /#6! sit0ati#$' Choi%e # is not %o""e%t sin%e a home /isit

"e6$i"es that the n$"se spend so m$%h time with the family Choi%e C is an ad/antage of a g"o$p %onfe"en%e& while %hoi%e ) is t"$e of a %lini% %ons$ltation .1 Hhi%h is CO*!#A to the p"in%iples in planning a home /isitQ # # home /isit sho$ld ha/e a p$"pose o" obEe%ti/e @ !he plan sho$ld "e/ol/e a"o$nd family health needs C # home /isit sho$ld be %ond$%ted in the manne" p"es%"ibed by the ?U ) Planning of %ontin$ing %a"e sho$ld in/ol/e a "esponsible family membe" A$s-!r C A /#6! 8isit s/#0+% 7! "#$%0"t!% i$ t/! 6a$$!r *r!s"ri7!% 7 t/! RHU' !he home /isit plan sho$ld be fle-ible and p"a%ti%al& depending on fa%to"s& s$%h as the familyKs needs and the "eso$"%es a/ailable to the n$"se and the family

.2 !he P?* bag is an impo"tant tool in p"o/iding n$"sing %a"e d$"ing a home /isit !he most impo"tant p"in%iple of bag te%hni6$e states that it # Sho$ld sa/e time and effo"t @ Sho$ld minimi(e if not totally p"e/ent the sp"ead of infe%tion C Sho$ld not o/e"shadow %on%e"n fo" the patient and his family )
A$s-!r ) S/#0+% 6i$i6i9! i $#t t#ta++ *r!8!$t t/! s*r!a% # i$!"ti#$' @ag te%hni6$e is pe"fo"med befo"e and afte" handling a %lient in the home to p"e/ent t"ansmission of infe%tion to and f"om the %lient

.+ !o maintain the %leanliness of the bag and its %ontents& whi%h of the following m$st the n$"se doQ # Hash hisGhe" hands befo"e and afte" p"o/iding n$"sing %a"e to the family membe"s @ In the %a"e of family membe"s& as m$%h as possible& $se only a"ti%les taen f"om the bag C P$t on an ap"on to p"ote%t he" $nifo"m and fold it with the "ight side o$t befo"e p$tting it ba% into the bag ) #t the end of the /isit& fold the lining on whi%h the bag was pla%ed& ens$"ing that the %ontaminated side is on the o$tside A$s-!r A as/ /is=/!r /a$%s 7!#r! a$% at!r *r#8i%i$ $0rsi$ "ar! t# t/! a6i+ 6!67!rs' Choi%e @ goes against the idea of $tili(ing the familyKs "eso$"%es& whi%h is en%o$"aged in C?* Choi%es C and ) goes against the p"in%iple of asepsis of %onfining the %ontaminated s$"fa%e of obEe%ts

.. !he p$bli% health n$"se %ond$%ts a st$dy on the fa%to"s %ont"ib$ting to the high mo"tality "ate d$e to hea"t disease in the m$ni%ipality whe"e she wo"s Hhi%h b"an%h of epidemiology does the n$"se p"a%ti%e in this sit$ationQ # )es%"ipti/e @ #nalyti%al C !he"ape$ti% ) ,/al$ation A$s-!r ) A$a+ti"a+ #nalyti%al epidemiology is the st$dy of fa%to"s o" dete"minants affe%ting the patte"ns of o%%$""en%e and dist"ib$tion of disease in a %omm$nity

. Hhi%h of the following is a f$n%tion of epidemiologyQ # Identifying the disease %ondition based on manifestations p"esented by a %lient @ )ete"mining fa%to"s that %ont"ib$ted to the o%%$""en%e of pne$monia in a + yea" old C )ete"mining the effi%a%y of the antibioti% $sed in the t"eatment of the + yea" old %lient with pne$monia ) ,/al$ating the effe%ti/eness of the implementation of the Integ"ated
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | +

.5 Hhi%h of the following is an epidemiologi% f$n%tion of the n$"se d$"ing an epidemi%Q # Cond$%ting assessment of s$spe%ted %ases to dete%t the %omm$ni%able disease @
.8 !he p"ima"y p$"pose of %ond$%ting an epidemiologi% in/estigation is to # )elineate the etiology of the epidemi% @ ,n%o$"age %oope"ation and s$ppo"t of the %omm$nity C Identify g"o$ps who a"e at "is of %ont"a%ting the disease ) Identify geog"aphi%al lo%ation of %ases of the disease in the %omm$nity A$s-!r A D!+i$!at! t/! !ti#+# # t/! !*i%!6i" )elineating the etiology of an epidemi% is identifying its so$"%e

. Hhi%h is a %ha"a%te"isti% of pe"son=to=pe"son p"opagated epidemi%sQ # !he"e a"e mo"e %ases of the disease than e-pe%ted @ !he disease m$st ne%essa"ily be t"ansmitted th"o$gh a /e%to" C !he sp"ead of the disease %an be att"ib$ted to a %ommon /ehi%le ) !he"e is a g"ad$al b$ild $p of %ases befo"e the epidemi% be%omes easily noti%eable A$s-!r D T/!r! is a ra%0a+ 70i+% 0* # "as!s 7!#r! t/! !*i%!6i" 7!"#6!s !asi+ $#ti"!a7+!' # g"ad$al o" insidio$s onset of the epidemi% is $s$ally obse"/able in pe"son=to=pe"son p"opagated epidemi%s

.9 In the in/estigation of an epidemi%& yo$ %ompa"e the p"esent f"e6$en%y of the disease with the $s$al f"e6$en%y at this time of the yea" in this %omm$nity !his is done d$"ing whi%h stage of the in/estigationQ # ,stablishing the epidemi% @ !esting the hypothesis C Fo"m$lation of the hypothesis ) #pp"aisal of fa%ts

A$s-!r A Esta7+is/i$ t/! !*i%!6i" ,stablishing the epidemi% is dete"mining whethe" the"e is an epidemi% o" not !his is done by %ompa"ing the p"esent n$mbe" of %ases with the $s$al n$mbe" of %ases of the disease at the same time of the yea"& as well as establishing the "elatedness of the %ases of the disease

0 !he n$mbe" of %ases of )eng$e fe/e" $s$ally in%"eases towa"ds the end of the "ainy season !his patte"n of o%%$""en%e of )eng$e fe/e" is best des%"ibed as # ,pidemi% o%%$""en%e @ Cy%li%al /a"iation C Spo"adi% o%%$""en%e ) Se%$la" /a"iation A$s-!r ) C"+i"a+ 8ariati#$ # %y%li%al /a"iation is a pe"iodi% fl$%t$ation in the n$mbe" of %ases of a disease in the %omm$nity

1 In the yea" 190& the Ho"ld ?ealth O"gani(ation de%la"ed the Philippines& togethe" with some othe" %o$nt"ies in the Heste"n Pa%ifi% egion& f"eeT of whi%h diseaseQ # Pne$moni% plag$e @ Poliomyelitis C Small po) #nth"aA$s-!r C S6a++ *#< !he last do%$mented %ase of Small po- was in 1988 at Somalia

2 In the %ens$s of the Philippines in 199& the"e we"e abo$t +&299&000 males and abo$t +.&95&000 females Hhat is the se- "atioQ # 9905:100 @ 1009.:100 C 02+V ) .985V A$s-!r ) 1??'>41?? Se- "atio is the n$mbe" of males fo" e/e"y 100 females in the pop$lation

+ P"ima"y health %a"e is a total app"oa%h to %omm$nity de/elopment Hhi%h of the following is an indi%ato" of s$%%ess in the $se of the p"ima"y health %a"e app"oa%hQ # ?ealth se"/i%es a"e p"o/ided f"ee of %ha"ge to indi/id$als and families @ 'o%al offi%ials a"e empowe"ed as the maEo" de%ision mae"s in matte"s of health C ?ealth wo"e"s a"e able to p"o/ide %a"e based on identified health needs of the people ) ?ealth p"og"ams a"e s$stained a%%o"ding to the le/el of de/elopment of the %omm$nity A$s-!r D H!a+t/ *r#ra6s ar! s0stai$!% a""#r%i$ t# t/! +!8!+ # %!8!+#*6!$t # t/! "#660$it' P"ima"y health %a"e is essential health %a"e that

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | .

%an be s$stained in all stages of de/elopment of the %omm$nity . Sp$t$m e-amination is the maEo" s%"eening tool fo" p$lmona"y t$be"%$losis Clients wo$ld sometimes get false negati/e "es$lts in this e-am !his means that the test is not pe"fe%t in te"ms of whi%h %ha"a%te"isti% of a diagnosti% e-aminationQ # ,ffe%ti/eness @ ,ffi%a%y C Spe%ifi%ity ) Sensiti/ity

P"esident Fe"dinand
A$s-!r D S!$siti8it Sensiti/ity is the %apa%ity of a diagnosti% e-amination to dete%t %ases of the disease If a test is 100V sensiti/e& all the %ases tested will ha/e a positi/e "es$lt& ie& the"e will be no false negati/e "es$lts

A$s-!r D C##*!rati#$ 7!t-!!$ t/! PHN a$% *07+i" s"/##+ t!a"/!r Inte"se%to"al linages "efe" to wo"ing "elationships between the health se%to" and othe" se%to"s in/ol/ed in %omm$nity de/elopment

 Use of app"op"iate te%hnology "e6$i"es nowledge of indigeno$s te%hnology Hhi%h medi%inal he"b is gi/en fo" fe/e"& heada%he and %o$ghQ # Sambong @ !saang g$bat C #ap$lo ) 'ag$ndi

50 !he m$ni%ipality assigned to yo$ has a pop$lation of abo$t 20&000 ,stimate the n$mbe" of 1=. yea" old %hild"en who will be gi/en etinol %aps$le 200&000 IU e/e"y 5 months # 1&00 @ 1&00 C 2&000 ) 2&+00

A$s-!r D La0$%i Sambong is $sed as a di$"eti% !saang g$bat is $sed to "elie/e dia""hea #ap$lo is $sed fo" its antif$ngal p"ope"ty

A$s-!r D 2,3?? @ased on the Philippine pop$lation %omposition& to estimate the n$mbe" of 1=. yea" old %hild"en& m$ltiply total pop$lation by 11V

5 Hhat law %"eated the Philippine Instit$te of !"aditional and #lte"nati/e ?ealth Ca"eQ # # .2+ @ # .2+ C # 2.+ ) # +.2

51 ,stimate the n$mbe" of p"egnant women who will be gi/en tetan$s to-oid d$"ing an imm$ni(ation o$t"ea%h a%ti/ity in a ba"angay with a pop$lation of abo$t 1&00 # 25 @ +00 C +8 ) .00

A$s-!r A R'A' 423 none

8 In t"aditional Chinese medi%ine& the yielding& negati/e and feminine fo"%e is te"med # Ain @ Aang C >i ) Chai A$s-!r A (i$ Aang is the male dominating& positi/e and mas%$line fo"%e

 Hhat is the legal basis fo" P"ima"y ?ealth Ca"e app"oa%h in the PhilippinesQ # #lma #ta )e%la"ation on P?C @ 'ette" of Inst"$%tion *o 9.9 C P"esidential )e%"ee *o 1.8 ) P"esidential )e%"ee 995 A$s-!r ) L!tt!r # I$str0"ti#$ N#' >4> 'ette" of Inst"$%tion 9.9 was iss$ed by then

A$s-!r A 2;5 !o estimate the n$mbe" of p"egnant women& m$ltiply the total pop$lation by +V

52 !o des%"ibe the se- %omposition of the pop$lation& whi%h demog"aphi% tool may be $sedQ # Se- "atio @ Se- p"opo"tion C Pop$lation py"amid ) #ny of these may be $sed A$s-!r D A$ # t/!s! 6a 7! 0s!%' Se- "atio and se- p"opo"tion a"e $sed to dete"mine the se- %omposition of a pop$lation # pop$lation py"amid is $sed to p"esent the %omposition of a pop$lation by age and se-

5+ Hhi%h of the following is a natality "ateQ # C"$de bi"th "ate @ *eonatal mo"tality "ate

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 

C Infant mo"tality "ate ) Dene"al fe"tility "ate A$s-!r A Cr0%! 7irt/ rat! *atality means bi"th # natality "ate is a bi"th "ate

5. Ao$ a"e %omp$ting the %"$de death "ate of yo$" m$ni%ipality& with a total pop$lation of abo$t 1&000& fo" last yea" !he"e we"e 9. deaths #mong those who died& 20 died be%a$se of diseases of the hea"t and +2 we"e aged 0 yea"s o" olde" Hhat is the %"$de death "ateQ # .2G1&000 @ 2G1&000 C 5+G1&000 ) 8+G1&000 A$s-!r ) 5'2=1,??? !o %omp$te %"$de death "ate di/ide total n$mbe" of deaths 9. by total pop$lation 1&000 and m$ltiply by 1&000

5 nowing that maln$t"ition is a f"e6$ent %omm$nity health p"oblem& yo$ de%ided to %ond$%t n$t"itional assessment Hhat pop$lation is pa"ti%$la"ly s$s%eptible to p"otein ene"gy maln$t"ition P,<Q # P"egnant women and the elde"ly @ Unde"= yea" old %hild"en

!o %omp$te fo" neonatal mo"tality "ate& di/ide the n$mbe" of babies who died befo"e "ea%hing the age of 2 days by the total n$mbe" of li/e bi"ths& then m$ltiply by 1&000 5 Hhi%h statisti% best "efle%ts the n$t"itional stat$s of a pop$lationQ # 1=. yea" old age=spe%ifi% mo"tality "ate @ P"opo"tionate mo"tality "ate C Infant mo"tality "ate ) Swa"oopKs indeA$s-!r A 14 !ar #+% a!s*!"ii" 6#rta+it rat! Sin%e p"es%hoole"s a"e the most s$s%eptible to the effe%ts of maln$t"ition& a pop$lation with poo" n$t"itional stat$s will most liely ha/e a high 1=. yea" old age=spe%ifi% mo"tality "ate& also nown as %hild mo"tality "ate

59 Hhat n$me"ato" is $sed in %omp$ting gene"al fe"tility "ateQ # ,stimated midyea" pop$lation @ *$mbe" of "egiste"ed li/e bi"ths C *$mbe" of p"egnan%ies in the yea" ) *$mbe" of females of "ep"od$%ti/e age A$s-!r ) N067!r # r!ist!r!% +i8! 7irt/s !o %omp$te fo" gene"al o" total fe"tility "ate& di/ide the n$mbe" of "egiste"ed li/e bi"ths by the

C 1=. yea" old %hild"en ) S%hool age %hild"en

n$mbe" of females of "ep"od$%ti/e age 1=. yea"s& then m$ltiply by 1&000

A$s-!r C 14 !ar #+% "/i+%r!$ P"es%hoole"s a"e the most s$s%eptible to P,< be%a$se they ha/e gene"ally been weaned #lso& this is the pop$lation who& $nable to feed themsel/es& a"e often the /i%tims of poo" int"afamilial food dist"ib$tion

80 Ao$ will gathe" data fo" n$t"itional assessment of a p$"o Ao$ will gathe" info"mation only f"om families with membe"s who belong to the ta"get pop$lation fo" P,< Hhat method of data gathe"ing is best fo" this p$"poseQ # Cens$s @ S$"/ey C e%o"d "e/iew ) e/iew of %i/il "egist"y

55 Hhi%h statisti% %an gi/e the most a%%$"ate "efle%tion of the health stat$s of a %omm$nityQ # 1=. yea" old age=spe%ifi% mo"tality "ate @ Infant mo"tality "ate C Swa"oopKs inde) C"$de death "ate A$s-!r C S-ar##*.s i$%!< Swa"oopKs inde- is the p"opo"tion of deaths aged 0 yea"s and abo/e !he highe" the Swa"oopKs inde- of a pop$lation& the g"eate" the p"opo"tion of the deaths who we"e able to "ea%h the age of at least 0 yea"s& ie& mo"e people g"ew old befo"e they died 58 In the past yea"& @a"angay # had an a/e"age pop$lation of 15 .5 babies we"e bo"n in that yea"& 2 of whom died less than . wees afte" they we"e bo"n !he"e we"e . "e%o"ded stillbi"ths Hhat is the neonatal mo"tality "ateQ # 28G1&000 @ .+G1&000 C 59G1&000 ) 1+0.G1&000 A$s-!r ) 43'5=1,???

A$s-!r ) S0r8! # s$"/ey& also %alled sample s$"/ey& is data gathe"ing abo$t a sample of the pop$lation

81 In the %ond$%t of a %ens$s& the method of pop$lation assignment based on the a%t$al physi%al lo%ation of the people is te"med # )e E$"e @ )e lo%$s C )e fa%to ) )e no/o A$s-!r C D! a"t# !he othe" method of pop$lation assignment& de E$"e& is based on the $s$al pla%e of "esiden%e of the people

82 !he Field ?ealth Se"/i%es and Info"mation System F?SIS is the "e%o"ding and "epo"ting system in p$bli% health %a"e in the Philippines !he

epo"t is a fo"m $sed in whi%h of the %omponents of the F?SISQ # !ally "epo"t @ O$tp$t "epo"t C !a"getG%lient list ) Indi/id$al health "e%o"d A$s-!r A Ta++ r!*#rt # tally "epo"t is p"epa"ed monthly o" 6$a"te"ly by the ?U pe"sonnel and t"ansmitted to the P"o/in%ial ?ealth Offi%e

8+ !o monito" %lients "egiste"ed in long=te"m "egimens& s$%h as the <$lti=)"$g !he"apy& whi%h %omponent will be most $sef$lQ # !ally "epo"t @ O$tp$t "epo"t C !a"getG%lient list ) Indi/id$al health "e%o"d A$s-!r C Tar!t="+i!$t +ist !he <)! Client 'ist is a "e%o"d of %lients en"olled in <)! and othe" "ele/ant data& s$%h as dates when %lients %olle%ted thei" monthly s$pply of d"$gs

8. Ci/il "egist"ies a"e impo"tant so$"%es of data Hhi%h law "e6$i"es "egist"ation of bi"ths within +0 days f"om the o%%$""en%e of the bi"thQ # P) 51 @ #%t +8+ C # +8+ ) # ++8 A$s-!r A P'D' ;51 P) 51 amended # +8+& "e6$i"ing the "egist"y of bi"ths within +0 days f"om thei" o%%$""en%e

8 Hhi%h of the following p"ofessionals %an sign the bi"th %e"tifi%ateQ # P$bli% health n$"se @ $"al health midwife C <$ni%ipal health offi%e" ) #ny of these health p"ofessionals A$s-!r D A$ # t/!s! /!a+t/ *r#!ssi#$a+s

) # +8+ states that any bi"th attendant may sign the %e"tifi%ate of li/e bi"th 85 Hhi%h %"ite"ion in p"io"ity setting of health p"oblems is $sed only in %omm$nity health %a"eQ #

%onside"ed in both family and %omm$nity health %a"e 88 !he Sent"ong Sigla
8 Hhi%h of the following women sho$ld be %onside"ed as spe%ial ta"gets fo" family planningQ # !hose who ha/e two %hild"en o" mo"e @ !hose with medi%al %onditions s$%h as anemia C !hose yo$nge" than 20 yea"s and olde" than + yea"s ) !hose who E$st had a deli/e"y within the past 1 months A$s-!r D T/#s! -/# J0st /a% a %!+i8!r -it/i$ t/! *ast 15 6#$t/s !he ideal bi"th spa%ing is at least two yea"s 1 months pl$s 9 months of p"egnan%y  2 yea"s

89 F"eedom of %hoi%e is one of the poli%ies of the Family Planning P"og"am of the Philippines Hhi%h of the following ill$st"ates this p"in%ipleQ # Info"mation dissemination abo$t the need fo" family planning @ S$ppo"t of "esea"%h and de/elopment in family planning methods C #de6$ate info"mation fo" %o$ples "ega"ding the diffe"ent methods ) ,n%o$"agement of %o$ples to tae family planning as a Eoint "esponsibility A$s-!r C A%!0at! i$#r6ati#$ #r "#0*+!s r!ar%i$ t/! %i!r!$t 6!t/#%s !o enable the %o$ple to %hoose f"eely among diffe"ent methods of family planning& they m$st be gi/en f$ll info"mation "ega"ding the diffe"ent methods that a"e a/ailable to them& %onside"ing the a/ailability of 6$ality se"/i%es that %an s$ppo"t thei" %hoi%e

0 # woman& 5 months p"egnant& %ame to the %ente" fo" %ons$ltation Hhi%h of the following s$bstan%es is %ont"aindi%atedQ


# !etan$s to-oid @ etinol 200&000 IU C Fe""o$s s$lfate 200 mg ) Potassi$m iodate 200 mg %aps$le A$s-!r ) R!ti$#+ 2??,??? IU etinol 200&000 IU is a fo"m of megadose 7itamin # !his may ha/e a te"atogeni% effe%t

1 )$"ing p"enatal %ons$ltation& a %lient ased yo$ if she %an ha/e he" deli/e"y at home #fte" histo"y taing and physi%al e-amination& yo$ ad/ised he" against a home deli/e"y Hhi%h of the following findings dis6$alifies he" fo" a home deli/e"yQ # ?e" O@ s%o"e is DP+ @ She has some palma" pallo" C ?e" blood p"ess$"e is 1+0G0 ) ?e" baby is in %ephali% p"esentation A$s-!r A H!r O) s"#r! is G5P3' Only women with less than  p"egnan%ies a"e 6$alified fo" a home deli/e"y It is also ad/isable fo" a p"imig"a/ida to ha/e deli/e"y at a %hildbi"th fa%ility

2 Inade6$ate intae by the p"egnant woman of whi%h /itamin may %a$se ne$"al t$be defe%tsQ # *ia%in @ ibofla/in C Foli% a%id ) !hiamine A$s-!r C F#+i" a"i% It is estimated that the in%iden%e of ne$"al t$be defe%ts %an be "ed$%ed d"asti%ally if p"egnant women ha/e an ade6$ate intae of foli% a%id

+ Ao$ a"e in a %lientKs home to attend to a deli/e"y Hhi%h of the following will yo$ do fi"stQ # Set $p the ste"ile a"ea @ P$t on a %lean gown o" ap"on C Cleanse the %lientKs /$l/a with soap and wate" ) *ote the inte"/al& d$"ation and intensity of labo" %ont"a%tions A$s-!r D N#t! t/! i$t!r8a+, %0rati#$ a$% i$t!$sit # +a7#r "#$tra"ti#$s' #ssessment of the woman sho$ld be done fi"st to dete"mine whethe" she is ha/ing t"$e labo" and& if so& what stage of labo" she is in

. In p"epa"ing a p"imig"a/ida fo" b"eastfeeding& whi%h of the following will yo$ doQ # !ell he" that la%tation begins within a day afte" deli/e"y @ !ea%h he" nipple st"et%hing e-e"%ises if he" nipples a"e e/e"ted C Inst"$%t he" to wash he" nipples befo"e and afte" ea%h b"eastfeeding ) ,-plain to he" that p$tting the baby to b"east will lessen blood loss afte" deli/e"y

A$s-!r D E<*+ai$ t# /!r t/at *0tti$ t/! 7a7 t# 7r!ast -i++ +!ss!$ 7+##% +#ss at!r %!+i8!r' S$%ling of the nipple stim$lates the "elease of o-yto%in by the poste"io" pit$ita"y gland& whi%h %a$ses $te"ine %ont"a%tion 'a%tation begins 1 to + days afte" deli/e"y *ipple st"et%hing e-e"%ises a"e done when the nipples a"e flat o" in/e"ted F"e6$ent washing d"ies $p the nipples& maing them p"one to the fo"mation of fiss$"es

 # p"imig"a/ida is inst"$%ted to offe" he" b"east to the baby fo" the fi"st time within +0 min$tes afte" deli/e"y Hhat is the p$"pose of offe"ing the b"east this ea"lyQ # !o initiate the o%%$""en%e of mil letdown @ !o stim$late mil p"od$%tion by the mamma"y a%ini C !o mae s$"e that the baby is able to get the %olost"$m ) !o allow the woman to p"a%ti%e b"eastfeeding in the p"esen%e of the health wo"e" A$s-!r ) T# sti60+at! 6i+B *r#%0"ti#$ 7 t/! 6a66ar a"i$i S$%ling of the nipple stim$lates p"ola%tin "eflethe "elease of p"ola%tin by the ante"io" pit$ita"y gland& whi%h initiates la%tation

5 In a mothe"sK %lass& yo$ dis%$ss p"ope" b"eastfeeding te%hni6$e Hhi%h is of these is a sign that the baby has lat%hed onT to the b"east p"ope"lyQ # !he baby taes shallow& "apid s$%s @ !he mothe" does not feel nipple pain C !he babyKs mo$th is only pa"tly open ) Only the mothe"Ks nipple is inside the babyKs mo$th A$s-!r ) T/! 6#t/!r %#!s $#t !!+ $i**+! *ai$' Hhen the baby has p"ope"ly lat%hed on to the b"east& he taes deep& slow s$%sW his mo$th is wide openW and m$%h of the a"eola is inside his mo$th #nd& yo$K"e "ight\ !he mothe" does not feel nipple pain

8 Ao$ e-plain to a b"eastfeeding mothe" that b"east mil is s$ffi%ient fo" all of the babyKs n$t"ient needs only $p to  # + months @ 5 months C 1 yea" ) 2 yea"s A$s-!r ) ; 6#$t/s #fte" 5 months& the babyKs n$t"ient needs& espe%ially the babyKs i"on "e6$i"ement& %an no longe" be p"o/ided by mothe"Ks mil alone

 Hhat is gi/en to a woman within a month afte" the deli/e"y of a babyQ #
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 

C etinol 200&000 IU& 1 %aps$le ) Potassi$m iodate 200 mg& 1 %aps$le

t"eatment& with the fo"mation of a pe"manent s%a"

A$s-!r C R!ti$#+ 2??,??? I'U', 1 "a*s0+! # %aps$le of etinol 200&000 IU is gi/en within 1 month afte" deli/e"y Potassi$m iodate is gi/en d$"ing p"egnan%yW mal$nggay %aps$le is not "o$tinely administe"ed afte" deli/e"yW and fe""o$s s$lfate is taen fo" two months afte" deli/e"y

9+ # .=wee old baby was b"o$ght to the health %ente" fo" his fi"st imm$ni(ation Hhi%h %an be gi/en to himQ # )P!1 @ OP71 C Infant @CD ) ?epatitis @ /a%%ine 1

9 Hhi%h biologi%al $sed in ,-panded P"og"am on Imm$ni(ation ,PI is sto"ed in the f"ee(e"Q # )P! @ !etan$s to-oid C
A$s-!r C I$a$t )CG Infant @CD may be gi/en at bi"th #ll the othe" imm$ni(ations mentioned %an be gi/en at 5 wees of age

A$s-!r C M!as+!s 8a""i$! #mong the biologi%als $sed in the ,-panded P"og"am on Imm$ni(ation& measles /a%%ine and OP7 a"e highly sensiti/e to heat& "e6$i"ing sto"age in the f"ee(e"

90 Un$sed @CD sho$ld be dis%a"ded how many ho$"s afte" "e%onstit$tionQ # 2 @ . C 5 ) #t the end of the day A$s-!r ) 4 Hhile the $n$sed po"tion of othe" biologi%als in ,PI may be gi/en $ntil the end of the day& only @CD is dis%a"ded . ho$"s afte" "e%onstit$tion !his is why @CD imm$ni(ation is s%hed$led only in the mo"ning

91 In imm$ni(ing s%hool ent"ants with @CD& yo$ a"e not obliged to se%$"e pa"ental %onsent !his is be%a$se of whi%h legal do%$mentQ # P) 995 @ # 8.5 C P"esidential P"o%lamation *o 5 ) P"esidential P"o%lamation *o .5 A$s-!r A P'D' >>; P"esidential )e%"ee 995& ena%ted in 1985& made imm$ni(ation in the ,PI %omp$lso"y fo" %hild"en $nde"  yea"s of age ?epatitis @ /a%%ination was made %omp$lso"y fo" the same age g"o$p by # 8.5

92 Hhi%h imm$ni(ation p"od$%es a pe"manent s%a"Q # )P! @ @CD C
9. Ao$ will not gi/e )P! 2 if the mothe" says that the infant had # Sei($"es a day afte" )P! 1 @ Fe/e" fo" + days afte" )P! 1 C #bs%ess fo"mation afte" )P! 1 ) 'o%al tende"ness fo" + days afte" )P! 1 A$s-!r A S!i90r!s a %a at!r DPT 1' Sei($"es within + days afte" administ"ation of )P! is an indi%ation of hype"sensiti/ity to pe"t$ssis /a%%ine& a %omponent of )P! !his is %onside"ed a spe%ifi% %ont"aindi%ation to s$bse6$ent doses of )P!

9 # 2=month old infant was b"o$ght to the health %ente" fo" imm$ni(ation )$"ing assessment& the infantKs tempe"at$"e "egiste"ed at +1RC Hhi%h is the best %o$"se of a%tion that yo$ will taeQ # Do on with the infantKs imm$ni(ations @ Di/e Pa"a%etamol and wait fo" his fe/e" to s$bside C efe" the infant to the physi%ian fo" f$"the" assessment ) #d/ise the infantKs mothe" to b"ing him ba% fo" imm$ni(ation when he is well A$s-!r A G# #$ -it/ t/! i$a$t.s i660$i9ati#$s' In the ,PI& fe/e" $p to +RC is not a %ont"aindi%ation to imm$ni(ation
95 # p"egnant woman had E$st "e%ei/ed he" .th dose of tetan$s to-oid S$bse6$ently& he" baby will ha/e p"ote%tion against tetan$s fo" how longQ # 1 yea" @ + yea"s C 10 yea"s ) 'ifetime A$s-!r A 1 !ar !he baby will ha/e passi/e nat$"al imm$nity by pla%ental t"ansfe" of antibodies !he mothe" will ha/e a%ti/e a"tifi%ial imm$nity lasting fo" abo$t 10 yea"s  doses will gi/e the mothe" lifetime p"ote%tion


98 # .=month old infant was b"o$ght to the health %ente" be%a$se of %o$gh ?e" "espi"ato"y "ate is .2Gmin$te Using the Integ"ated
9 Hhi%h of the following signs will indi%ate that a yo$ng %hild is s$ffe"ing f"om se/e"e pne$moniaQ # )yspnea @ Hhee(ing C Fast b"eathing ) Chest ind"awing A$s-!r D C/!st i$%ra-i$ In I
99 Using I
A$s-!r ) R!!r /i6 0r!$t+ t# t/! /#s*ita+' Se/e"e pne$monia "e6$i"es $"gent "efe""al to a hospital #nswe"s #& C and ) a"e done fo" a %lient %lassified as ha/ing pne$monia

100 # =month old infant was b"o$ght by his mothe" to the health %ente" be%a$se of dia""hea o%%$""ing . to  times a day ?is sin goes ba% slowly afte" a sin pin%h and his eyes a"e s$nen Using the I
101 @ased on assessment& yo$ %lassified a += month old infant with the %hief %omplaint of dia""hea in the %atego"y of SO<,

),?A)#!IO* @ased on I
10+ # 1 [ yea" old %hild was %lassified as ha/ing +"d deg"ee p"otein ene"gy maln$t"ition& washio"o" Hhi%h of the following signs will be most appa"ent in this %hildQ # 7o"a%io$s appetite @ Hasting C #pathy ) ,dema A$s-!r D E%!6a ,dema& a maEo" sign of washio"o"& is %a$sed by de%"eased %olloidal osmoti% p"ess$"e of the blood b"o$ght abo$t by hypoalb$minemia )e%"eased blood alb$min le/el is d$e a p"otein= defi%ient diet

10. #ssessment of a 2=yea" old %hild "e/ealed baggy pantsT Using the I

C
10 )$"ing the physi%al e-amination of a yo$ng %hild& what is the ea"liest sign of -e"ophthalmia that yo$ may obse"/eQ # e"atomala%ia @ Co"neal opa%ity C *ight blindness ) ConE$n%ti/al -e"osis A$s-!r D C#$J0$"ti8a+
105 !o p"e/ent -e"ophthalmia& yo$ng %hild"en a"e gi/en etinol %aps$le e/e"y 5 months Hhat is the dose gi/en to p"es%hoole"sQ # 10&000 IU @ 20&000 IU C 100&000 IU ) 200&000 IU A$s-!r D 2??,??? IU P"es%hoole"s a"e gi/en etinol 200&000 IU e/e"y 5 months 100&000 IU is gi/en on%e to infants aged 5 to 12 months !he dose fo" p"egnant women is 10&000 IU

108 !he maEo" sign of i"on defi%ien%y anemia is pallo" Hhat pa"t is best e-amined fo" pallo"Q # Palms @ *ailbeds C #"o$nd the lips ) 'owe" %onE$n%ti/al sa% A$s-!r A Pa+6s !he anatomi% %ha"a%te"isti%s of the palms allow a "eliable and %on/enient basis fo" e-amination fo" pallo" 10 Food fo"tifi%ation is one of the st"ategies to p"e/ent mi%"on$t"ient defi%ien%y %onditions # 985 mandates fo"tifi%ation of %e"tain food items Hhi%h of the following is among these food itemsQ # S$ga" @ @"ead C
flo$"& s$ga" and %ooing oil with 7itamin #& i"on andGo" iodine 109 Hhat is the best %o$"se of a%tion when the"e is a measles epidemi% in a nea"by m$ni%ipalityQ # Di/e measles /a%%ine to babies aged 5 to  months @ Di/e babies aged 5 to 11 months one dose of 100&000 IU of etinol C Inst"$%t mothe"s to eep thei" babies at home to p"e/ent disease t"ansmission ) Inst"$%t mothe"s to feed thei" babies ade6$ately to enhan%e thei" babiesK "esistan%e A$s-!r A Gi8! 6!as+!s 8a""i$! t# 7a7i!s a!% ; t#  6#$t/s' O"dina"ily& measles /a%%ine is gi/en at 9 months of age )$"ing an impending epidemi%& howe/e"& one dose may be gi/en to babies aged 5 to  months !he mothe" is inst"$%ted that the baby needs anothe" dose when the baby is 9 months old

110 # mothe" b"o$ght he" da$ghte"& . yea"s old& to the ?U be%a$se of %o$gh and %olds Following the I
111
112 # mothe" b"o$ght he" 10 month old infant fo" %ons$ltation be%a$se of fe/e"& whi%h sta"ted . days p"io" to %ons$ltation !o dete"mine mala"ia "is& what will yo$ doQ # )o a to$"ni6$et test @ #s whe"e the family "esides C Det a spe%imen fo" blood smea"


) #s if the fe/e" is p"esent e/e"yday A$s-!r ) AsB -/!r! t/! a6i+ r!si%!s' @e%a$se mala"ia is endemi%& the fi"st 6$estion to dete"mine mala"ia "is is whe"e the %lientKs family "esides If the a"ea of "esiden%e is not a nown endemi% a"ea& as if the %hild had t"a/eled within the past 5 months& whe"e heGshe was b"o$ght and whethe" heGshe stayed o/e"night in that a"ea

11+ !he following a"e st"ategies implemented by the )epa"tment of ?ealth to p"e/ent mos6$ito=bo"ne diseases Hhi%h of these is most effe%ti/e in the %ont"ol of )eng$e fe/e"Q # St"eam seeding with la"/a=eating fish @ )est"oying b"eeding pla%es of mos6$itoes C Chemop"ophyla-is of non=imm$ne pe"sons going to endemi% a"eas ) !ea%hing people in endemi% a"eas to $se %hemi%ally t"eated mos6$ito nets

of the following signs: fe/e" fo" 1 month o" mo"eW %hest pain lasting fo" 2 wees o" mo"e not att"ib$ted to othe" %onditionsW p"og"essi/e& $ne-plained weight lossW night sweatsW and hemoptysis 118 Hhi%h %lients a"e %onside"ed ta"gets fo" )O!S Catego"y IQ # Sp$t$m negati/e %a/ita"y %ases @ Clients "et$"ning afte" a defa$lt C elapses and fail$"es of p"e/io$s P!@ t"eatment "egimens ) Clients diagnosed fo" the fi"st time th"o$gh a positi/e sp$t$m e-am A$s-!r D C+i!$ts %ia$#s!% #r t/! irst ti6! t/r#0/ a *#siti8! s*0t06 !
A$s-!r ) D!str#i$ 7r!!%i$ *+a"!s # 6#s0it#!s #edes aegypti& the /e%to" of )eng$e fe/e"& b"eeds in stagnant& %lea" wate" Its feeding time is $s$ally d$"ing the daytime It has a %y%li%al patte"n of o%%$""en%e& $nlie mala"ia whi%h is endemi% in %e"tain pa"ts of the %o$nt"y

11 !o imp"o/e %omplian%e to t"eatment& what inno/ation is being implemented in )O!SQ # ?a/ing the health wo"e" follow $p the %lient at home @ ?a/ing the health wo"e" o" a "esponsible family membe" monito" d"$g intae C ?a/ing the patient %ome to the health %ente" e/e"y month to get his medi%ations

11. Se%onda"y p"e/ention fo" mala"ia in%l$des # Planting of neem o" e$%alypt$s t"ees @ esid$al sp"aying of inse%ti%ides at night C )ete"mining whethe" a pla%e is endemi% o" not ) D"owing la"/a=eating fish in mos6$ito b"eeding pla%es

) ?a/ing a ta"get list to %he% on whethe" the patient has %olle%ted his monthly s$pply of d"$gs

A$s-!r C D!t!r6i$i$ -/!t/!r a *+a"! is !$%!6i" #r $#t !his is diagnosti% and the"efo"e se%onda"y le/el p"e/ention !he othe" %hoi%es a"e fo" p"ima"y p"e/ention

11 S%ot%h tape swab is done to %he% fo" whi%h intestinal pa"asiteQ # #s%a"is @ Pinwo"m C ?oowo"m ) S%histosoma A$s-!r ) Pi$-#r6 Pinwo"m o/a a"e deposited a"o$nd the anal o"ifi%e

115 Hhi%h of the following signs indi%ates the need fo" sp$t$m e-amination fo" #F@Q # ?ematemesis @ Fe/e" fo" 1 wee C Co$gh fo" + wees ) Chest pain fo" 1 wee A$s-!r C C#0/ #r 3 -!!Bs # %lient is %onside"ed a P!@ s$spe%t when he has %o$gh fo" 2 wees o" mo"e& pl$s one o" mo"e

A$s-!r ) Ha8i$ t/! /!a+t/ -#rB!r #r a r!s*#$si7+! a6i+ 6!67!r 6#$it#r %r0 i$taB! )i"e%tly Obse"/ed !"eatment Sho"t Co$"se is so= %alled be%a$se a t"eatment pa"tne"& p"efe"ably a health wo"e" a%%essible to the %lient& monito"s the %lientKs %omplian%e to the t"eatment

119 )iagnosis of lep"osy is highly dependent on "e%ognition of symptoms Hhi%h of the following is an ea"ly sign of lep"osyQ #
120 Hhi%h of the following %lients sho$ld be %lassified as a %ase of m$ltiba%illa"y lep"osyQ # + sin lesions& negati/e slit sin smea" @ + sin lesions& positi/e slit sin smea" C  sin lesions& negati/e slit sin smea" )  sin lesions& positi/e slit sin smea"


A$s-!r D 5 sBi$ +!si#$s, *#siti8! s+it sBi$ s6!ar # m$ltiba%illa"y lep"osy %ase is one who has a positi/e slit sin smea" and at least  sin lesions

121 In the Philippines& whi%h %ondition is the most f"e6$ent %a$se of death asso%iated with s%histosomiasisQ # 'i/e" %an%e" @ 'i/e" %i""hosis C @ladde" %an%e" ) Intestinal pe"fo"ation A$s-!r ) Li8!r "irr/#sis !he etiologi% agent of s%histosomiasis in the Philippines is S%histosoma Eaponi%$m& whi%h affe%ts the small intestine and the li/e" 'i/e" damage is a %onse6$en%e of fib"oti% "ea%tions to s%histosoma eggs in the li/e"

122 Hhat is the most effe%ti/e way of %ont"olling s%histosomiasis in an endemi% a"eaQ # Use of moll$s%i%ides @ @$ilding of foot b"idges C P"ope" $se of sanita"y toilets ) Use of p"ote%ti/e footwea"& s$%h as "$bbe" boots A$s-!r C Pr#*!r 0s! # sa$itar t#i+!ts

!he o/a of the pa"asite get o$t of the h$man body togethe" with fe%es C$tting the %y%le at this stage is the most effe%ti/e way of p"e/enting the sp"ead of the disease to s$s%eptible hosts 12+ Hhen "esidents obtain wate" f"om an a"tesian well in the neighbo"hood& the le/el of this app"o/ed type of wate" fa%ility is # I @ II C III ) I7 A$s-!r ) II # %omm$nal fa$%et o" wate" standpost is %lassified as 'e/el II

12. Fo" p"e/ention of hepatitis #& yo$ de%ided to %ond$%t health ed$%ation a%ti/ities Hhi%h of the following is I,',7#*!Q # Use of ste"ile sy"inges and needles @ Safe food p"epa"ation and food handling by /endo"s C P"ope" disposal of h$man e-%"eta and pe"sonal hygiene ) Immediate "epo"ting of wate" pipe leas and illegal wate" %onne%tions A$s-!r A Us! # st!ri+! sri$!s a$% $!!%+!s ?epatitis # is t"ansmitted th"o$gh the fe%al o"al "o$te ?epatitis @ is t"ansmitted th"o$gh infe%ted body se%"etions lie blood and semen

125 Hhi%h biologi%al $sed in ,-panded P"og"am on Imm$ni(ation ,PI sho$ld *O! be sto"ed in the f"ee(e"Q # )P! @ O"al polio /a%%ine C
128 Ao$ will %ond$%t o$t"ea%h imm$ni(ation in a ba"angay with a pop$lation of abo$t 100 ,stimate the n$mbe" of infants in the ba"angay # . @ 0 C  ) 50 A$s-!r A 45 !o estimate the n$mbe" of infants& m$ltiply total pop$lation by +V

12 In Integ"ated
129 # %lient was diagnosed as ha/ing )eng$e fe/e" Ao$ will say that the"e is slow %apilla"y "efill when the %olo" of the nailbed that yo$ p"essed does not "et$"n within how many se%ondsQ # + @  C  ) 10 A$s-!r A 3 #de6$ate blood s$pply to the a"ea allows the "et$"n of the %olo" of the nailbed within + se%onds

1+0 # +=yea" old %hild was b"o$ght by his mothe" to the health %ente" be%a$se of fe/e" of .=day d$"ation !he %hild had a positi/e


to$"ni6$et test "es$lt In the absen%e of othe" signs& whi%h is the most app"op"iate meas$"e that the P?* may %a""y o$t to p"e/ent )eng$e sho% synd"omeQ # Inse"t an *D! and gi/e fl$ids pe" *D! @ Inst"$%t the mothe" to gi/e the %hild O"esol C Sta"t the patient on int"a/eno$s fl$ids S!#! ) efe" the %lient to the physi%ian fo" app"op"iate management A$s-!r ) I$str0"t t/! 6#t/!r t# i8! t/! "/i+% Or!s#+' Sin%e the %hild does not manifest any othe" dange" sign& maintenan%e of fl$id balan%e and "epla%ement of fl$id loss may be done by gi/ing the %lient O"esol

1+1 !he pathognomoni% sign of measles is opliKs spot Ao$ may see opliKs spot by inspe%ting the  # *asal m$%osa @ @$%%al m$%osa C Sin on the abdomen ) Sin on the ante%$bital s$"fa%e A$s-!r ) )0""a+ 60"#sa opliKs spot may be seen on the m$%osa of the mo$th o" the th"oat

1+2 #mong the following diseases& whi%h is ai"bo"neQ # 7i"al %onE$n%ti/itis @ #%$te poliomyelitis C )iphthe"ia )
1++ #mong %hild"en aged 2 months to + yea"s& the most p"e/alent fo"m of meningitis is %a$sed by whi%h mi%"oo"ganismQ # ?emophil$s infl$en(ae @
1+. ?$man beings a"e the maEo" "ese"/oi" of mala"ia Hhi%h of the following st"ategies in mala"ia %ont"ol is based on this fa%tQ # St"eam seeding

@ St"eam %lea"ing C )est"$%tion of b"eeding pla%es ) Joop"ophyla-is A$s-!r D K##*r#*/+a
1+ !he $se of la"/i/o"o$s fish in mala"ia %ont"ol is the basis fo" whi%h st"ategy of mala"ia %ont"olQ # St"eam seeding @ St"eam %lea"ing C )est"$%tion of b"eeding pla%es ) Joop"ophyla-is A$s-!r A Str!a6 s!!%i$ St"eam seeding is done by p$tting tilapia f"y in st"eams o" othe" bodies of wate" identified as b"eeding pla%es of the #nopheles mos6$ito

1+5
1+8 # .=yea" old %lient was b"o$ght to the health %ente" with the %hief %omplaint of se/e"e dia""hea and the passage of "i%e wate"T stools !he %lient is most p"obably s$ffe"ing f"om whi%h %onditionQ # Dia"diasis @ Chole"a C #mebiasis ) )ysente"y A$s-!r ) C/#+!ra Passage of p"of$se wate"y stools is the maEo" symptom of %hole"a @oth amebi% and ba%illa"y dysente"y a"e %ha"a%te"i(ed by the p"esen%e of blood andGo" m$%$s in the stools Dia"diasis is %ha"a%te"i(ed by fat malabso"ption and& the"efo"e& steato""hea

1+ In the Philippines& whi%h spe%ie of s%histosoma is endemi% in %e"tain "egionsQ # S mansoni @ S Eaponi%$m C S malayensis


) S haematobi$m A$s-!r ) S' Ja*#$i"06 S mansoni is fo$nd mostly in #f"i%a and So$th #me"i%aW S haematobi$m in #f"i%a and the
1+9 # +2=yea" old %lient %ame fo" %ons$ltation at the health %ente" with the %hief %omplaint of fe/e" fo" a wee #%%ompanying symptoms we"e m$s%le pains and body malaise # wee afte" the sta"t of fe/e"& the %lient noted yellowish dis%olo"ation of his s%le"a ?isto"y showed that he waded in flood wate"s abo$t 2 wees befo"e the onset of symptoms @ased on his histo"y& whi%h disease %ondition will yo$ s$spe%tQ # ?epatitis # @ ?epatitis @ C !etan$s ) 'eptospi"osis A$s-!r D L!*t#s*ir#sis 'eptospi"osis is t"ansmitted th"o$gh %onta%t with the sin o" m$%o$s memb"ane with wate" o" moist soil %ontaminated with $"ine of infe%ted animals& lie "ats

# @eing faithf$l to a single se-$al pa"tne" @ Using a %ondom d$"ing ea%h se-$al %onta%t C #/oiding se-$al %onta%t with %omme"%ial sewo"e"s )
1.0
1.. !o dete"mine possible so$"%es of se-$ally t"ansmitted infe%tions& whi%h is the @,S! method that may be $nde"taen by the p$bli% health n$"seQ

whi%h le/el of wate" fa%ilityQ # I @ II C III ) I7

# Conta%t t"a%ing @ Comm$nity s$"/ey C
A$s-!r C III Hate"wo"s systems& s$%h as
A$s-!r A C#$ta"t tra"i$ Conta%t t"a%ing is the most p"a%ti%al and "eliable method of finding possible so$"%es of pe"son=to= pe"son t"ansmitted infe%tions& s$%h as se-$ally t"ansmitted diseases

1.1 Ao$ a"e the P?* in the %ity health %ente" # %lient $nde"went s%"eening fo" #I)S $sing ,'IS# ?is "es$lt was positi/e Hhat is the best %o$"se of a%tion that yo$ may taeQ # Det a tho"o$gh histo"y of the %lient& fo%$sing on the p"a%ti%e of high "is beha/io"s @ #s the %lient to be a%%ompanied by a signifi%ant pe"son befo"e "e/ealing the "es$lt C efe" the %lient to the physi%ian sin%e he is the best pe"son to "e/eal the "es$lt to the %lient ) efe" the %lient fo" a s$pplementa"y test& s$%h as Heste"n blot& sin%e the ,'IS# "es$lt may be false A$s-!r D R!!r t/! "+i!$t #r a s0**+!6!$tar t!st, s0"/ as !st!r$ 7+#t, si$"! t/! ELISA r!s0+t 6a 7! a+s!' # %lient ha/ing a "ea%ti/e ,'IS# "es$lt m$st $nde"go a mo"e spe%ifi% test& s$%h as Heste"n blot # negati/e s$pplementa"y test "es$lt means that the ,'IS# "es$lt was false and that& most p"obably& the %lient is not infe%ted

1.2 Hhi%h is the @,S! %ont"ol meas$"e fo" #I)SQ

1. #nti"et"o/i"al agents& s$%h as #J!& a"e $sed in the management of #I)S Hhi%h of the following is *O! an a%tion e-pe%ted of these d"$gs # !hey p"olong the life of the %lient with #I)S @ !hey "ed$%e the "is of oppo"t$nisti% infe%tions C !hey sho"ten the pe"iod of %omm$ni%ability of the disease ) !hey a"e able to b"ing abo$t a %$"e of the disease %ondition A$s-!r D T/! ar! a7+! t# 7ri$ a7#0t a "0r! # t/! %is!as! "#$%iti#$' !he"e is no nown t"eatment fo" #I)S #nti"et"o/i"al agents "ed$%e the "is of oppo"t$nisti% infe%tions and p"olong life& b$t does not %$"e the $nde"lying imm$nodefi%ien%y

1.5 # ba"angay had an o$tb"ea of De"man measles !o p"e/ent %ongenital "$bella& what is the @,S! ad/i%e that yo$ %an gi/e to women in the fi"st t"imeste" of p"egnan%y in the ba"angayQ # #d/i%e them on the signs of De"man measles @ #/oid %"owded pla%es& s$%h as ma"ets and mo/ieho$ses


C Cons$lt at the health %ente" whe"e "$bella /a%%ine may be gi/en ) Cons$lt a physi%ian who may gi/e them "$bella imm$noglob$lin A$s-!r D C#$s0+t a */si"ia$ -/# 6a i8! t/!6 r07!++a i660$#+#70+i$' $bella /a%%ine is made $p of atten$ated De"man measles /i"$ses !his is %ont"aindi%ated in p"egnan%y Imm$ne glob$lin& a spe%ifi% p"ophyla%ti% against De"man measles& may be gi/en to p"egnant women

1.8 Ao$ we"e be the "eso$"%e pe"son a t"aining %lass in/ited fo" foodtohandle"s Hhi%h of the in following wo$ld yo$ emphasi(e "ega"ding p"e/ention of staphylo%o%%al food poisoningQ # #ll %ooing and eating $tensils m$st be tho"o$ghly washed @ Food m$st be %ooed p"ope"ly to dest"oy staphylo%o%%al mi%"oo"ganisms C Food handle"s and food se"/e"s m$st ha/e a negati/e stool e-amination "es$lt ) P"ope" handwashing d$"ing food p"epa"ation is the best way of p"e/enting the %ondition A$s-!r D Pr#*!r /a$%-as/i$ %0ri$ ##% *r!*arati#$ is t/! 7!st -a # *r!8!$ti$ t/! "#$%iti#$' Symptoms of this food poisoning a"e d$e to staphylo%o%%al ente"oto-in& not the mi%"oo"ganisms themsel/es Contamination is by food handling by pe"sons with staphylo%o%%al sin o" eye infe%tions

1. In a mothe"sK %lass& yo$ dis%$ssed %hildhood diseases s$%h as %hi%en po- Hhi%h of the following statements abo$t %hi%en po- is %o""e%tQ # !he olde" one gets& the mo"e s$s%eptible he be%omes to the %ompli%ations of %hi%en po- @ # single atta% of %hi%en po- will p"e/ent f$t$"e episodes& in%l$ding %onditions s$%h as shingles C !o p"e/ent an o$tb"ea in the %omm$nity& 6$a"antine may be imposed by health a$tho"ities ) Chi%en po- /a%%ine is best gi/en when the"e is an impending o$tb"ea in the %omm$nity A$s-!r A T/! #+%!r #$! !ts, t/! 6#r! s0s"!*ti7+! /! 7!"#6!s t# t/! "#6*+i"ati#$s # "/i"B!$ *#<' Chi%en po- is $s$ally mo"e se/e"e in ad$lts than in %hild"en Compli%ations& s$%h as pne$monia& a"e highe" in in%iden%e in ad$lts

1.9 Compli%ations to infe%tio$s pa"otitis m$mps may be se"io$s in whi%h type of %lientsQ # P"egnant women @ ,lde"ly %lients C Ao$ng ad$lt males ) Ao$ng infants A$s-!r C (#0$ a%0+t 6a+!s ,pididymitis and o"%hitis a"e possible %ompli%ations of m$mps In post=adoles%ent males& bilate"al inflammation of the testes and epididymis

may %a$se ste"ility


MEDICAL SURGICAL NURSING Part 1

1 <"s Ch$a a 8 yea" old %lient is admitted with the diagnosis of mild %h"oni% hea"t fail$"e !he n$"se e-pe%ts to hea" when listening to %lientKs l$ngs indi%ati/e of %h"oni% hea"t fail$"e wo$ld be: a St"ido" b C"a%les % Hhee(es d F"i%tion "$bs 2 Pat"i% who is hospitali(ed following a myo%a"dial infa"%tion ass the n$"se why he is taing mo"phine !he n$"se e-plains that mo"phine: a )e%"ease an-iety and "estlessness b P"e/ents sho% and "elie/es pain % )ilates %o"ona"y blood /essels d ?elps p"e/ent fib"illation of the hea"t + Hhi%h of the following sho$ld the n$"se tea%h the %lient abo$t the signs of digitalis to-i%ityQ a In%"eased appetite b ,le/ated blood p"ess$"e % Sin "ash o/e" the %hest and ba% d 7is$al dist$"ban%es s$%h as seeing yellow spots . *$"se !"isha tea%hes a %lient with hea"t fail$"e to tae o"al F$"osemide in the mo"ning !he "eason fo" this is to helpM a eta"d "apid d"$g abso"ption b ,-%"ete e-%essi/e fl$ids a%%$m$lated at night % P"e/ents sleep dist$"ban%es d$"ing night d P"e/ention of ele%t"olyte imbalan%e  Hhat wo$ld be the p"ima"y goal of the"apy fo" a %lient with p$lmona"y edema and hea"t fail$"eQ a ,nhan%e %omfo"t


b In%"ease %a"dia% o$tp$t % Imp"o/e "espi"ato"y stat$s d Pe"iphe"al edema de%"eased 5 *$"se 'inda is %a"ing fo" a %lient with head inE$"y and monito"ing the %lient with de%e"eb"ate post$"ing Hhi%h of the following is a %ha"a%te"isti% of this type of post$"ingQ a Uppe" e-t"emity fle-ion with lowe" e-t"emity fle-ion b Uppe" e-t"emity fle-ion with lowe" e-t"emity e-tension % ,-tension of the e-t"emities afte" a stim$l$s d Fle-ion of the e-t"emities afte" stim$l$s 8 # female %lient is taing Cas%a"a Sag"ada *$"se @etty info"ms the %lient that the following maybe e-pe"ien%ed as side effe%ts of this medi%ation: a DI bleeding b Pepti% $l%e" disease % #bdominal %"amps d Pa"tial bowel obst"$%tion  )" $inidine S$lfate % 7itamin C d Co$madin 1 In "ed$%ing the "is of endo%a"ditis& good dental %a"e is an impo"tant meas$"e !o p"omote good dental %a"e in %lient with mit"al stenosis in tea%hing plan sho$ld in%l$de p"ope" $se ofM a )ental floss b ,le%t"i% toothb"$sh %

15 #mong the following signs and symptoms& whi%h wo$ld most liely be p"esent in a %lient with mit"al g$"gitationQ a #lte"ed le/el of %ons%io$sness b ,-%eptional )yspnea % In%"ease %"eatine phospholinase %on%ent"ation d Chest pain 18 "is with a histo"y of %h"oni% infe%tion of the $"ina"y system %omplains of $"ina"y f"e6$en%y and b$"ning sensation !o fig$"e o$t whethe" the %$""ent p"oblem is in "enal o"igin& the n$"se sho$ld assess whethe" the %lient has dis%omfo"t o" pain in theM a U"ina"y meat$s b Pain in the 'abi$m % S$p"ap$bi% a"ea d ight o" left %osto/e"teb"al angle 1 *$"se Pe""y is e/al$ating the "enal f$n%tion of a male %lient #fte" do%$menting $"ine /ol$me and %ha"a%te"isti%s& *$"se Pe""y assesses whi%h signs as the best indi%ato" of "enal f$n%tion a @lood p"ess$"e b Cons%io$sness % )istension of the bladde" d P$lse "ate 19 Bohn s$ddenly e-pe"ien%es a sei($"e& and *$"se Dina noti%e that Bohn e-hibits $n%ont"ollable Ee"ing mo/ements *$"se Dina do%$ments that Bohn e-pe"ien%ed whi%h type of sei($"eQ a !oni% sei($"e b #bsen%e sei($"e %

d Using a filte" mas 28 # female %lient is e-pe"ien%ing painf$l and "igid abdomen and is diagnosed with pe"fo"ated pepti% $l%e" # s$"ge"y has been s%hed$led and a nasogast"i% t$be is inse"ted !he n$"se sho$ld pla%e the %lient befo"e s$"ge"y in a Sims position b S$pine position % Semi=fowle"s position d )o"sal "e%$mbent position 2 Hhi%h n$"sing inte"/ention ens$"es ade6$ate /entilating e-%hange afte" s$"ge"yQ a emo/e the ai"way only when %lient is f$lly %ons%io$s b #ssess fo" hypo/entilation by a$s%$ltating the l$ngs % Position %lient late"ally with the ne% e-tended d

b !ae a sho"t wal % )"in plenty of wate" d 'ie down at least +0 min$tes + #fte" gast"os%opy& an adaptation that indi%ates maEo" %ompli%ation wo$ld be: a *a$sea and /omiting b #bdominal distention % In%"eased DI motility d )iffi%$lty in swallowing +9 # %lient who has $nde"gone a %hole%yste%tomy ass the n$"se whethe" the"e a"e any dieta"y "est"i%tions that m$st be followed *$"se ?ila"y wo$ld "e%ogni(e that the dieta"y tea%hing was well $nde"stood when the %lient tells a family membe" that: a 

. Be""y has diagnosed with appendi%itis ?e de/elops a fe/e"& hypotension and ta%hy%a"dia !he n$"se s$spe%ts whi%h of the following %ompli%ationsQ a Intestinal obst"$%tion b Pe"itonitis % @owel is%hemia d )efi%ient fl$id /ol$me .9 Hhi%h of the following %ompilations sho$ld the n$"se %a"ef$lly monito"s a %lient with a%$te pan%"eatitis a
ANSERS a$% RATIONALES #r MEDICAL SURGICAL NURSING Part 1

1 ) 'eft sided hea"t fail$"e %a$ses fl$id a%%$m$lation in the %apilla"y netwo" of the l$ng Fl$id e/ent$ally ente"s al/eola" spa%es and %a$ses %"a%ling so$nds at the end of inspi"ation

2 )
+ D Seeing yellow spots and %olo"ed /ision a"e %ommon symptoms of digitalis to-i%ity . C Hhen di$"eti%s a"e taen in the mo"ning& %lient will /oid f"e6$ently d$"ing daytime and will not need to /oid f"e6$ently at night  ) !he p"ima"y goal of the"apy fo" the %lient with p$lmona"y edema o" hea"t fail$"e is in%"easing %a"dia% o$tp$t P$lmona"y edema is an a%$te medi%al eme"gen%y "e6$i"ing immediate inte"/ention

5 C )e%e"eb"ate post$"ing is the e-tension of the e-t"emities afte" a stim$l$s& whi%h may o%%$" with $ppe" b"ain stem inE$"y

8 C !he most f"e6$ent side effe%ts of Cas%a"a Sag"ada 'a-ati/e is abdominal %"amps and na$sea  D #dminist"ation of Int"a/eno$s *it"ogly%e"in inf$sion "e6$i"es p$mp fo" a%%$"ate %ont"ol of medi%ation

9 A @y the 2 nd day of hospitali(ation afte" s$ffe"ing a
10 ) !he left side of the body will be affe%ted in a "ight=sided b"ain atta% 11 A #fte" neph"e%tomy& it is ne%essa"y to meas$"e $"ine o$tp$t ho$" ly !his is done to assess the effe%ti/eness of the "emaining idney also to dete%t "enal fail$"e ea"ly

12 ) !he l$men of the a"te"ies %an be assessed by %a"dia% %athete"i(ation #ngina is $s$ally %a$sed by na""owing of the %o"ona"y a"te"ies

1+ C @lood p"ess$"e is monito"ed to dete%t hypotension whi%h may indi%ate sho% o" hemo""hage #pi%al p$lse is taen to dete%t dys"hythmias "elated to %a"dia% i""itability


1. A P"otamine S$lfate is $sed to p"e/ent %ontin$o$s bleeding in %lient who has $nde"gone open hea"t s$"ge"y

1 C !he $se of ele%t"oni% toothb"$sh& i""igation de/i%e o" dental floss may %a$se bleeding of g$ms& allowing ba%te"ia to ente" and in%"easing the "is of endo%a"ditis

15 ) Height gain d$e to "etention of fl$ids and wo"sening hea"t fail$"e %a$ses e-e"tional dyspnea in %lients with mit"al "eg$"gitation

18 D )is%omfo"t o" pain is a p"oblem that o"iginates in the idney It is felt at the %osto/e"teb"al angle on the affe%ted side

1 A Pe"f$sion %an be best estimated by blood p"ess$"e& whi%h is an indi"e%t "efle%tion of the ade6$a%y of %a"dia% o$tp$t

19 C
20 D *i%otine *i%ot"ol is gi/en in %ont"olled and de%"easing doses fo" the management of ni%otine withd"awal synd"ome

21 D ayna$dKs disease is %ha"a%te"i(ed by /asospasms of the small %$taneo$s a"te"ies that in/ol/es finge"s and toes

22 A U"ine testing p"o/ides an indi"e%t meas$"e that maybe infl$en%ed by idney f$n%tion while blood gl$%ose testing is a mo"e di"e%t and a%%$"ate meas$"e

2+ C One lite" of fl$id app"o-imately weighs 22 po$nds # . po$nd weight loss e6$als to app"o-imately 2'

2. A Osmosis is the mo/ement of fl$id f"om an a"ea of lesse" sol$te %on%ent"ation to an a"ea of g"eate" sol$te %on%ent"ation

2 D Fo"ea"m m$s%le weaness is a p"obable sign of "adial ne"/e inE$"y %a$sed by %"$t%h p"ess$"e on the a-illae

25 ) *e$t"openi% %lient is at "is fo" infe%tion espe%ially ba%te"ial infe%tion of the gast"ointestinal and "espi"ato"y t"a%t

28 C Semi=fowle"s position will lo%ali(e the spilled stoma%h %ontents in the lowe" pa"t of the abdominal %a/ity

2 C Positioning the %lient late"ally with the ne% e-tended does not obst"$%t the ai"way so that d"ainage of se%"etions and o-ygen and %a"bon dio-ide e-%hange %an o%%$"

29 ) ,-%essi/e b$bbling indi%ates an ai" lea whi%h m$st be eliminated to pe"mit l$ng e-pansion +0 C Hheat %e"eal has a low sodi$m %ontent +1 A ,nla"ged %i""hoti% li/e" impinges the po"tal system %a$sing in%"eased hyd"ostati% p"ess$"e "es$lting to as%ites

+2 C #ssessing fo" an open ai"way is the p"io"ity !he p"o%ed$"e in/ol/es the ne%& the anesthesia may ha/e

++ +. + +5

+8 + +9 .0 .1 .2 .+ .. . .5

affe%ted the swall owing "efle- o" the inflammation may ha/e %losed in on the ai"way leadi ng to ineffe%ti/e ai" e-%hange A !ypi%al signs and symptoms of hypo/olemi% sho% in%l$des systoli% blood p"ess$"e of less than 90 mm ?g D #spi"in %ontaining medi%ations sho$ld not be taen 1. days befo"e s$"ge"y to de%"ease the "is of bleeding A

.8 A S$dden de%"ease in d"ainage o" onset of se/e"e abdominal pain sho$ld be "epo"ted immediately to the physi%ian be%a$se it %o$ld mean that obst"$%tion has been de/eloped

. ) Compli%ations of a%$te appendi%itis a"e pe"itonitis& pe"fo"ation and abs%ess de/elopment .9 D # %lient with a%$te pan%"eatitis is p"one to %ompli%ations asso%iated with "espi"ato"y system 0 ) 'i/e" inflammation and obst"$%tion blo% the no"mal flow of bile ,-%ess bili"$bin t$"ns the sin and s%le"a yellow and the $"ine da" and f"othy


1 # %lient is s%hed$led fo" inse"tion of an infe"io" /ena %a/a I7C filte" *$"se Pat"i%ia %ons$lts the physi%ian abo$t withholding whi%h "eg$la"ly s%hed$led medi%ation on the day befo"e the s$"ge"yQ a Potassi$m Chlo"ide b Ha"fa"in Sodi$m % F$"osemide d )o%$sate 2 # n$"se is planning to assess the %o"neal "efle- on $n%ons%io$s %lient Hhi%h of the following is the safest stim$l$s to to$%h the %lientKs %o"neaQ a Cotton b$ds b Ste"ile glo/e % Ste"ile tong$e dep"esso" d Hisp of %otton + # female %lient de/elops an infe%tion at the %athete" inse"tion site !he n$"se in %ha"ge $ses the te"m iat"ogeni%T when des%"ibing the infe%tion be%a$se it "es$lted f"om: a ClientKs de/elopmental le/el b !he"ape$ti% p"o%ed$"e % Poo" hygiene d Inade6$ate dieta"y patte"ns . *$"se Ca"ol is assessing a %lient with Pa"insonKs disease !he n$"se "e%ogni(e b"adyinesia when the %lient e-hibits:


a Intentional t"emo" b Pa"alysis of limbs % <$s%le spasm d 'a% of spontaneo$s mo/ement  # %lient who s$ffe"ed f"om a$tomobile a%%ident %omplains of seeing f"e6$ent flashes of light !he n$"se sho$ld e-pe%t: a

a !ingling in the finge"s b Pain in hands and feet % !ension on the s$t$"e lines d @leeding on the ba% of the d"essing 15 #  yea" old woman has newly diagnosed with hypothy"oidism !he n$"se is awa"e that the signs and symptoms of hypothy"oidism in%l$de: a )ia""hea b 7omiting % !a%hy%a"dia d Height gain 18 # %lient has $nde"gone fo" an ileal %ond$it& the n$"se in %ha"ge sho$ld %losely monito" the %lient fo" o%%$""en%e of whi%h of the following %ompli%ations "elated to pel/i% s$"ge"yQ a #s%ites b !h"ombophlebitis % Ing$inal he"nia d Pe"itonitis 1 )"

% Pea"ly %olo"ed tympani% memb"ane d

a Const"i%ting p$pil b ela-ing %ilia"y m$s%le % Const"i%ting int"ao%$la" /essel d Pa"aly(ing %ilia"y m$s%le +9 Hhen s$%tioning an $n%ons%io$s %lient& whi%h n$"sing inte"/ention sho$ld the n$"se p"io"iti(e in maintaining %e"eb"al pe"f$sionQ a #dministe" di$"eti%s b #dministe" analgesi%s % P"o/ide hygiene d ?ype"o-ygenate befo"e and afte" s$%tioning .0 Hhen dis%$ssing b"eathing e-e"%ises with a postope"ati/e %lient& *$"se ?a(el sho$ld in%l$de whi%h of the following tea%hingQ a Sho"t f"e6$ent b"eaths b ,-hale with mo$th open % ,-e"%ise twi%e a day d Pla%e hand on the abdomen and feel it "ise .1 'o$ie& with b$"ns o/e" +V of the body& %omplains of %hilling In p"omoting the %lientKs %omfo"t& the n$"se sho$ld: a

a Se"$m bili"$bin le/el b Se"$m amylase le/el % Potassi$m le/el d Sodi$m le/el 0 )"

1 ) In p"eope"ati/e pe"iod& the n$"se sho$ld %ons$lt with the physi%ian abo$t withholding Ha"fa"in Sodi$m to a/oid o%%$""en%e of hemo""hage 2 D # %lient who is $n%ons%io$s is at g"eate" "is fo" %o"neal ab"asion Fo" this "eason& the safest way to test the %o"nel "efle- is by to$%hing the %o"nea lightly with a wisp of %otton + ) Iat"ogeni% infe%tion is %a$sed by the heath %a"e p"o/ide" o" is ind$%ed inad/e"tently by medi%al t"eatment o" p"o%ed$"es . D @"adyinesia is slowing down f"om the initiation and e-e%$tion of mo/ement  ) !his symptom is %a$sed by stim$lation of "etinal %ells by o%$la" mo/ement 5 D estlessness indi%ates a la% of o-ygen to the b"ain stem whi%h impai"s the "eti%$la" a%ti/ating system 8 C hythmi% %ont"a%tion and "ela-ation asso%iated with toni%=%loni% sei($"e %an %a$se "epeated banging of head  A ight side lying position o" s$pine position pe"mits /entilation of the "emaining l$ng and p"e/ent fl$id f"om d"aining into s$t$"ed b"on%hial st$mp 9 C Isonia(id I*? inte"fe"es in the effe%ti/eness of o"al %ont"a%epti/es and %lients of %hildbea"ing age sho$ld be %o$nseled to $se an alte"nati/e fo"m of bi"th %ont"ol while taing this d"$g 10 ) # %lient who has had abdominal s$"ge"y is best pla%ed in a low fowle"Ks position !his "ela-es abdominal m$s%les and p"o/ides ma-im$m "espi"ato"y and %a"dio/as%$la" f$n%tion 11 A )a" "ed to p$"ple stoma indi%ates inade6$ate blood s$pply 12 C !he "ationale fo" a%ti/ity "est"i%tion is to help "ed$%e the hype"motility of the %olon


1+ A )$"ing !otal Pa"ente"al *$t"ition !P* administ"ation& the %lient sho$ld be monito"ed "eg$la"ly fo" hype"gly%emia 1. D Ba$ndi%e may be p"esent in a%$te pan%"eatitis owing to obst"$%tion of the bilia"y d$%t 1 A !etany may o%%$" afte" thy"oide%tomy if the pa"athy"oid glands a"e a%%identally inE$"ed o" "emo/ed 15 D !ypi%al signs of hypothy"oidism in%l$des weight gain& fatig$e& de%"eased ene"gy& apathy& b"ittle nails& d"y sin& %old intole"an%e& %onstipation and n$mbness 18 ) #fte" a pel/i% s$"ge"y& the"e is an in%"eased %han%e of th"ombophlebitits owing to the pel/i% manip$lation that %an inte"fe"e with %i"%$lation and p"omote /eno$s stasis 1 D Fo" the safety of all pe"sonnel& if the defib"illato" paddles a"e being dis%ha"ged& all pe"sonnel m$st stand ba% and be %lea" of all the %onta%t with the %lient o" the %lientKs bed 19 D ?a"d %andy will "elie/e thi"st and in%"ease %a"bohyd"ates b$t does not s$pply e-t"a fl$id 20 C Infe%tion is "esponsible fo" one thi"d of the t"a$mati% o" s$"gi%ally ind$%ed death of %lients with "enal fail$"e as well as medi%al ind$%ed a%$te "enal fail$"e #F 21 C !he"e is no "espi"ato"y mo/ement in stage . of anesthesia& p"io" to this stage& "espi"ation is dep"essed b$t p"esent 22 ) Comp"ession of the l$ng by fl$id that a%%$m$lates at the base of the l$ngs "ed$%es e-pansion and ai" e-%hange 2+ C #ssessment of a %lient with ?odginKs disease most often "e/eals enla"ged& painless lymph node& fe/e"& malaise and night sweats 2. A F"a%t$"ed pain is gene"ally des%"ibed as sha"p& %ontin$o$s& and in%"easing in f"e6$en%y 2 D Signs and symptoms of infe%tion $nde" a %asted a"ea in%l$de odo" o" p$"$lent d"ainage and the p"esen%e of hot spotT whi%h a"e a"eas on the %ast that a"e wa"me" than the othe"s 25 ) Otos%opi% e-amnation in a %lient with mastoiditis "e/eals a d$ll& "ed& thi% and immobile tymphani% memb"ane with o" witho$t pe"fo"ation 28 D 'oss of gast"i% fl$id /ia nasogast"i% s$%tion o" /omiting %a$ses metaboli% alalosis be%a$se of the loss of hyd"o%hlo"i% a%id whi%h is a potent a%id in the body 2 A !he ad$lt with no"mal %e"eb"ospinal fl$id has no "ed blood %ells 29 D


1

b #pple E$i%e % Hhole wheat b"ead d Cottage %heese  enneth who has diagnosed with $"emi% synd"ome has the potential to de/elop %ompli%ations Hhi%h among the following %ompli%ations sho$ld the n$"se anti%ipates: a Flapping hand t"emo"s b #n ele/ated hemato%"it le/el % ?ypotension d ?ypoalemia 5 # %lient is admitted to the hospital with benign p"ostati% hype"plasia& the n$"se most "ele/ant assessment wo$ld be: a Flan pain "adiating in the g"oin b )istention of the lowe" abdomen % Pe"ineal edema d U"eth"al dis%ha"ge 8 # %lient has $nde"gone with penile implant #fte" 2. h"s of s$"ge"y& the %lientKs s%"ot$m was edemato$s and painf$l !he n$"se sho$ld: a #ssist the %lient with sit( bath b #pply wa" soas in the s%"ot$m % ,le/ate the s%"ot$m $sing a soft s$ppo"t d P"epa"e fo" a possible in%ision and d"ainage  *$"se ha(el "e%ei/es eme"gen%y labo"ato"y "es$lts fo" a %lient with %hest pain and immediately info"ms the physi%ian #n in%"eased myoglobin le/el s$ggests whi%h of the followingQ a 'i/e" disease b

d Intae and o$t p$t 15 'ydia is s%hed$led fo" ele%ti/e splene%tomy @efo"e the %lients goes to s$"ge"y& the n$"se in %ha"ge final assessment wo$ld be: a signed %onsent b /ital signs % name band d empty bladde" 18 Hhat is the pea age "ange in a%6$i"ing a%$te lympho%yti% le$emia #''Q a . to 12 yea"s b 20 to +0 yea"s % .0 to 0 yea"s d 50 50 80 yea"s 1

28 Hhile pe"fo"ming a physi%al assessment of a male %lient with go$t of the g"eat toe& *$"se 7i/ian sho$ld assess fo" additional tophi $"ate deposits on the: a @$tto%s b ,a"s % Fa%e d #bdomen 2 *$"se at"ina wo$ld "e%ogni(e that the demonst"ation of %"$t%h waling with t"ipod gait was $nde"stood when the %lient pla%es weight on the: a Palms of the hands and a-illa"y "egions b Palms of the hand % #-illa"y "egions d Feet& whi%h a"e set apa"t 29

+ Hhi%h of the following stage the %a"%inogen is i""e/e"sibleQ a P"og"ession stage b Initiation stage % eg"ession stage d P"omotion stage +9 #mong the following %omponents tho"o$gh pain assessment& whi%h is the most signifi%antQ a ,ffe%t b Ca$se % Ca$sing fa%to"s d Intensity .0 # 5 yea" old female is e-pe"ien%ing fla"e $p of p"$"it$s Hhi%h of the %lientKs a%tion %o$ld agg"a/ate the %a$se of fla"e $psQ a Sleeping in %ool and h$midified en/i"onment b )aily baths with f"ag"ant soap % Using %lothes made f"om 100V %otton d In%"easing fl$id intae .1 #t"opine s$lfate #t"opine is %ont"aindi%ated in all b$t one of the following %lientQ a # %lient with high blood b # %lient with bowel obst"$%tion % # %lient with gla$%oma d # %lient with U!I .2 #mong the following %lien ts& whi%h among them is high "is fo" poten tial ha(a"ds f"om the s$"gi%al e-pe"ien%eQ a 58=yea"=old %lient b .9=yea"=old %lient % ++=yea"=old %lient d 1=yea"=old %lient .+ *$"se Bon assesses /ital signs on a %lient $nde"gone epid$"al anesthesia Hhi%h of the following wo$ld the n$"se assess ne-tQ a ?eada%he b @ladde" distension % )i((iness d #bility to mo/e legs .. *$"se at"ina sho$ld anti%ipate that all of the following d"$gs may be $sed in the attempt to %ont"ol the symptoms of

0 # %lient has $nde"gone la"ynge%tomy !he immediate n$"sing p"io"ity wo$ld be: a eep t"a%hea f"ee of se%"etions b

1 C Dl$%o%o"ti%oids ste"oids a"e $sed fo" thei" anti=inflammato"y a%tion& whi%h de%"eases the de/elopment of edema 2 A !he blood m$st be stopped at on%e& and then no"mal saline sho$ld be inf$sed to eep the line patent and maintain blood /ol$me + ) !hese tests %onfi"m the p"esen%e of ?I7 antibodies that o%%$" in "esponse to the p"esen%e of the h$man imm$nodefi%ien%y /i"$s ?I7 . D One %$p of %ottage %heese %ontains app"o-imately 22 %alo"ies& 28 g of p"otein& 9 g of fat& +0 mg %holeste"ol& and 5 g of %a"bohyd"ate P"oteins of high biologi% /al$e ?@7 %ontain optimal le/els of amino a%ids essential fo" life  A ,le/ation of $"emi% waste p"od$%ts %a$ses i""itation of the ne"/es& "es$lting in flapping hand t"emo"s 5 ) !his indi%ates that the bladde" is distended with $"ine& the"efo"e palpable 8 C ,le/ation in%"eases lymphati% d"ainage& "ed$%ing edema and pain  ) )ete%tion of myoglobin is a diagnosti% tool to dete"mine whethe" myo%a"dial damage has o%%$""ed 9 D Hhen mit"al stenosis is p"esent& the left at"i$m has diffi%$lty emptying its %ontents into the left /ent"i%le be%a$se the"e is no /al/e to p"e/ent ba% wa"d flow into the p$lmona"y /ein& the p$lmona"y %i"%$lation is $nde" p"ess$"e 10 A

12 A #n in%"eased in ')' %holeste"ol %on%ent"ation has been do%$mented at "is fa%to" fo" the de/elopment of athe"os%le"osis ')' %holeste"ol is not b"oen down into the li/e" b$t is deposited into the wall of the blood /essels 1+ D !he"e is a potential alte"ation in "enal pe"f$sion manifested by de%"eased $"ine o$tp$t !he alte"ed "enal pe"f$sion may be "elated to "enal a"te"y embolism& p"olonged hypotension& o" p"olonged ao"ti% %"oss= %lamping d$"ing the s$"ge"y 1. A Dood so$"%e of /itamin @12 a"e dai"y p"od$%ts and meats 1 C #plasti% anemia de%"eases the bone ma""ow p"od$%tion of @CKs& white blood %ells& and platelets !he %lient is at "is fo" b"$ising and bleeding tenden%ies 15 )' #n ele%ti/e p"o%ed$"e is s%hed$led in ad/an%e so that all p"epa"ations %an be %ompleted ahead of time !he /ital signs a"e the final %he% that m$st be %ompleted befo"e the %lient lea/es the "oom so that %ontin$ity of %a"e and assessment is p"o/ided fo" 18 A !he pea in%iden%e of #%$te 'ympho%yti% 'e$emia #'' is . yea"s of age It is $n%ommon afte" 1 yea"s of age 1 D #%$te 'ympho%yti% 'e$emia #'' does not %a$se gast"i% distention It does in/ade the %ent"al ne"/o$s system& and %lients e-pe"ien%e heada%hes and /omiting f"om meningeal i""itation 19 ) )isseminated Int"a/as%$la" Coag$lation )IC has not been fo$nd to "espond to o"al anti%oag$lants s$%h as Co$madin 20 A U"ine o$tp$t p"o/ides the most sensiti/e indi%ation of the %lientKs "esponse to the"apy fo" hypo/olemi% sho% U"ine o$tp$t sho$ld be %onsistently g"eate" than +0 to + m'Gh" 21 C ,a"ly wa"ning signs of la"yngeal %an%e" %an /a"y depending on t$mo" lo%ation ?oa"seness lasting 2 wees sho$ld be e/al$ated be%a$se it is one of the most %ommon wa"ning signs 22 C Ste"oids de%"ease the bodyKs imm$ne "esponse th$s de%"easing the p"od$%tion of antibodies that atta% the a%etyl%holine "e%epto"s at the ne$"om$s%$la" E$n%tion 2+ C !he osmoti% di$"eti% mannitol is %ont"aindi%ated in the p"esen%e of inade6$ate "enal f$n%tion o" hea"t fail$"e be%a$se it in%"eases the int"a/as%$la" /ol$me that m$st be filte"ed and e-%"eted by the idney 2. A !hese de/i%es a"e mo"e a%%$"ate be%a$se they a"e easily to $sed and ha/e imp"o/ed adhe"en%e in ins$lin "egimens by yo$ng people be%a$se the medi%ation %an be administe"ed dis%"eetly 2 C )amage to blood /essels may de%"ease the %i"%$lato"y pe"f$sion of the toes& this wo$ld indi%ate the la% of blood s$pply to the e-t"emity 25 D' ,le/ation will help %ont"ol the edema that $s$ally o%%$"s 28 )' U"i% a%id has a low sol$bility& it tends to p"e%ipitate and fo"m deposits at /a"io$s sites whe"e blood flow is least a%ti/e& in%l$ding %a"tilagino$s tiss$e s$%h as the ea"s 2 ) !he palms sho$ld bea" the %lientKs weight to a/oid damage to the ne"/es in the a-illa 29 A #%ti/e e-e"%ises& alte"nating e-tension& fle-ion& abd$%tion& and add$%tion& mobili(e e-$dates in the Eoints "elie/es stiffness and pain +0 C' #lte"ation in sensation and %i"%$lation indi%ates damage to the spinal %o"d& if these o%%$"s notify physi%ian immediately +1 A In the di$"eti% phase fl$id "etained d$"ing the olig$"i% phase is e-%"eted and may "ea%h + to  lite"s daily& hypo/olemia may o%%$" and fl$ids sho$ld be "epla%ed +2 C !he %onstit$ents of CSF a"e simila" to those of blood plasma #n e-amination fo" gl$%ose %ontent is done to dete"mine whethe" a body fl$id is a m$%$s o" a CSF # CSF no"mally %ontains gl$%ose ++ ) !"a$ma is one of the p"ima"y %a$se of b"ain damage and sei($"e a%ti/ity in ad$lts Othe" %ommon %a$ses of sei($"e a%ti/ity in ad$lts in%l$de neoplasms& withd"awal f"om d"$gs and al%ohol& and /as%$la" disease +. A It is %"$%ial to monito" the p$pil si(e and papilla"y "esponse to indi%ate %hanges a"o$nd the %"anial ne"/es + C !he n$"se most positi/e app"oa%h is to en%o$"age the %lient with m$ltiple s%le"osis to stay a%ti/e& $se st"ess "ed$%tion te%hni6$es and a/oid fatig$e be%a$se it is impo"tant to s$ppo"t the imm$ne system while "emaining a%ti/e +5 D estlessness is an ea"ly indi%ato" of hypo-ia !he n$"se sho$ld s$spe%t hypo-ia in $n%ons%io$s %lient who s$ddenly be%omes "estless +8 ) In spinal sho%& the bladde" be%omes %ompletely atoni% and will %ontin$e to fill $nless the %lient is %athete"i(ed + A P"og"ession stage is the %hange of t$mo" f"om the p"eneoplasti% state o" low deg"ee of malignan%y to a fast g"owing t$mo" that %annot be "e/e"sed +9 D Intensity is the maEo" indi%ati/e of se/e"ity of pain and it is impo"tant fo" the e/al$ation of the t"eatment .0 )' !he $se of f"ag"ant soap is /e"y d"ying to sin hen%e %a$sing the p"$"it$s .1 C' #t"opine s$lfate is %ont"aindi%ated with gla$%oma patients be%a$se it in%"eases int"ao%$la" p"ess$"e .2 A # 58 yea" old %lient is g"eate" "is be%a$se the olde" ad$lt %lient is mo"e liely to ha/e a less=effe%ti/e imm$ne system .+ ) !he last a"ea to "et$"n sensation is in the pe"ineal a"ea& and the n$"se in %ha"ge sho$ld monito" the %lient fo" distended bladde" .. D Dl$%o%o"ti%oids play no signifi%ant "ole in disease t"eatment . D !"a%heostomy t$be has se/e"al potential %ompli%ations in%l$ding bleeding& infe%tion and la"yngeal ne"/e damage


.5 C In b$"n& the %apilla"ies and small /essels dilate& and %ell damage %a$se the "elease of a histamine=lie s$bstan%e !he s$bstan%e %a$ses the %apilla"y walls to be%ome mo"e pe"meable and signifi%ant 6$antities of fl$id a"e lost .8 A #ging p"o%ess in/ol/ es in%"eased %apilla"y f"agility and pe"meability Olde" ad$lts ha/e a de%"eased amo$nt of s$b%$taneo$s fat and %a$se an in%"eased in%iden%e of b"$ise lie lesions %a$sed by %olle%tion of e-t"a/as%$la" blood in loosely st"$%t$"ed de"mis . D Inte"mittent pain is the %lassi% sign of "enal %a"%inoma It is p"ima"ily d$e to %apilla"y e"osion by the %an%e"o$s g"owth .9 )' !$be"%le ba%ill$s is a d"$g "esistant o"ganism and taes a long time to be e"adi%ated Us$ally a %ombination of th"ee d"$gs is $sed fo" minim$m of 5 months and at least si- months beyond %$lt$"e %on/e"sion 0 A' Patent ai"way is the most p"io"ityW the"efo"e "emo/al of se%"etions is ne%essa"y


PS(CHIATRIC NURSING Part 1

1

a P"o/ide p"i/a%y d$"ing meals b Set=$p a st"i%t eating plan fo" the %lient % ,n%o$"age %lient to e-e"%ise to "ed$%e an-iety d est"i%t /isits with the family  # %lient is e-pe" ien%ing an-iety atta% !he most app"op" iate n$"sing inte"/ention sho$ld in%l$deQ a !$"ning on the tele/ision b 'ea/ing the %lient alone % Staying with the %lient and speaing in sho"t senten%es d #s the %lient to play with othe" %lients 5 # female %lient is admitted with a diagnosis of del$sions of D#*),U !his diagnosis "efle%ts a belief that one is: a @eing illed b ?ighly famo$s and impo"tant % esponsible fo" e/il wo"ld d Conne%ted to %lient $n"elated to oneself 8 # 20 yea" old %lient was diagnosed with dependent pe"sonality diso"de" Hhi%h beha/io" is not most liely to be e/iden%e of ineffe%ti/e indi/id$al %opingQ a e%$""ent self=dest"$%ti/e beha/io" b #/oiding "elationship % Showing inte"est in solita"y a%ti/ities d Inability to mae %hoi%es and de%ision witho$t ad/ise  # male %lient is diagnosed with s%hi(otypal pe"sonality diso"de" H hi%h signs wo$ld this %lient e-hibit d$"ing so%ial sit$ationQ a Pa"anoid tho$ghts b ,motional affe%t % Independen%e need d #gg"essi/e beha/io" 9 *$"se Clai"e is %a"ing fo" a %lient diagnosed with b$limia !he most app"op"iate initial goal fo" a %lient diagnosed with b$limia isQ a ,n%o$"age to a/oid foods b Identify an-iety %a$sing sit$ations % ,at only th"ee meals a day d #/oid shopping plenty of g"o%e"ies 10 *$"se !ony was %a"ing fo" a .1 yea" old female %lient Hhi%h beha/io" by the %lient indi%ates ad$lt %ogniti/e de/elopmentQ a Dene"ates new le/els of awa"eness b #ss$mes "esponsibility fo" he" a%tions % ?as ma-im$m ability to sol/e p"oblems and lea"n new sills d ?e" pe"%eption a"e based on "eality 11 # ne$"om$s%$la" blo%ing agent is administe"ed to a %lient befo"e ,C! the"apy !he *$"se sho$ld %a"ef$lly obse"/e the %lient fo"Q a espi"ato"y diffi%$lties b *a$sea and /omiting % )i((iness d Sei($"es 12 # 8 yea" old %lient is admitted to the hospital with the diagnosis of dementia of the #l(heime"Ks type and dep"ession !he symptom that is $n"elated to dep"ession wo$ld beQ a #patheti% "esponse to the en/i"onment b I donKt nowT answe" to 6$estions % Shallow of labile effe%t d *egle%t of pe"sonal hygiene 1+ *$"se !"ish is wo"ing in a mental health fa%ilityW the n$"se p"io"ity n$"sing inte"/ention fo" a newly admitted %lient with b$limia ne"/osa wo$ld be toQ a !ea%h %lient to meas$"e I N O b In/ol/e %lient in planning daily meal % Obse"/e %lient d$"ing meals d

b limiting $nne%essa"y inte"a%tion % in%"easing app"op"iate senso"y pe"%eption d ens$"ing %onstant %lient and staff %onta%t 15 # +9 yea" old mothe" with obsessi/e=%omp$lsi/e diso"de" has be%ome immobili(ed by he" elabo"ate hand washing and waling "it$als *$"se !"ish "e%ogni(es that the basis of OC diso"de" is often: a P"oblems with being too %ons%ientio$s b P"oblems with ange" and "emo"se % Feelings of g$ilt and inade6$a%y d Feeling of $nwo"thiness and ho pelessness 18

a ?a/e mo"e positi/e "elation with the fathe" than the mothe" b Cling to mothe" N %"y on sepa"ation % @e able to de/elop only s$pe"fi%ial "elation with the othe"s d ?a/e been physi%ally ab$se 28 Hhen tea%hing pa"ents abo$t %hildhood dep"ession *$"se !"ina sho$ld sayQ a It may appea" a%ting o$t beha/io" b )oes not "espond to %on/entional t"eatment % Is sho"t in d$"ation N "esol/es easily d 'oos almost identi%al to ad$lt dep"ession 2 *$"se Pe""y is awa"e that lang$age de/elopment in a$tisti% %hild "esembles: a S%anning spee%h b Spee%h lag % Sh$tte"ing d ,%holalia 29 # 50 yea" old female %lient who li/es alone tells the n$"se at the %omm$nity health %ente" I "eally donKt need anyone to tal toT !he !7 is my best f"iend !he n$"se "e%ogni(es that the %lient is $sing the defense me%hanism nown asQ a )ispla%ement b P"oEe%tion % S$blimation d )enial +0 Hhen wo"ing with a male %lient s$ffe"ing phobia abo$t bla% %ats& *$"se !"ish sho$ld anti%ipate that a p"oblem fo" this %lient wo$ld beQ a #n-iety when dis%$ssing phobia b #nge" towa"d the fea"ed obEe%t % )enying that the phobia e-ist d )isto"tion of "eality when %ompleting daily "o$tines +1 'inda is pa%ing the floo" and appea"s e-t"emely an-io$s !he d$ty n$"se app"oa%hes in an attempt to alle/iate 'indaKs an-iety !he most the"ape$ti% 6$estion by the n$"se wo$ld beQ a Ho$ld yo$ lie to wat%h !7Q b Ho$ld yo$ lie me to tal with yo$Q % #"e yo$ feeling $pset nowQ d Igno"e the %lient +2 *$"se Penny is awa"e that the symptoms that disting$ish post t"a$mati% st"ess diso"de" f"om othe" an-iety diso"de" wo$ld be: a #/oidan%e of sit$ation N %e"tain a%ti/ities that "esemble the st"ess b )ep"ession and a bl$nted affe%t when dis%$ssing the t"a$mati% sit$ation % 'a% of inte"est in family N othe"s d e=e-pe"ien%ing the t"a$ma in d"eams o" flashba% ++ *$"se @enEie is %omm$ni%ating with a male %lient with s$bstan%e=ind$%ed pe"sisting dementiaW the %lient %annot "emembe" fa%ts and fills in the gaps with imagina"y info"mation *$"se @enEie is awa"e that this is typi%al ofQ a Flight of ideas b #sso%iati/e looseness % Confab$lation d Con%"etism +. *$"se Boey is awa"e that the signs N symptoms that wo$ld be most spe%ifi% fo" diagnosis ano"e-ia a"eQ a ,-%essi/e weight loss& ameno""hea N abdominal distension b Slow p$lse& 10V weight loss N alope%ia % Comp$lsi/e beha/io"& e-%essi/e fea"s N na$sea d ,-%essi/e a%ti/ity& memo"y lapses N an in%"eased p$lse + # %ha"a%te"isti% that wo$ld s$ggest to *$"se #nne that an adoles%ent may ha/e b$limia wo$ld be: a F"e6$ent "eg$"gitation N "e=swallowing of food b P"e/io$s histo"y of gast"itis % @adly stained teeth d Positi/e body image +5 *$"se

% #n-iety N loneliness d ?elplessness N hop elessness + # n$"sing %a"e plan fo" a male %lient with bipola" I diso"de" sho$ld in%l$de: a P"o/iding a st"$%t$"ed en/i"onment b )esigning a%ti/ities that will "e6$i"e the %lient to maintain %onta%t with "eality % ,ngaging the %lient in %on/e"sing abo$t %$""ent affai"s d !o$%hing the %lient p"o/ide ass$"an%e +9 Hhen planning %a"e fo" a female %lient $sing "it$alisti% beha/io"& *$"se Dina m$st "e%ogni(e that the "it$al: a ?elps the %lient fo%$s on the inability to deal with "eality b ?elps the %lient %ont"ol the an-iety % Is $nde" the %lientKs %ons%io$s %ont"ol d Is $sed by the %lient p"ima"ily fo" se%onda"y gains .0 # +2 yea" old male g"ad$ate st$dent& who has be%ome in%"easingly withd"awn and negle%tf$l of his wo" and pe"sonal hygiene& is b"o$ght to the psy%hiat"i% hospital by his pa"ents #fte" detailed assessment& a diagnosis of s%hi(oph"enia is made It is $nliely that the %lient will demonst"ate: a 'ow self esteem b Con%"ete thining % ,ffe%ti/e self bo$nda"ies d Hea ego .1 # 2+ yea" old %lient has been admitted with a diagnosis of s%hi(oph"enia says to the n$"se Aes& its ma"%h&

. Hhen planning the dis%ha"ge of a %lient with %h"oni% an-iety& *$"se Ch"is e/al$ates a%hie/ement of the dis%ha"ge maintenan%e goals Hhi%h goal wo$ld be most app"op"iately ha/ing been in%l$ded in the plan of %a"e "e6$i"ing e/al$ationQ a !he %lient eliminates all an-iety f"om daily sit$ations b !he %lient igno"es feelings of an-iety % !he %lient identifies an-iety p"od$%ing sit$ations d !he %lient maintains %onta%t with a %"isis %o$nselo" .9 *$"se !ina is %a"ing fo" a %lient with dep"ession who has not "esponded to antidep"essant medi%ation !he n$"se anti%ipates that what t"eatment p"o%ed$"e may be p"es%"ibedQ a *e$"olepti% medi%ation b Sho"t te"m se%l$sion % Psy%hos$"ge"y d ,le%t"o%on/$lsi/e the "apy 0
ANSERS a$% RATIONALES #r PS(CHIATRIC NURSING Part 1

1 C !otal abstinen%e is the only effe%ti/e t"eatment fo" al%oholism 2 A ?all$%inations a"e /is$al& a$dito"y& g$stato"y& ta%tile o" olfa%to"y pe"%eptions that ha/e no basis in "eality + D !he *$"se has a "esponsibility to obse"/e %ontin$o$sly the a%$tely s$i%idal %lient !he *$"se sho$ld wat%h fo" %l$es& s$%h as %omm$ni%ating s$i%idal tho$ghts& and messagesW hoa"ding medi%ations and taling abo$t death . )' ,stablishing a %onsistent eating plan and monito"ing %lientKs weight a"e impo"tant to this diso"de"  C #pp"op"iate n$"sing inte"/entions fo" an an-iety atta% in%l$de $sing sho"t senten%es& staying with the %lient& de%"easing stim$li& "emaining %alm and medi%ating as needed 5 ) )el$sion of g"ande$" is a false belief that one is highly famo$s and impo"tant 8 D Indi/id$al with dependent pe"sonality diso"de" typi%ally shows inde%isi/eness s$bmissi/eness and %linging beha/io" so that othe"s will mae de%isions with them  A Clients with s%hi(otypal pe"sonality diso"de" e-pe"ien%e e-%essi/e so%ial an-iety that %an lead to pa"anoid tho$ghts 9 ) @$limia diso"de" gene"ally is a maladapti/e %oping "esponse to st"ess and $nde"lying iss$es !he %lient sho$ld identify an-iety %a$sing sit$ation that stim$late the b$limi% beha/io" and then lea"n new ways of %oping with the an-iety 10 A #n ad$lt age +1 to . gene"ates new le/el of awa"eness 11 A *e$"om$s%$la" @lo%e"& s$%h as SUCCI*A'C?O'I*, #ne%tine p"od$%es "espi"ato"y dep"ession be%a$se it inhibits %ont"a%tions of "espi"ato"y m$s%les


12 C Hith dep"ession& the"e is little o" no emotional in/ol/ement the"efo"e little alte"ation in affe%t 1+ D !hese %lients often hide food o" fo"%e /omitingW the"efo"e they m$st be %a"ef$lly monito"ed 1. A !hese %lients ha/e se/e"ely depleted le/els of sodi$m and potassi$m be%a$se of thei" sta"/ation diet and ene"gy e-pendit$"e& these ele%t"olytes a"e ne%essa"y fo" %a"dia% f$n%tioning 1 ) 'imiting $nne%essa"y inte"a%tion will de%"ease stim$lation and agitation 15 C it$alisti% beha/io" seen in this diso"de" is aimed at %ont"olling g$ilt and inade6$a%y by maintaining an absol$te set patte"n of beha/io" 18 D !he n$"se needs to set limits in the %lientKs manip$lati/e beha/io" to help the %lient %ont"ol dysf$n%tional beha/io" # %onsistent app"oa%h by the staff is ne%essa"y to de%"ease manip$lation 1 ) #ny s$i%idal statement m$st be assessed by the n$"se !he n$"se sho$ld dis%$ss the %lientKs statement with he" to dete"mine its meaning in te"ms of s$i%ide 19 A Hhen the staff membe" as the %lient if he wonde"s why othe"s find him "ep$lsi/e& the %lient is liely to feel defensi/e be%a$se the 6$estion is belittling !he nat$"al tenden%y is to %o$nte"atta% the th"eat to self image 20 ) !he n$"se wo$ld spe%ifi%ally $se s$ppo"ti/e %onf"ontation with the %lient to point o$t dis%"epan%ies between what the %lient states and what a%t$ally e-ists to in%"ease "esponsibility fo" self 21 C !he n$"se wo$ld most liely administe" ben(odia(epine& s$%h as lo"a(epan ati/an to the %lient who is e-pe"ien%ing symptom: !he %lientKs e-pe"ien%es symptoms of withd"awal be%a$se of the "ebo$nd phenomenon when the sedation of the C*S f"om al%ohol begins to de%"ease 22 D eg$la" %offee %ontains %affeine whi%h a%ts as psy%homoto" stim$lants and leads to feelings of an-iety and agitation Se"/ing %offee top the %lient may add to t"emo"s o" waef$lness 2+ D 7omiting and dia""hea a"e $s$ally the late signs of he"oin withd"awal& along with m$s%le spasm& fe/e"& na$sea& "epetiti/e& abdominal %"amps and ba%a%he 2. D

.9 D ,le%t"o%on/$lsi/e the"apy is an effe%ti/e t"eatment fo" dep"ession that has not "esponded to medi%ation 0 ) In an eme"gen%y& li/es sa/ing fa%ts a"e obtained fi"st !he name and the amo$nt of medi%ation ingested a"e of o$tmost impo"tant in t"eating this potentially life th"eatening sit$ation


1 *$"se !ony sho$ld fi"st dis%$ss te"minating the n$"se=%lient "elationship with a %lient d$"ing the: a !e"mination phase when dis%ha"ge plans a"e being made b Ho"ing phase when the %lient shows some p"og"ess % O"ientation phase when a %ont"a%t is established d Ho"ing phase when the %lient b"ings it $p 2 $estion the %lient $ntil he "esponds b Initiate %onta%t with the %lient f"e6$ently % Sit o$tside the %lients "oom d Hait fo" the %lient to begin the %on/e"sation + Boe who is /e"y dep"essed e-hibits psy%homoto" "eta"dation& a flat affe%t and apathy !he n$"se in %ha"ge obse"/es Boe to be in need of g"ooming and hygiene Hhi%h of the following n$"sing a%tions wo$ld be most app"op"iateQ a Haiting $ntil the %lientKs family %an pa"ti%ipate in the %lientKs %a"e b #sing the %lient if he is "eady to tae showe" % ,-plaining the impo"tan%e of hygiene to the %lient d Stating to the %lient that itKs time fo" him to tae a showe"


. Hhen tea%hing

% !he %lient wals with the n$"se to he" "oom d !he %lient is able to mo/e all e-t"emities o%%asionally 1 *$"se ?a(el in/ites new %lientKs pa"ents to attend the psy%ho ed$%ational p"og"am fo" families of the %h"oni%ally mentally ill !he p"og"am wo$ld be most liely to help the family with whi%h of the following iss$esQ a )e/eloping a s$ppo"t netwo" with othe" families b Feeling mo"e g$ilty abo$t the %lientKs illness % e%ogni(ing the %lientKs weaness d

2 Boey who has a %h"oni% $se" of %o%aine "epo"ts that he feels lie he has %o%"oa%hes %"awling $nde" his sin ?is a"ms a"e "ed be%a$se of s%"at%hing !he n$"se in %ha"ge inte"p"ets these findings as possibly indi%ating whi%h of the followingQ a )el$sion b Fo"mi%ation % Flash ba% d Conf$sion 25 Bose is diagnosed with amphetamine psy%hosis and was admitted in the eme"gen%y "oom *$"se onald wo$ld most liely p"epa"e to administe" whi%h of the following medi%ationQ a 'ib"i$m b 7ali$m % #ti/an d ?aldol 28 Hhi%h of the following li6$ids wo$ld n$"se 'eng administe" to a female %lient who is into-i%ated with phen%y%lidine PCP to hasten e-%"etion of the %hemi%alQ a Shae b !ea % C"anbe""y B$i%e d D"ape E$i%e 2 Hhen de/eloping a plan of %a"e fo" a female %lient with a%$te st"ess diso"de" who lost he" siste" in a %a" a%%ident Hhi%h of the following wo$ld the n$"se e-pe%t to initiateQ a Fa%ilitating p"og"essi/e "e/iew of the a%%ident and its %onse6$en%es b Postponing dis%$ssion of the a%%ident $ntil the %lient b"ings it $p % !elling the %lient to a/oid details of the a%%ident d ?elping the %lient to e/al$ate he" siste"Ks beha/io" 29 !he n$"sing assistant tells n$"se onald that the %lient is not in the dining "oom fo" l$n%h *$"se onald wo$ld di"e%t the n$"sing assistant to do whi%h of the followingQ a !ell the %lient heKll need to wait $ntil s$ppe" to eat if he misses l$n%h b In/ite the %lient to l$n%h and a%%ompany him to the dining "oom % Info"m the %lient that he has 10 min$tes to get to the dining "oom fo" l$n%h d !ae the %lient a l$n%h t"ay and let the %lient eat in his "oom +0 !he initial n$"sing inte"/ention fo" the signifi%ant=othe"s d$"ing sho% phase of a g"ief "ea%tion sho$ld be fo%$sed on: a P"esenting f$ll "eality of the loss of the indi/id$als b )i"e%ting the indi/id$alKs a%ti/ities at this time % Staying with the indi/id$als in/ol/ed d

+5 Hhen de/eloping an initial n$"sing %a"e plan fo" a male %lient with a @ipola" I diso"de" mani% episode n$"se on sho$ld plan toQ a Isolate his gym time b ,n%o$"age his a%ti/e pa"ti%ipation in $nit p"og"ams % P"o/ide foods& fl$ids and "est d ,n%o$"age his pa"ti%ipation in p"og"ams +8 D"a%e is e-hibiting withd"awn patte"ns of beha/io" *$"se Bohnny is awa"e that this type of beha/io" e/ent$ally p"od$%es feeling of: a ep"ession b 'oneliness % #nge" d Pa"anoia + One mo"ning a female %lient on the inpatient psy%hiat"i% se"/i%e %omplains to n$"se ?a(el that she has been waiting fo" o/e" an ho$" fo" someone to a%%ompany he" to a%ti/ities *$"se ?a(el "eplies to the %lient HeK"e doing the best we %an !he"e a"e a lot of othe" people on the $nit who needs attention tooT !his statement shows that the n$"seKs $se of: a )efensi/e beha/io" b eality "einfo"%ement % 'imit=setting beha/io" d Imp$lse %ont"ol +9 # n$"sing diagnosis fo" a male %lient with a diagnosed m$ltiple pe"sonality diso"de" is %h"oni% low self= esteem p"obably "elated to %hildhood ab$se !he most app"op"iate sho"t te"m %lient o$t%ome wo$ld be: a 7e"bali(ing the need fo" an-iety medi%ations b e%ogni(ing ea%h e-isting pe"sonality % ,ngaging in obEe%t=o"iented a%ti/ities d ,liminating defense me%hanisms and phobia .0 # 2 yea" old male is admitted to a mental health fa%ility be%a$se of inapp"op"iate beha/io" !he %lient has been hea"ing /oi%es& "esponding to imagina"y %ompanions and withd"awing to his "oom fo" se/e"al days at a time *$"se
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+0

a Hhile wat%hing !7 b )$"ing meal time % )$"ing g"o$p a%ti/ities d #fte" going to bed .8 *$"se Bohn "e%ogni(es that pa"anoid del$sions $s$ally a"e "elated to the defense me%hanism of: a P"oEe%tion b Identifi%ation % ep"ession d eg"ession . Hhen planning %a"e fo" a male %lient $sing pa"anoid ideation& n$"se Basmin sho$ld "eali(e the impo"tan%e of: a Di/ing the %lient diffi%$lt tass to p"o/ide stim$lation b P"o/iding the %lient with a%ti/ities in whi%h s$%%ess %an be a%hie/ed % emo/ing st"ess so that the %lient %an "elad *ot pla%ing any demands on the %lient .9 *$"se De""y is awa"e that the defense me%hanism %ommonly $sed by %lients who a"e al%oholi%s is: a )ispla%ement b )enial % P"oEe%tion d Compensation 0 Hithin a few ho$"s of al%ohol withd"awal& n$"se Bohn sho$ld assess the male %lient fo" the p"esen%e of: a )iso"ientation& pa"anoia& ta%hy%a"dia b !"emo"s& fe/e"& p"of$se diapho"esis % I""itability& heightened ale"tness& Ee"y mo/ements d Aawning& an-iety& %on/$lsions

ANSERS a$% RATIONALES #r PS(CHIATRIC NURSING Pa"t 2

1

C Hhen the n$"se and %lient ag"ee to wo" togethe"& a %ont"a%t sho$ld be established& the length of the "elationship sho$ld be dis%$ssed in te"ms of its $ltimate te"mination 2 ) !he n$"se sho$ld initiate b"ief& f"e6$ent %onta%ts th"o$gho$t the day to let the %lient now that he is impo"tant to the n$"se !his will positi/ely affe%t the %lientKs self=esteem + D !he %lient with dep"ession is p"eo%%$pied& has de%"eased ene"gy& and is $nable to mae de%isions !he n$"se p"esents the sit$ation& ItKs time fo" a showe"T& and assists the %lient with pe"sonal hygiene to p"ese"/e his dignity and self=esteem . C Foods high in ty"amine& those that a"e fe"mented& pi%led& aged& o" smoed m$st be a/oided be%a$se when they a"e ingested in %ombination with <#OIs a hype"tensi/e %"isis will o%%$"  A #nti%holine"gi% effe%ts& whi%h "es$lt f"om blo%age of the pa"asympatheti% %"aniosa%"al ne"/o$s system in%l$ding $"ine "etention& bl$""ed /ision& d"y mo$th N %onstipation 5 ) )ysthymia is a less se/e"e& %h"oni% dep"ession diagnosed when a %lient has had a dep"essed mood fo" mo"e days than not o/e" a pe"iod of at least 2 yea"s Client with dysthymi% diso"de" benefit f"om psy%hothe"ape$ti% app"oa%hes that assist the %lient in "e/e"sing the negati/e self image& negati/e feelings abo$t the f$t$"e 8 D Flight of ideas is spee%h patte"n of "apid t"ansition f"om topi% to topi%& often witho$t finishing one idea It is %ommon in mania




) !he %lient with mania is /e"y a%ti/e N needs to ha/e this ene"gy %hanneled in a %onst"$%ti/e tas s$%h as %leaning o" tidying the "oom 9 C # %"$%ial fa%to" is dete"mining the lethality of a method is the amo$nt of time that o%%$"s between initiating the method N the deli/e"y of the lethal impa%t of the method 10 D !he statement I donKt thin abo$t illing myself as m$%h as I $sed toT Indi%ates a lessening of s$i%idal ideation and imp"o/ement in the %lientKs %ondition 11 A Using e-e"%ise bi%y%le is app"op"iate fo" the %lient who be%omes /e"y an-io$s when tho$ghts of s$i%idal o%%$" 12 C !he d"$g of %hoi%e fo" a %lient e-pe"ien%ing e-t"a py"amidal side effe%ts f"om halope"idol ?aldol is ben(t"opine mesylate %ogentin be%a$se of its anti %holine"gi% p"ope"ties 1+ D #llowing the %lient to be the fi"st to open the %a"t N tae a t"ay p"esents the %lient with the "eality that the n$"ses a"e not to$%hing the food N t"ay& the"eby dispelling the del$sion

1.

) #ltho$gh all the a%tions indi%ate imp"o/ement& the ability to initiate simple a%ti/ities witho$t di"e%tions indi%ates the most imp"o/ement in the %atatoni% beha/io"s 1 A Psy%hoed$%ational g"o$ps fo" families de/elop a s$ppo"t netwo" !hey p"o/ide ed$%ation abo$t the bio%hemi%al etiology of psy%hiat"i% disease to "ed$%e& not in%"ease family g$ilt 15 C #ttending a%ti/ity with the n$"se assists the %lient to be%ome in/ol/ed with othe"s slowly !he %lient with s%hi(otypal pe"sonality diso"de" needs s$ppo"t& indness N gentle s$ggestion to imp"o/e so%ial sills N inte"pe"sonal "elationship 18 C #n indi/id$al with pe"sonality diso"de" $s$ally is not hospitali(ed $nless a %oe-isting #-is I psy%hiat"i% diso"de" is p"esent Dene"ally& these indi/id$als mae ma"ginal adE$stments and "emain in so%iety& altho$gh they typi%ally e-pe"ien%e "elationship and o%%$pational p"oblems "elated to thei" infle-ible beha/io"s Pe"sonality diso"de"s a"e %h"oni% lifelong patte"ns of beha/io"W a%$te episodes do not o%%$" Psy%hoti% beha/io" is $s$ally not %ommon& altho$gh it %an o%%$" in eithe" s%hi(otypal pe"sonality diso"de" o" bo"de"line pe"sonality diso"de" @e%a$se these diso"de"s a"e end$"ing and e/asi/e and the indi/id$al is infle-ible& p"ognosis fo" "e%o/e"y is $nfa/o"able Dene"ally& the indi/id$al does not see t"eatment be%a$se he does not pe"%ei/e p"oblems with his own beha/io" )ist"ess %an o%%$" based on othe" peopleKs "ea%tion to the indi/id$alKs beha/io" 1 D !he n$"se wo$ld e-plain the negati/e "ea%tions of othe"s towa"ds the %lientKs beha/io"s to mae

the %lients awa"e of the impa%t of his sed$%ti/e beha/io"s on othe"s 19 ) !he n$"se wo$ld $se "ole=playing to tea%h the %lient app"op"iate "esponses to othe"s and in /a"io$s sit$ations !his %lient d"amati(es e/ents& d"awn attention to self& and is $nawa"e of and does not deal with feelings !he n$"se wo"s to help the %lient %la"ify t"$e feelings N lea"n to e-p"ess them app"op"iately 20 C #ntisepti% mo$thwash often %ontains al%ohol N sho$ld be ept in lo%ed a"ea& $nless labeling %lea"ly indi%ates that the p"od$%t does not %ontain al%ohol 21 D

++

C !his a%tion maintains fo" as long as possible& the %lients intelle%t$al f$n%tions by p"o/iding an oppo"t$nity to $se them +. A Indi/id$als with ano"e-ia often display i""itability& hospitality& and a dep"essed mood + D )ep"essed %lients demonst"ate de%"eased %omm$ni%ation be%a$se of la% of psy%hi% o" physi%al ene"gy +5 C !he %lient in a mani% episode of the illness often negle%ts basi% needs& these needs a"e a p"io"ity to ens$"e ade6$ate n$t"ition& fl$id& and "est +8 ) !he withd"awn patte"n of beha/io" p"esents the indi/id$al f"om "ea%hing o$t to othe"s fo" sha"ing the isolation p"od$%es feeling of loneliness + A !he n$"seKs "esponse is not the"ape$ti% be%a$se it does not "e%ogni(e the %lientKs needs b$t t"ies to mae the %lient feel g$ilty fo" being demanding +9 ) !he %lient m$st "e%ogni(e the e-isten%e of the s$b pe"sonalities so that inte"p"etation %an o%%$"

.0

D #n aloof& deta%hed& withd"awn post$"e is a means of p"ote%ting the self by withd"awing and maintaining a safe& emotional distan%e .1 C !he $s$al age of onset of s%hi(oph"enia is adoles%en%e o" ea"ly %hildhood .2 A Somati% del$sion is a fi-ed false belief abo$t oneKs body .+ C !hese a"e the %lassi% beha/io"s e-hibited by %lients with a diagnosis of s%hi(oph"enia .. D !he fetal position "ep"esents "eg"essed beha/io" eg"ession is a way of "esponding to o/e"whelming an-iety . ) !his p"o/ides a stim$l$s that %ompetes with and "ed$%es hall$%ination .5 D #$dito"y hall$%inations a"e most t"o$blesome when en/i"onmental stim$li a"e diminished and the"e a"e few %ompeting dist"a%tions .8 A P"oEe%tion is a me%hanism in whi%h inne" tho$ghts and feelings a"e p"oEe%ted onto the en/i"onment& seeming to %ome f"om o$tside the self "athe" than f"om within . ) !his will help the %lient de/elop self=esteem and "ed$%e the $se of pa"anoid ideation .9 ) )enial is a method of "esol/ing %onfli%t o" es%aping $npleasant "ealities by igno"ing thei" e-isten%e 0 C #l%ohol is a %ent"al ne"/o$s system dep"essant !hese symptoms a"e the bodyKs ne$"ologi% adaptation to the withd"awal of al%ohol


1 F"an%is who is addi%ted to %o%aine withd"aws f"om the d"$g *$"se on sho$ld e-pe%t to obse"/e: a ?ype"a%ti/ity b )ep"ession % S$spi%ion d )eli"i$m 2 *$"se Bohn is awa"e that a se"io$s effe%t of inhaling %o%aine isQ a )ete"io"ation of nasal sept$m b #%$te fl$id and ele%t"olyte imbalan%es % ,-t"a py"amidal t"a%t symptoms d ,sophageal /a"i%es + # tentati/e diagnosis of opiate addi%tion& *$"se Candy sho$ld assess a "e%ently hospitali(ed %lient fo" signs of opiate withd"awal !hese signs wo$ld in%l$de:

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1++

a hino""hea& %on/$lsions& s$bno"mal tempe"at$"e b *a$sea& dilated p$pils& %onstipation % 'a%"imation& /omiting& d"owsiness d <$s%le a%hes& papilla"y %onst"i%tion& yawning . # . yea" old male %lient is b"o$ght to the psy%hiat"i% eme"gen%y "oom afte" attempting to E$mp off a b"idge !he %lientKs wife states that he lost his Eob se/e"al months ago and has been $nable to find anothe" Eob !he p"ima"y n$"sing inte"/ention at this time wo$ld be to assess fo": a # past histo"y of dep"ession b C$""ent plans to %ommit s$i%ide % !he p"esen%e of ma"ital diffi%$lties d Feelings of e-%essi/e fail$"e  @efo"e helping a male %lient who has been se-$ally assa$lted& n$"se
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+.

1.
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+

% In/ol/ing the %lient in a 6$iet a%ti/ity to di/e"t attention d ?elping the %lient identify and e-p"ess feelings of an-iety and ange" 25 osana is in the se%ond stage of #l(heime"Ks disease who appea"s to be in pain Hhi%h 6$estion by *$"se Benny wo$ld best eli%it info"mation abo$t the painQ a Hhe"e is yo$" pain lo%atedQT b )o yo$ h$"tQ pa$se )o yo$ h$"tQT % Can yo$ des%"ibe yo$" painQT d Hhe"e do yo$ h$"tQT 28 *$"sing p"epa"ation fo" a %lient $nde"going ele%t"o%on/$lsi/e the"apy ,C! "esemble those $sed fo": a Dene"al anesthesia b Ca"dia% st"ess testing % *e$"ologi% e-amination d Physi%al the"apy 2 Bose who is "e%ei/ing monoamine o-idase inhibito" antidep"essant sho$ld a/oid ty"amine& a %ompo$nd fo$nd in whi%h of the following foodsQ a Figs and %"eam %heese b F"$its and yellow /egetables % #ged %heese and Chianti wine d D"een leafy /egetables 29 ,"linda& age & with maEo" dep"ession $nde"goes a si-th ele%t"o%on/$lsi/e the"apy ,C! t"eatment Hhen assessing the %lient immediately afte" ,C!& the n$"se e-pe%ts to find: a Pe"manent sho"t=te"m memo"y loss and hype"tension b Pe"manent long=te"m memo"y loss and hypomania % !"ansito"y sho"t=te"m memo"y loss and pe"manent long=te"m memo"y loss d !"ansito"y sho"t and long te"m memo"y loss and %onf$sion +0 @a"ba"a with bipola" diso"de" is being t"eated with lithi$m fo" the fi"st time *$"se Clint sho$ld obse"/e the %lient fo" whi%h %ommon ad/e"se effe%t of lithi$mQ a Poly$"ia b Sei($"es % Constipation d Se-$al dysf$n%tion +1 *$"se F"ed is assessing a %lient who has E$st been admitted to the , depa"tment Hhi%h signs wo$ld s$ggest an o/e"dose of an antian-iety agentQ a S$spi%io$sness& dilated p$pils and in%omplete @P b #gitation& hype"a%ti/ity and g"andiose ideation % Combati/eness& sweating and %onf$sion d ,motional lability& e$pho"ia and impai"ed memo"y +2 )is%ha"ge inst"$%tions fo" a male %lient "e%ei/ing t"i%y%li% antidep"essants in%l$de whi%h of the following info"mationQ a est"i%t fl$ids and sodi$m intae b )onKt %ons$me al%ohol % )is%ontin$e if d"y mo$th and bl$""ed /ision o%%$" d est"i%t fl$id and sodi$m intae ++ Impo"tant tea%hing fo" women in thei" %hildbea"ing yea"s who a"e "e%ei/ing antipsy%hoti% medi%ations in%l$des whi%h of the followingQ a In%"eased in%iden%e of dysmeno""hea while taing the d"$g b O%%$""en%e of in%omplete libido d$e to medi%ation ad/e"se effe%ts % Contin$ing p"e/io$s $se of %ont"a%eption d$"ing pe"iods of ameno""hea d Inst"$%tion that ameno""hea is i""e/e"sible +. # %lient "ef$ses to "emain on psy%hot"opi% medi%ations afte" dis%ha"ge f"om an inpatient psy%hiat"i% $nit Hhi%h info"mation sho$ld the %omm$nity health n$"se assess fi"st d$"ing the initial follow=$p with this %lientQ a In%ome le/el and li/ing a""angements b In/ol/ement of family and s$ppo"t systems % eason fo" inpatient admission d eason fo" "ef$sal to tae medi%ations + !he n$"se $nde"stands that the the"ape$ti% effe%ts of typi%al antipsy%hoti% medi%ations a"e asso%iated with whi%h ne$"ot"ansmitte" %hangeQ a )e%"eased dopamine le/el b In%"eased a%etyl%holine le/el % Stabili(ation of se"otonin d Stim$lation of D#@# +5 Hhi%h of the following best e-plains why t"i%y%li% antidep"essants a"e $sed with %a$tion in elde"ly patientsQ a Cent"al *e"/o$s System effe%ts b Ca"dio/as%$la" system effe%ts


% Dast"ointestinal system effe%ts d Se"otonin synd"ome effe%ts +8 # %lient with dep"essi/e symptoms is gi/en p"es%"ibed medi%ations and tals with his the"apist abo$t his belief that he is wo"thless and $nable to %ope with life Psy%hiat"i% %a"e in this t"eatment plan is based on whi%h f"amewo"Q a @eha/io"al f"amewo" b Cogniti/e f"amewo" % Inte"pe"sonal f"amewo" d Psy%hodynami% f"amewo" + # n$"se who e-plains that a %lientKs psy%hoti% beha/io" is $n%ons%io$sly moti/ated $nde"stands that the %lientKs diso"de"ed beha/io" a"ises f"om whi%h of the followingQ a #bno"mal thining b #lte"ed ne$"ot"ansmitte"s % Inte"nal needs d esponse to stim$li +9 # %lient with dep"ession has been hospitali(ed fo" t"eatment afte" taing a lea/e of absen%e f"om wo" !he %lientKs employe" e-pe%ts the %lient to "et$"n to wo" following inpatient t"eatment !he %lient tells the n$"se& IKm no good IKm a fail$"eT #%%o"ding to %ogniti/e theo"y& these statements "efle%t: a 'ea"ned beha/io" b P$niti/e s$pe"ego and de%"eased self=esteem % Fa$lty tho$ght p"o%esses that go/e"n beha/io" d ,/iden%e of diffi%$lt "elationships in the wo" en/i"onment .0 !he n$"se des%"ibes a %lient as an-io$s Hhi%h of the following statement abo$t an-iety is t"$eQ a #n-iety is $s$ally pathologi%al b #n-iety is di"e%tly obse"/able % #n-iety is $s$ally ha"mf$l d #n-iety is a "esponse to a th"eat .1 # %lient with a phobi% diso"de" is t"eated by systemati% desensiti(ation !he n$"se $nde"stands that this app"oa%h will do whi%h of the followingQ a ?elp the %lient e-e%$te a%tions that a"e fea"ed b ?elp the %lient de/elop insight into i""ational fea"s % ?elp the %lient s$bstit$tes one fea" fo" anothe" d ?elp the %lient de%"ease an-iety .2 Hhi%h %lient o$t%ome wo$ld best indi%ate s$%%essf$l t"eatment fo" a %lient with an antiso%ial pe"sonality diso"de"Q a !he %lient e-hibits %ha"ming beha/io" when a"o$nd a$tho"ity fig$"es b !he %lient has de%"eased episodes of imp$lsi/e beha/io"s % !he %lient maes statements of self=satisfa%tion d !he %lientKs statements indi%ate no "emo"se fo" beha/io"s .+ !he n$"se is %a"ing fo" a %lient with an a$toimm$ne diso"de" at a medi%al %lini%& whe"e alte"nati/e medi%ine is $sed as an adE$n%t to t"aditional the"apies Hhi%h info"mation sho$ld the n$"se tea%h the %lient to help foste" a sense of %ont"ol o/e" his symptomsQ a Pathophysiology of disease p"o%ess b P"in%iples of good n$t"ition % Side effe%ts of medi%ations d St"ess management te%hni6$es .. Hhi%h of the following is the most disting$ishing feat$"e of a %lient with an antiso%ial pe"sonality diso"de"Q a #ttention to detail and o"de" b @i(a""e manne"isms and tho$ghts % S$bmissi/e and dependent beha/io" d )is"ega"d fo" so%ial and legal no"ms . Hhi%h n$"sing diagnosis is most app"op"iate fo" a %lient with ano"e-ia ne"/osa who e-p"esses feelings of g$ilt abo$t not meeting family e-pe%tationsQ a #n-iety b )ist$"bed body image % )efensi/e %oping d Powe"lessness .5 # n$"se is e/al$ating the"apy with the family of a %lient with ano"e-ia ne"/osa Hhi%h of the following wo$ld indi%ate that the the"apy was s$%%essf$lQ a !he pa"ents "einfo"%ed in%"eased de%ision maing by the %lient b !he pa"ents %lea"ly /e"bali(e thei" e-pe%tations fo" the %lient % !he %lient /e"bali(es that family meals a"e now enEoyable d !he %lient tells he" pa"ents abo$t feelings of low=self esteem .8 # %lient with dysthymi% diso"de" "epo"ts to a n$"se that his life is hopeless and will ne/e" imp"o/e in the f$t$"e ?ow %an the n$"se best "espond $sing a %ogniti/e app"oa%hQ


a #g"ee with the %lientKs painf$l feelings b Challenge the a%%$"a%y of the %lientKs belief % )eny that the sit$ation is hopeless d P"esent a %hee"f$l attit$de . # %lient with maEo" dep"ession has not /e"bali(ed p"oblem a"eas to staff o" pee"s sin%e admission to a psy%hiat"i% $nit Hhi%h a%ti/ity sho$ld the n$"se "e%ommend to help this %lient e-p"ess himselfQ a #"t the"apy in a small g"o$p b @asetball game with pee"s on the $nit % eading a self=help boo on dep"ession d Hat%hing mo/ie with the pee" g"o$p .9 !he home health psy%hiat"i% n$"se /isits a %lient with %h"oni% s%hi(oph"enia who was "e%ently dis%ha"ged afte" a p"olong stay in a state hospital !he %lient li/es in a boa"ding home& "epo"ts no family in/ol/ement& and has little so%ial inte"a%tion !he n$"se plan to "efe" the %lient to a day t"eatment p"og"am in o"de" to help him with: a
ANSERS a$% RATIONALES #r PS(CHIATRIC NURSING Pa"t +

1 ) !he"e is no set of symptoms asso%iated with %o%aine withd"awal& only the dep"ession that follows the high %a$sed by the d"$g 2 A Co%aine is a %hemi%al that when inhaled& %a$ses dest"$%tion of the m$%o$s memb"anes of the nose + D !hese adaptations a"e asso%iated with opiate withd"awal whi%h o%%$"s afte" %essation o" "ed$%tion of p"olonged mode"ate o" hea/y $se of opiates . ) Hhethe" the"e is a s$i%ide plan is a %"ite"ion when assessing the %lientKs dete"mination to mae anothe" attempt  A apists a"e belie/ed to ha"bo" and a%t o$t hostile feelings towa"d all women th"o$gh the a%t of "ape 5 C !hese %hild"en often ha/e nonse-$al needs met by indi/id$al and a"e powe"less to "ef$se #mbi/alen%e "es$lts in self=blame and also g$ilt 8 ) !he %lientKs ange" o/e" the abo"tion is shifted to the staff and the hospital be%a$se she is $nable to deal with the abo"tion at this time

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+

 A Pe"sonal inte"nal st"ength and s$ppo"ti/e indi/id$als a"e %"iti%al fa%to"s that %an be employed to assist the indi/id$al to %ope with a %"isis 9 D C"isis inte"/ention g"o$p helps %lient "eestablish psy%hologi% e6$ilib"i$m by assisting them to e-plo"e new alte"nati/es fo" %oping It %onside"s "ealisti% sit$ations $sing "ational and fle-ible p"oblem sol/ing methods 10 C !his wo$ld do%$ment that the %lient feels %omfo"table eno$gh to dis%$ss the p"oblems that ha/e moti/ated the beha/io" 11 C !he most s$%%essf$l the"apy fo" people with phobias in/ol/es beha/io" modifi%ation te%hni6$es $sing desensiti(ation 12 A Pe"%ept$al field is a ey indi%ato" of an-iety le/el be%a$se the pe"%ept$al fields na""ow as an-iety in%"eases 1+ D One of the symptoms of a$tisti% %hild displays a la% of "esponsi/eness to othe"s !he"e is little o" no e-tension to the e-te"nal en/i"onment 1. ) Somati% del$sions fo%$s on bodily f$n%tions o" systems and %ommonly in%l$de del$sion abo$t fo$l odo" emissions& inse%t manifestations& inte"nal pa"asites and misshapen pa"ts 1 D # %lient with bo"de"line pe"sonality displays a pe"/asi/e patte"n of $np"edi%table beha/io"& mood and self image Inte"pe"sonal "elationships may be intense and $nstable and beha/io" may be inapp"op"iate and imp$lsi/e 15 A P"op"anolol is a potent beta ad"ene"gi% blo%e" and p"od$%ing a sedating effe%t& the"efo"e it is $sed to t"eat antipsy%hoti% ind$%ed aathisia and an-iety 18 ) #mantadine is an anti%holine"gi% d"$g $sed to "eli/e d"$g=ind$%ed e-t"a py"amidal ad/e"se effe%ts s$%h as m$s%le weaness& in/ol$nta"y m$s%le mo/ements& pse$dopa"insonism and ta" di/e dysinesia 1 C <#OI antidep"essants when %ombined with a n$mbe" of d"$gs %an %a$se life=th"eatening hype"tensi/e %"isis ItKs impe"ati/e that a %lient %he%s with his physi%ian and pha"ma%ist befo"e taing any othe" medi%ations 19 ) Pani% is the most se/e"e le/el of an-iety )$"ing pani% atta%& the %lient e-pe"ien%es a de%"ease in the pe"%ept$al field& be%oming mo"e fo%$sed on self& less awa"e of s$""o$ndings and $nable to p"o%ess info"mation f"om the en/i"onment !he de%"eased pe"%ept$al field %ont"ib$tes to impai"ed attention and inability to %on%ent"ate

20 A !he eme"gen%y n$"se m$st establish "appo"t and t"$st with the an-io$s %lient befo"e $sing the"ape$ti%

to$%h !o$%hing an an-io$s %lient may a%t$ally in%"ease an-iety 21 D )ia""hea is a %ommon physiologi%al "esponse to st"ess and an-iety 22 ) !he pa"asympatheti% ne"/o$s system wo$ld p"od$%e in%omplete DI motility "es$lting in hype"a%ti/e bowel so$nds& possibly leading to dia""hea 2+ C !he antidep"essants fl$/o-amine and %lomip"amine ha/e been effe%ti/e in the t"eatment of OC) 2. A Phobias %a$se se/e"e an-iety s$%h as pani% atta% that is o$t of p"opo"tion to the th"eat of the fea"ed obEe%t o" sit$ation Physi%al signs and symptoms of phobias in%l$de p"of$se sweating& poo" moto" %ont"ol& ta%hy%a"dia and ele/ated @P 2 D In many instan%es& the n$"se %an diff$se impending /iolen%e by helping the %lient identify and e-p"ess feelings of ange" and an-iety S$%h statement as Hhat happened to get yo$ this ang"yQT may help the %lient /e"bali(es feelings "athe" than a%t on them 25 ) Hhen speaing to a %lient with #l(heime"Ks disease& the n$"se sho$ld $se %lose=ended 6$estions !hose that the %lient %an answe" with yesT o" noT whene/e" possible and a/oid 6$estions that "e6$i"e the %lient to mae %hoi%es epeating the 6$estion aids %omp"ehension 28 A !he n$"se sho$ld p"epa"e a %lient fo" ,C! in a manne" simila" to that fo" gene"al anesthesia 2 C #ged %heese and Chianti wine %ontain high %on%ent"ations of ty"amine

29 D ,C! %ommonly %a$ses t"ansito"y sho"t and long te"m memo"y loss and %onf$sion& espe%ially in ge"iat"i% %lients It "a"ely "es$lts in pe"manent sho"t and long te"m memo"y loss +0 A Poly$"ia %ommonly o%%$"s ea"ly in the t"eatment with lithi$m and %o$ld "es$lt in fl$id /ol$me defi%it +1 D Signs of an-iety agent o/e"dose in%l$de emotional lability& e$pho"ia and impai"ed memo"y +2 ) )"ining al%ohol %an potentiate the sedating a%tion of t"i%y%li% antidep"essants )"y mo$th and bl$""ed /ision a"e no"mal ad/e"se effe%ts of t"i%y%li% antidep"essants ++ C Homen may e-pe"ien%e ameno""hea& whi%h is "e/e"sible& while taing antipsy%hoti%s #meno""hea doesnKt indi%ate %essation of o/$lation th$s& the %lient %an still be p"egnant +. D !he fi"st a"e fo" assessment wo$ld be the %lientKs "eason fo" "ef$sing medi%ation !he %lient may not $nde"stand the p$"pose fo" the medi%ation& may be e-pe"ien%ing dist"essing side effe%ts& o" may be %on%e"ned abo$t the %ost of medi%ine In any %ase& the n$"se %annot p"o/ide app"op"iate inte"/ention befo"e assessing the %lientKs p"oblem with the medi%ation !he patientKs in%ome le/el& li/ing a""angements& and in/ol/ement of family and s$ppo"t systems a"e "ele/ant iss$es following dete"mination of the %lientKs "eason fo" "ef$sing medi%ation !he n$"se p"o/iding follow=$p %a"e wo$ld ha/e a%%ess to the %lientKs medi%al "e%o"d and sho$ld al"eady now the "eason fo" inpatient admission


+ A ,-%ess dopamine is tho$ght to be the %hemi%al %a$se fo" psy%hoti% thining !he typi%al antipsy%hoti%s a%t to blo% dopamine "e%epto"s and the"efo"e de%"ease the amo$nt of ne$"ot"ansmitte" at the synapses !he typi%al antipsy%hoti%s do not in%"ease a%etyl%holine& stabili(e se"otonin& stim$late D#@# +5 ) !he !C#s affe%t no"epineph"ine as well as othe" ne$"ot"ansmitte"s& and th$s ha/e signifi%ant %a"dio/as%$la" side effe%ts !he"efo"e& they a"e $sed with %a$tion in elde"ly %lients who may ha/e in%"eased "is fa%to"s fo" %a"dia% p"oblems be%a$se of thei" age and othe" medi%al %onditions !he "emaining side effe%ts wo$ld apply to any %lient taing a !C# and a"e not pa"ti%$la" to an elde"ly pe"son +8 ) Cogniti/e thining the"apy fo%$ses on the %lientKs mispe"%eptions abo$t self& othe"s and the wo"ld that impa%t f$n%tioning and %ont"ib$te to symptoms Using medi%ations to alte" ne$"ot"ansmitte" a%ti/ity is a psy%hobiologi% app"oa%h to t"eatment !he othe" answe" %hoi%es a"e f"amewo"s fo" %a"e& b$t hey a"e not appli%able to this sit$ation + C !he %on%ept that beha/io" is moti/ated and has meaning %omes f"om the psy%hodynami% f"amewo" #%%o"ding to thisf"om pe"spe%ti/e& beha/io"!he a"ises f"om inte"nal wishes <$%h what moti/ates beha/io" %omes the $n%ons%io$s "emaining "esponses do o" notneeds add"ess the of inte"nal fo"%es tho$ght to moti/ate beha/io" +9 C !he %lient is demonst"ating fa$lty tho$ght p"o%esses that a"e negati/e and that go/e"n his beha/io" in his wo" sit$ation X iss$es that a"e typi%ally e-amined $sing a %ogniti/e theo"y app"oa%h Iss$es in/ol/ing lea"ned beha/io" a"e best e-plo"ed th"o$gh beha/io" theo"y& not %ogniti/e theo"y Iss$es in/ol/ing ego de/elopment a"e the fo%$s of psy%hoanalyti% theo"y Option . is in%o""e%t be%a$se the"e is no e/iden%e in this sit$ation that the %lient has %onfli%t$al "elationships in the wo" en/i"onment .0 D #n-iety is a "esponse to a th"eat a"ising f"om inte"nal o" e-te"nal stim$li .1 A Systemati% desensiti(ation is a beha/io"al the"apy te%hni6$e that helps %lients with i""ational fea"s and a/oidan%e beha/io" to fa%e the thing they fea"& witho$t e-pe"ien%ing an-iety !he"e is no attempt to p"omote insight with this p"o%ed$"e& and the %lient will not be ta$ght to s$bstit$te one fea" fo" anothe" #ltho$gh the %lientKs an-iety may de%"ease with s$%%essf$l %onf"ontation of i""ational fea"s& the p$"pose of the p"o%ed$"e is spe%ifi%ally "elated to pe"fo"ming a%ti/ities that typi%ally a"e a/oided as pa"t of the phobi% "esponse .2 ) # %lient with antiso%ial pe"sonality diso"de" typi%ally has f"e6$ent episodes of a%ting imp$lsi/ely with poo" ability to delay self=g"atifi%ation !he"efo"e& de%"eased f"e6$en%y of imp$lsi/e beha/io"s wo$ld be e/iden%e of imp"o/ement Cha"ming beha/io" when a"o$nd a$tho"ity fig$"es and statements indi%ating no "emo"se a"e e-amples of symptoms typi%al of someone with this diso"de" and wo$ld not indi%ate s$%%essf$l t"eatment Self=satisfa%tion wo$ld be /iewed as a positi/e %hange if the %lient e-p"esses low self=esteemW howe/e" this is not a %ha"a%te"isti% of a %lient with antiso%ial pe"sonality diso"de" .+ D In a$toimm$ne diso"de"s& st"ess and the "esponse to st"ess %an e-a%e"bate symptoms St"ess management te%hni6$es %an help the %lient "ed$%e the psy%hologi%al "esponse to st"ess& whi%h in t$"n will help "ed$%e the physiologi% st"ess "esponse !his will affo"d the %lient an in%"eased sense of %ont"ol o/e" his symptoms !he n$"se %an add"ess the "emaining answe" %hoi%es in he" tea%hing abo$t the %lientKs disease and t"eatmentW howe/e"& nowledge alone will not help the %lient to manage his st"ess effe%ti/ely eno$gh to %ont"ol symptoms .. D )is"ega"d fo" established "$les of so%iety is the most %ommon %ha"a%te"isti% of a %lient with antiso%ial pe"sonality diso"de" #ttention to detail and o"de" is %ha"a%te"isti% of someone with obsessi/e %omp$lsi/e diso"de" @i(a""e manne"isms and tho$ghts a"e %ha"a%te"isti%s of a %lient with s%hi(oid o" s%hi(otypal diso"de" S$bmissi/e and dependent beha/io"s a"e %ha"a%te"isti% of someone with a dependent pe"sonality . D !he %lient with ano"e-ia typi%ally feels powe"less& with a sense of ha/ing little %ont"ol o/e" any aspe%t of life besides eating beha/io" Often& pa"ental e-pe%tations and standa"ds a"e 6$ite high and lead to the %lientsK sense of g$ilt o/e" not meas$"ing $p .5 A One of the %o"e iss$es %on%e"ning the family of a %lient with ano"e-ia is %ont"ol !he familyKs a%%eptan%e of the %lientKs ability to mae independent de%isions is ey to s$%%essf$l family inte"/ention #ltho$gh the "emaining options may o%%$" d$"ing the p"o%ess of the"apy& they wo$ld not ne%essa"ily indi%ate a s$%%essf$l o$t%omeW the %ent"al family iss$es of dependen%e and independen%e a"e not add"esses on these "esponses .8 ) Use of %ogniti/e te%hni6$es allows the n$"se to help the %lient "e%ogni(e that this negati/e beliefs may be disto"tions and that& by %hanging his thining& he %an adopt mo"e positi/e beliefs that a"e "ealisti% and hopef$l #g"eeing with the %lientKs feelings and p"esenting a %hee"f$l attit$de a"e not %onsistent with a %ogniti/e app"oa%h and wo$ld not be helpf$l in this sit$ation )enying the %lientKs feelings is belittling and may %on/ey that the n$"se does not $nde"stand the depth of the %lientKs dist"ess . A' #"t the"apy p"o/ides a nonth"eatening /ehi%le fo" the e-p"ession of feelings& and $se of a small g"o$p will help the %lient be%ome %omfo"table with pee"s in a g"o$p setting @asetball is a %ompetiti/e game that "e6$i"es ene"gyW the %lient with maEo" dep"ession is not liely to pa"ti%ipate in this a%ti/ity e%ommending that the %lient "ead a self=help boo may in%"ease& not de%"ease his isolation Hat%hing mo/ie with a pee" g"o$p does not g$a"antee that inte"a%tion will o%%$"W the"efo"e& the %lient may "emain isolated .9 C' )ay t"eatment p"og"ams p"o/ide %lients with %h"oni%& pe"sistent mental illness t"aining in so%ial sills& s$%h as meeting and g"eeting people& asing 6$estions o" di"e%tions& pla%ing an o"de" in a "esta$"ant& taing t$"ns in a g"o$p setting a%ti/ity #ltho$gh management of hall$%inations and medi%ation tea%hing may also be pa"t of the p"og"am offe"ed in a day t"eatment& the n$"se is "efe""ing the %lient in this sit$ation be%a$se of his

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.0

need fo" so%iali(ation sills 7o%ational t"aining gene"ally taes pla%e in a "ehabilitation fa%ilityW the %lient des%"ibed in this sit$ation wo$ld not be a %andidate fo" this se"/i%e 0 A' !he best app"oa%h with a withd"awn %lient is to initiate b"ief& nondemanding a%ti/ities on a one=to=one basis !his app"oa%h gi/es the n$"se an oppo"t$nity to establish a t"$sting "elationship with the %lient # boa"d game with a g"o$p %lients o" playing a team spo"t in the gym may o/e"whelm a se/e"ely withd"awn %lient Hat%hing !7 is a solita"y a%ti/ity that will "einfo"%e the %lientKs withd"awal f"om othe"s


PROFESSIONAL ADUSTMENT

1 # n$"se who wo$ld lie to p"a%ti%e n$"sing in the Philippines %an obtain a li%ense to p"a%ti%e by: # Paying the p"ofessional ta- afte" taing the boa"d e-ams @ Passing the boa"d e-ams and taing the oath of p"ofessionals C Paying the e-amination fee befo"e taing the boa"d e-ams


) Unde"going the inte"/iew %ond$%ted by the @oa"d of *$"sing and taing the boa"d e-ams #nswe": @ Passing the boa"d e-ams and taing the oath of p"ofessionals Fo" a n$"se to obtain a li%ense to p"a%ti%e n$"sing in the Philippines& sGhe m$st pass the boa"d e-aminations and then tae the oath of p"ofessionals befo"e the @oa"d of *$"sing

2 e%ip"o%ity of li%ense to p"a%ti%e "e6$i"es that the %o$nt"y of o"igin of the inte"ested fo"eign n$"se %omplies with the following %onditions: # !he %o$nt"y of o"igin has simila" p"epa"ation fo" a n$"se and has laws allowing Filipino n$"ses to p"a%ti%e in thei" %o$nt"y @ !he Philippines is "e%ogni(ed by the %o$nt"y of o"igin as one that has high 6$ality of n$"sing ed$%ation C !he %o$nt"y of o"igin "e6$i"es Filipinos to tae thei" own boa"d e-amination ) !he %o$nt"y of o"igin e-empts Filipinos f"om passing thei" li%ens$"e e-amination #nswe": # !he %o$nt"y of o"igin has simila" p"epa"ation fo" a n$"se and has laws allowing Filipino n$"ses to p"a%ti%e in thei" %o$nt"y #%%o"ding to the Philippine *$"ses #%t of 2002& fo"eign n$"ses wanting to p"a%ti%e in the Philippines m$st show p"oof that hisGhe" %o$nt"y of o"igin meets the two essential %onditions: a the "e6$i"ements fo" "egist"ation between the two %o$nt"ies a"e s$bstantially the sameW and b the %o$nt"y of o"igin of the fo"eign n$"se has laws allowing the Filipino n$"se to p"a%ti%e in hisGhe" %o$nt"y E$st lie its own %iti(ens

+ *$"ses p"a%ti%ing the p"ofession in the Philippines and a"e employed in go/e"nment hospitals a"e "e6$i"ed to pay ta-es s$%h as: # @oth in%ome ta- and p"ofessional ta@ In%ome ta- only sin%e they a"e e-empt f"om paying p"ofessional taC P"ofessional ta- whi%h is paid by all n$"ses employed in both go/e"nment and p"i/ate hospitals ) In%ome ta- whi%h paid e/e"y
. #%%o"ding to # 918+ Philippine *$"sing #%t of 2002& a g"ad$ate n$"se who wants to tae m$st li%ens$"e e-amination m$st %omply with the following 6$alifi%ations: # #t least 21 yea"s old& g"ad$ate of @S* f"om a "e%ogni(ed s%hool& and of good mo"al %ha"a%te" @ #t least 1 yea"s old& g"ad$ate of @S* f"om a "e%ogni(ed s%hool and of good mo"al %ha"a%te" C #t least 1 yea"s old& p"o/ided that when sGhe passes the boa"d e-ams& sGhe m$st be at least 21 yea"s oldW @S* g"ad$ate of a "e%ogni(ed s%hool& and of good mo"al %ha"a%te" ) Filipino %iti(en o" a %iti(en of a %o$nt"y whe"e we ha/e "e%ip"o%ityW g"ad$ate of @S* f"om a "e%ogni(ed s%hool and of good mo"al %ha"a%te" #nswe": ) Filipino %iti(en o" a %iti(en of a %o$nt"y whe"e we ha/e "e%ip"o%ityW g"ad$ate of @S* f"om a "e%ogni(ed s%hool and of good mo"al %ha"a%te" # 918+ se%tion 1+ states that the 6$alifi%ations to tae the boa"d e-ams a"e: Filipino %iti(en o" %iti(en of a %o$nt"y whe"e the Philippines has "e%ip"o%ityW of good mo"al %ha"a%te" and g"ad$ate of @S* f"om a "e%ogni(ed s%hool of n$"sing !he"e is no e-pli%it p"o/ision abo$t the age "e6$i"ement in # 918 + $nlie in #815. old

law  Hhi%h of the following is !U, abo$t membe"ship to the Philippine *$"ses #sso%iation P*#Q #
5 Hhen the li%ense of the n$"se is "e/oed& it means that the n$"se: # Is no longe" allowed to p"a%ti%e the p"ofession fo" the "est of he" life @ Hill ne/e" ha/e he"Ghis li%ense "e=iss$ed sin%e it has been "e/oed

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.+

C
8 #%%o"ding to the %$""ent n$"sing law& the minim$m ed$%ational 6$alifi%ation fo" a fa%$lty membe" of a %ollege of n$"sing is: # Only a
 !he ed$%ational 6$alifi%ation of a n$"se to be%ome a s$pe"/iso" in a hospital is: # @S* with at least 9 $nits of post g"ad$ate st$dies in n$"sing administ"ation @
9 !he @oa"d of *$"sing has 6$asi=E$di%ial powe" #n e-ample of this powe" is: # !he @oa"d %an iss$e "$les and "eg$lations that will go/e"n the p"a%ti%e of n$"sing @ !he @oa"d %an in/estigate /iolations of the n$"sing law and %ode of ethi%s C !he @oa"d %an /isit a s%hool applying fo" a pe"mit in %ollabo"ation with C?,) ) !he @oa"d p"epa"es the boa"d e-aminations #nswe": @ !he @oa"d %an in/estigate /iolations of the n$"sing law and %ode of ethi%s >$asi=E$di%ial powe" means that the @oa"d of *$"sing has the a$tho"ity to in/estigate /iolations of the n$"sing law and %an iss$e s$mmons& s$bpoena o" s$bpoena d$%es te%$m as needed

10 Hhen a n$"se %a$ses an inE$"y to the patient and the inE$"y %a$sed be%omes the p"oof of the negligent a%t& the p"esen%e of the inE$"y is said to e-emplify the p"in%iple of: # Fo"%e maEe$"e @ espondeat s$pe"io" C es ipsa lo6$it$" ) ?oldo/e" do%t"ine #nswe": C es ipsa lo6$it$" es ipsa lo6$it$" lite"ally means the thing speas fo" itself !his means in ope"ational te"ms that the inE$"y %a$sed is the p"oof tha t the"e was a negligent a%t

11 ,ns$"ing that the"e is an info"med %onsent on the pa"t of the patient befo"e a s$"ge"y is done& ill$st"ates the bioethi%al p"in%iple of: # @enefi%en%e @ #$tonomy C !"$th tellingG/e"a%ity ) *on=malefi%en%e #nswe": @ #$tonomy Info"med %onsent means that the patient f$lly $nde"stands what will be the s$"ge"y to be done& the "iss in/ol/ed and the alte"nati/e sol$tions so that when sGhe gi/e %onsent it is done with f$ll nowledge and is gi/en f"eely !he a%tion of allowing the patient to de%ide whethe" a s$"ge"y is to be done o" not e-emplifies the bioethi%al p"in%iple

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1..

of a$tonomy

12 Hhen a n$"se is p"o/iding %a"e to he"Ghis patient& sGhe m$st "emembe" that she is d$ty bo$nd not to do doing any a%tion that will %a$se the patient ha"m !his is the meaning of the bioethi%al p"in%iple: # *on=malefi%en%e @ @enefi%en%e C B$sti%e ) Solida"ity #nswe": # *on=malefi%en%e *on=malefi%en%e means do not %a$se ha"m o" do any a%tion that will %a$se any ha"m to the patientG%lient !o do good is "efe""ed as benefi%en%e

1+ Hhen the patient is ased to testify in %o$"t& sGhe m$st abide by the ethi%al p"in%iple of: # P"i/ileged %omm$ni%ation @ Info"med %onsent C Solida"ity ) #$tonomy #nswe": # P"i/ileged %omm$ni%ation #ll %onfidential info"mation that %omes to the nowledge of the n$"se in the %a"e of he"Ghis patients is %onside"ed p"i/ileged %omm$ni%ations ?en%e& sGhe is not allowed to E$st "e/eal the %onfidential info"mation a"bit"a"ily SGhe may only be allowed to b"ea the seal of se%"e%y in %e"tain %onditions One s$%h %ondition is when the %o$"t o"de"s the n$"se to testify in a %"iminal o" medi%o=legal %ase

1. Hhen the do%to" o"de"s do not "es$s%itateT& this means that # !he n$"se need not gi/e d$e %a"e to the patient sin%e sGhe is te"minally ill @ !he patient need not be gi/en food and wate" afte" all sGhe is dying C !he n$"ses and the attending physi%ian sho$ld not do any he"oi% o" e-t"ao"dina"y meas$"es fo" the patient ) !he patient need not be gi/en o"dina"y %a"e so that he"Ghis dying p"o%ess is hastened #nswe": C !he n$"ses and the attending physi%ian sho$ld not do any he"oi% o" e-t"ao"dina"y meas$"es fo" the patient )o not "es$s%itateT is a medi%al o"de" whi%h is w"itten on the %ha"t afte" the do%to" has %ons$lted the family and this means that the membe"s of the health team a"e not "e6$i"ed to gi/e e-t"ao"dina"y meas$"es b$t %annot withhold the basi% needs lie food& wate"& and ai" It also means that the n$"se is still d$ty bo$nd to gi/e the basi% n$"sing %a"e to the te"minally ill patient and ens$"e that the spi"it$al needs of the patient is taen %a"ed of

1 Hhi%h of the following statements is !U, of abo"tion in the PhilippinesQ # Ind$%ed abo"tion is allowed in %ases of "ape and in%est @ Ind$%ed abo"tion is both a %"iminal a%t and an $nethi%al a%t fo" the n$"se C #bo"tion maybe %onside"ed a%%eptable if the mothe" is $np"epa"ed fo" the p"egnan%y ) # n$"se who pe"fo"ms ind$%ed abo"tion will ha/e no legal a%%o$ntability if the mothe" "e6$ested that the abo"tion done on he" #nswe": @ Ind$%ed abo"tion is both a %"iminal a%t and an $nethi%al a%t fo" the n$"se Ind$%ed abo"tion is %onside"ed a %"iminal a%t whi%h is p$nishable by imp"isonment whi%h maybe $p to a ma-im$m of 12 yea"s if the n$"se gets paid fo" it #lso& the PC Code of ,thi%s states that the n$"se m$st "espe%t life and m$st not do any a%tion that will dest"oy life #bo"tion is an a%t that dest"oys life albe it at the beginning

of life

LEADERSHIP a$% MANAGEMENT

1
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.

# O"gani(ation

C 'aisse( fai"e ) @$"ea$%"ati% #nswe": C 'aisse( fai"e 'aisse( fai"e leade"ship is p"efe""ed when the followe"s now what to do and a"e e-pe"ts in the field !his leade"ship style is "elationship=o"iented "athe" than tas=%ente"ed  She s$"fs the inte"net fo" mo"e info"mation abo$t leade"ship styles She "eads abo$t sha"ed leade"ship as a p"a%ti%e in some magnet hospitals Hhi%h of the following des%"ibes this style of leade"shipQ # 'eade"ship beha/io" is gene"ally dete"mined by the "elationship between the leade"Ks pe"sonality and the spe%ifi% sit$ation @ 'eade"s belie/e that people a"e basi%ally good and need not be %losely %ont"olled C 'eade"s "ely hea/ily on /isioning and inspi"e membe"s to a%hie/e "es$lts ) 'eade"ship is sha"ed at the point of %a"e #nswe": ) 'eade"ship is sha"ed at the point of %a"e Sha"ed go/e"nan%e allows the staff n$"ses to ha/e the a$tho"ity& "esponsibility and a%%o$ntability fo" thei" own p"a%ti%e 9

1+ #fte" dis%$ssing the possible effe%ts of the low patient satisfa%tion "ate& the staff sta"ted to list down possible st"ategies to sol/e the p"oblems head=on Sho$ld they de%ide to /ote on the best %hange st"ategy& whi%h of the following st"ategies is "efe""ed to thisQ # Collabo"ation @
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.

C
)

C Unity of %ommand ) O"de" #nswe": C Unity of %ommand !he p"in%iple of $nity of %ommand means that employees sho$ld "e%ei/e o"de"s %oming f"om only one manage" and not f"om two manage"s !his a/e"ts the possibility of sowing %onf$sion among the membe"s of the o"gani(ation 25 B$li$s o"ients his staff on the patte"ns of "epo"ting "elationship th"o$gho$t the o"gani(ation Hhi%h of the following p"in%iples "efe" to thisQ # Span of %ont"ol @ ?ie"a"%hy C ,sp"it dK %o"ps ) Unity of di"e%tion #nswe": @ ?ie"a"%hy ?ie"a"%hy "efe"s to the patte"n of "epo"ting o" the fo"mal line of a$tho"ity in an o"gani(ational st"$%t$"e 28 ?e emphasi(es to the team that they need to p$t thei" effo"ts togethe" towa"ds the attainment of the goals of the p"og"am Hhi%h of the following p"in%iples "efe"s to thisQ # Span of %ont"ol @ Unity of di"e%tion C Unity of %ommand ) Command "esponsibility #nswe": @ Unity of di"e%tion Unity of di"e%tion means ha/ing one goal o" one obEe%ti/e fo" the team to p$"s$eW hen%e all membe"s of the o"gani(ation sho$ld p$t thei" effo"ts togethe" towa"ds the attainment of thei" %ommon goal o" obEe%ti/e 2 B$li$s st"esses the impo"tan%e of p"omoting êsp"it d %o"psK among the membe"s of the $nit Hhi%h of the following "ema"s of the staff indi%ates that they $nde"stand what he pointed o$tQ # 'etKs wo" togethe" in ha"monyW we need to be s$ppo"ti/e of one anothe"T @ In o"de" that we a%hie/e the same "es$ltsW we m$st all follow the di"e%ti/es of B$li$s and not f"om othe" manage"sT C He will ens$"e that all the "eso$"%es we need a"e a/ailable when neededT ) He need to p$t o$" effo"ts togethe" in o"de" to "aise the ba" of e-%ellen%e in the %a"e we p"o/ide to all o$" patientsT #nswe": # 'etKs wo" togethe" in ha"monyW we need to be s$ppo"ti/e of one anothe"T !he p"in%iple of êsp"it dK %o"psK "efe"s to p"omoting ha"mony in the wo"pla%e& whi%h is essential in maintaining a %limate %ond$%i/e to wo" 29 ?e dis%$sses the goal of the depa"tment Hhi%h of the following statements is a goalQ # In%"ease the patient satisfa%tion "ate @ ,liminate the in%iden%e of delayed administ"ation of medi%ations C ,stablish "appo"t with patients ) ed$%e "esponse time to two min$tes #nswe": # In%"ease the patient satisfa%tion "ate Doal is a desi"ed "es$lt towa"ds whi%h effo"ts a"e di"e%ted Options #@& C and ) a"e all obEe%ti/es whi%h a"e aimed at spe%ifi% end +0 ?e wants to infl$en%e the %$stoma"y way of thining and beha/ing that is sha"ed by the membe"s of the depa"tment Hhi%h of the following te"ms "efe" to thisQ # O"gani(ational %ha"t @ C$lt$"al netwo" C O"gani(ational st"$%t$"e ) O"gani(ational %$lt$"e #nswe": ) O"gani(ational %$lt$"e #n o"gani(ational %$lt$"e "efe"s to the way the membe"s of the o"gani(ation thin togethe" and do things a"o$nd them togethe" ItKs thei" way of life in that o"gani(ation +1 ?e asse"ts the impo"tan%e of p"omoting a positi/e o"gani(ational %$lt$"e in thei" $nit Hhi%h of the following beha/io"s indi%ate that this is attained by the g"o$pQ

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 10

# P"oa%ti/e and %a"ing with one anothe" @ Competiti/e and pe"fe%tionist C Powe"f$l and oppositional ) Obedient and $n%omplaining #nswe": # P"oa%ti/e and %a"ing with one anothe" Positi/e %$lt$"e is based on h$manism and affiliati/e no"ms +2 Stephanie is a new Staff ,d$%ato" of a p"i/ate te"tia"y hospital She %ond$%ts o"ientation among new staff n$"ses in he" depa"tment Boseph& one of the new staff n$"ses& wants to $nde"stand the %hannel of %omm$ni%ation& span of %ont"ol and lines of %omm$ni%ation Hhi%h of the following will p"o/ide this info"mationQ # O"gani(ational st"$%t$"e @ Poli%y C Bob des%"iption )

p$"poses Hhi%h of these p$"poses in *O! in%l$dedQ #
+9 Stephanie %onside"s shifting to t"ansfo"mational leade"ship Hhi%h of the following statements best des%"ibes this type of leade"shipQ # Uses /isioning as the essen%e of leade"ship @ Se"/es the followe"s "athe" than being se"/ed C
.0 #s a manage"& she fo%$ses he" ene"gy on both the 6$ality of se"/i%es "ende"ed to the patients as well as the welfa"e of the staff of he" $nit Hhi%h of the following management styles does she adoptQ # Co$nt"y %l$b management @ O"gani(ation man management C !eam management ) #$tho"ity=obedien%e management #nswe": C !eam management !eam management has a high %on%e"n fo" se"/i%es and high %on%e"n fo" staff

.1 athe"ine is a yo$ng Unit $it he" Eob and loo fo" anothe" employment #nswe": # Identify the so$"%e of the %onfli%t and $nde"stand the points of f"i%tion !his in/ol/es a p"oblem sol/ing app"oa%h& whi%h add"esses the "oot %a$se of the p"oblem

.2 #s a yo$ng manage"& she nows that %onfli%t o%%$"s in any o"gani(ation Hhi%h of the following statements "ega"ding %onfli%t is *O! t"$eQ # Can be dest"$%ti/e if the le/el is too high @ Is not benefi%ialW hen%e it sho$ld be p"e/ented at all times C
team a"e wat%hing them


.+ athe"ine tells one of the staff& I donKt ha/e time to dis%$ss the matte" with yo$ now See me in my offi%e late"T when the latte" ass if they %an tal abo$t an iss$e Hhi%h of the following %onfli%t "esol$tion st"ategies did she $seQ # Smoothing @ Comp"omise C #/oidan%e ) est"i%tion #nswe": C #/oidan%e !his st"ategy sh$ns dis%$ssing the iss$e head=on and p"efe"s to postpone it to a late" time In effe%t the p"oblem "emains $nsol/ed and both pa"ties a"e in a lose=lose sit$ation  athleen nows that one of he" staff is e-pe"ien%ing b$"no$t Hhi%h of the following is the best thing fo" he"

.. to doQ # #d/ise he" staff to go on /a%ation @ Igno"e he" obse"/ationsW it will be "esol/ed e/en witho$t inte"/ention C emind he" to show loyalty to the instit$tion ) 'et the staff /entilate he" feelings and as how she %an be of help #nswe": ) 'et the staff /entilate he" feelings and as how she %an be of help ea%hing o$t and helping the staff is the most effe%ti/e st"ategy in dealing with b$"n o$t nowing that someone is "eady to help maes the staff feel impo"tantW hen%e he" self=wo"th is enhan%ed

. She nows that pe"fo"man%e app"aisal %onsists of all the following a%ti/ities ,;C,P!: # Setting spe%ifi% standa"ds and a%ti/ities fo" indi/id$al pe"fo"man%e @ Using agen%y standa"ds as a g$ide C )ete"mine a"eas of st"ength and weanesses ) Fo%$sing a%ti/ity on the %o""e%tion of identified beha/io" #nswe": ) Fo%$sing a%ti/ity on the %o""e%tion of identified beha/io" Pe"fo"man%e app"aisal deal with both positi/e and negati/e pe"fo"man%eW is not meant to be a fa$lt=finding a%ti/ity

.5 Hhi%h of the following statements is *O! t"$e abo$t pe"fo"man%e app"aisalQ # Info"ming the staff abo$t the spe%ifi% imp"essions of thei" wo" help imp"o/e thei" pe"fo"man%e @ # /e"bal app"aisal is an a%%eptable s$bstit$te fo" a w"itten "epo"t C Patients a"e the best so$"%e of info"mation "ega"ding pe"sonnel app"aisal ) !he o$t%ome of pe"fo"man%e app"aisal "ests p"ima"ily with the staff #nswe": C Patients a"e the best so$"%e of info"mation "ega"ding pe"sonnel app"aisal !he patient %an be a so$"%e of info"mation abo$t the pe"fo"man%e of the staff b$t it is ne/e" the best so$"%e )i"e%tly obse"/ing the staff is the best so$"%e of info"mation fo" pe"sonnel app"aisal

.8 !he"e a"e times when athe"ine e/al$ates he" staff as she maes he" daily "o$nds Hhi%h of the following is *O! a benefit of %ond$%ting an info"mal app"aisalQ # !he staff membe" is obse"/ed in nat$"al setting @ In%idental %onf"ontation and %ollabo"ation is allowed C !he e/al$ation is fo%$sed on obEe%ti/e data systemati%ally ) !he e/al$ation may p"o/ide /alid info"mation fo" %ompilation of a fo"mal "epo"t #nswe": C !he e/al$ation is fo%$sed on obEe%ti/e data systemati%ally Colle%ting obEe%ti/e data systemati%ally %an not be a%hie/ed in an info"mal app"aisal It is fo%$sed on what a%t$ally happens in the nat$"al wo" setting

. She %ond$%ts a 5=month pe"fo"man%e "e/iew session with a staff membe" Hhi%h of the following a%tions is app"op"iateQ # She ass anothe" n$"se to attest the session as a witness @ She info"ms the staff that she may as anothe" n$"se to "ead the app"aisal befo"e the session is o/e" C She tells the staff that the session is manage"=%ente"ed ) !he session is p"i/ate between the two membe"s #nswe": ) !he session is p"i/ate between the two membe"s !he session is p"i/ate between the manage" and the staff and "emains to be so when the two pa"ties do not di/$lge

the info"mation to othe"s

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+

.9 #le-and"a is tased to o"gani(e the new wing of the hospital She was gi/en the a$tho "ity to do as she deems fit She is awa"e that the di"e%to" of n$"sing has s$bstantial t"$st and %onfiden%e in he" %apabilities& %omm$ni%ates th"o$gh downwa"d and $pwa"d %hannels and $s$ally $ses the ideas and opinions of he" staff Hhi%h of the following is he" style of managementQ # @ene/olent Xa$tho"itati/e @ Cons$ltati/e C ,-ploiti/e=a$tho"itati/e ) Pa"ti%ipati/e #nswe": @ Cons$ltati/e # %ons$ltati/e manage" is almost lie a pa"ti%ipati/e manage" !he pa"ti%ipati/e manage" has %omplete t"$st and %onfiden%e di"e%tions in the s$bo"dinate& always $ses the opinions and ideas of s$bo"dinates and %omm$ni%ates in all 2 She de%ides to ill$st"ate the o"gani(ational st"$%t$"e Hhi%h of the following elements is *O! in%l$dedQ # 'e/el of a$tho"ity @ 'ines of %omm$ni%ation C Span of %ont"ol ) Unity of di"e%tion #nswe": ) Unity of di"e%tion Unity of di"e%tion is a management p"in%iple& not an element of an o"gani(ational st"$%t$"e

1 She plans of assigning %ompetent people to fill the "oles designed in the hie"a"%hy Hhi%h p"o%ess "efe"s to thisQ # Staffing @ S%hed$ling C e%"$itment ) Ind$%tion #nswe": # Staffing Staffing is a management f$n%tion in/ol/ing p$tting the best people to a%%omplish tass and a%ti/ities to attain the goals of the o"gani(ation

2 She %he%s the do%$menta"y "e6$i"ements fo" the appli%ants fo" staff n$"se position Hhi%h one is *O! ne%essa"yQ # Ce"tifi%ate of p"e/io$s employment @ e%o"d of "elated lea"ning e-pe"ien%e ', C
+ Hhi%h phase of the employment p"o%ess in%l$des getting on the pay"oll and %ompleting do%$menta"y "e6$i"ementsQ # O"ientation @ Ind$%tion C Sele%tion ) e%"$itment #nswe": @ Ind$%tion !his step in the "e%"$itment p"o%ess gi/es time fo" the staff to s$bmit all the do%$menta"y "e6$i"ements fo"

employment . She t"ies to design an o"gani(ational st"$%t$"e that allows %omm$ni%ation to flow in all di"e%tions and in/ol/e wo"e"s in de%ision maing Hhi%h fo"m of o"gani(ational st"$%t$"e is thisQ # Cent"ali(ed @ )e%ent"ali(ed C
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.

#nswe": @ )e%ent"ali(ed )e%ent"ali(ed st"$%t$"es allow the staff to mae de%isions on matte"s pe"taining to thei" p"a%ti%e and %omm$ni%ate in downwa"d& $pwa"d& late"al and diagonal flow

 In a ho"i(ontal %ha"t& the lowest le/el wo"e" is lo%ated at the # 'eftmost bo@
5 She de%ides to ha/e a de%ent"ali(ed staffing system Hhi%h of the following is an ad/antage of this system of staffingQ # g"eate" %ont"ol of a%ti/ities @ Conse"/es time C Compatible with %omp$te"i(ation ) P"omotes bette" inte"pe"sonal "elationship #nswe": ) P"omotes bette" inte"pe"sonal "elationship )e%ent"ali(ed st"$%t$"es allow the staff to sol/e de%isions by themsel/es& in/ol/e them in de%ision maingW hen%e they a"e always gi/en oppo"t$nities to inte"a%t with one anothe"

8 #$b"ey thins abo$t p"ima"y n$"sing as a system to deli/e" %a"e Hhi%h of the following a%ti/ities is *O! done by a p"ima"y n$"seQ # Collabo"ates with the physi%ian @ P"o/ides %a"e to a g"o$p of patients togethe" with a g"o$p of n$"ses C P"o/ides %a"e fo" =5 patients d$"ing thei" hospital stay ) Pe"fo"ms %omp"ehensi/e initial assessment #nswe": @ P"o/ides %a"e to a g"o$p of patients togethe" with a g"o$p of n$"ses !his f$n%tion is done in team n$"sing whe"e the n$"se is a membe" of a team that p"o/ides %a"e fo" a g"o$p of patients

 Hhi%h patte"n of n$"sing %a"e in/ol/es the %a"e gi/en by a g"o$p of pa"ap"ofessional wo"e"s led by a p"ofessional n$"se who tae %a"e of patients with the same disease %onditions and a"e lo%ated geog"aphi%ally nea" ea%h othe"Q # Case method @
9 St aphael $ality Cont"ol Offi%e" She %ommits he"self to he" new "ole and plans he" st"ategies to "eali(e the goals and obEe%ti/es of the depa"tment Hhi%h of the following is a p"ima"y tas that they sho$ld pe"fo"m to ha/e an effe%ti/e %ont"ol systemQ #
a%ti/ities 50
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1

C #ll patients shall ha/e thei" weights taen "e%o"ded ) Patients shall answe" the e/al$ation fo"m befo"e dis%ha"ge #nswe": @ otation of d$ty will be done e/e"y fo$" wees fo" all patient %a"e pe"sonnel St"$%t$"e standa"ds in%l$de management system& fa%ilities& e6$ipment& mate"ials needed to deli/e" %a"e to patients otation of d$ty is a management system

51 Hhen she p"esents the n$"sing p"o%ed$"es to be followed& she "efe"s to what type of standa"dsQ # P"o%ess @ O$t%ome C St"$%t$"e ) C"ite"ia #nswe": # P"o%ess P"o%ess standa"ds in%l$de %a"e plans& n$"sing p"o%ed$"e to be done to add"ess the needs of the patients

52 !he following a"e basi% steps in the %ont"olling p"o%ess of the depa"tment Hhi%h of the following is *O! in%l$dedQ #
5+ Hhi%h of the following statements "efe"s to %"ite"iaQ # #g"eed on le/el of n$"sing %a"e @ Cha"a%te"isti%s $sed to meas$"e the le/el of n$"sing %a"e C Step=by=step g$idelines ) Statement whi%h g$ide the g"o$p in de%ision maing and p"oblem sol/ing #nswe": @ Cha"a%te"isti%s $sed to meas$"e the le/el of n$"sing %a"e C"ite"ia a"e spe%ifi% %ha"a%te"isti%s $sed to meas$"e the standa"d of %a"e

5. She wants to ens$"e that e/e"y tas is %a""ied o$t as planned Hhi%h of the following tass is *O! in%l$ded in the %ont"olling p"o%essQ # Inst"$%ting the membe"s of the standa"ds %ommittee to p"epa"e poli%ies @ e/iewing the e-isting poli%ies of the hospital C ,/al$ating the %"edentials of all n$"sing staff ) Che%ing if a%ti/ities %onfo"m to s%hed$le #nswe": # Inst"$%ting the membe"s of the standa"ds %ommittee to p"epa"e poli%ies Inst"$%ting the membe"s in/ol/es a di"e%ting f$n%tion

5
55 Hhi%h of the following is e/iden%e that the %ont"olling p"o%ess is effe%ti/eQ # !he things that we"e planned a"e done @ Physi%ians do not %omplain C ,mployees a"e %ontended ) !he"e is an in%"ease in %$stome" satisfa%tion "ate #nswe": # !he things that we"e planned a"e done Cont"olling is defined as seeing to it t hat what is planned is done


58
5 She notes that the"e is an in%"easing $n"est of the staff d$e to fatig$e b"o$ght abo$t by sho"tage of staff Hhi%h a%tion is a p"io"ityQ # ,/al$ate the o/e"all "es$lt of the $n"est @ inte"a%tion C Initiate )e/elopa ag"o$p plan and implement it ) Identify e-te"nal and inte"nal fo"%es #nswe": @ Initiate a g"o$p inte"a%tion Initiate a g"o$p inte"a%tion will be an oppo"t$nity to dis%$ss the p"oblem in the open

NURSING RESEARCH Part 1

1 e/in is a membe" of the *$"sing esea"%h Co$n%il of the hospital ?is fi"st assignment is to dete"mine the le/el of patient satisfa%tion on the %a"e they "e%ei/ed f"om the hospital ?e plans to in%l$de all ad$lt patients admitted f"om #p"il to

@ 'ength of stay C #ge of patients ) #bsen%e of %ompli%ations #nswe": C #ge of patients #n e-t"aneo$s /a"iable is not the p"ima"y %on%e"n of the "esea"%he" b$t has an effe%t on the "es$lts of the st$dy #d$lt patients may be yo$ng& middle o" late ad$lt 2 ?e thins of an app"op"iate theo"eti%al f"amewo" Hhose theo"y add"esses the fo$" modes of adaptationQ #
8 ?e %he%s if his inst"$ments meet the %"ite"ia fo" e/al$ation Hhi%h of the following %"ite"ia "efe"s to the %onsisten%y o" the ability to yield the same "esponse $pon its "epeated administ"ationQ # 7alidity @ eliability C Sensiti/ity ) ObEe%ti/ity #nswe": @ eliability

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1

eliability is "epeatability of the inst"$mentW it %an eli%it the same "esponses e/en with /a"ied ad minist"ation of

the inst"$ment  Hhi%h %"ite"ia "efe" to the ability of the inst"$ment to dete%t fine diffe"en%es among the s$bEe%ts being st$diedQ # Sensiti/ity @ eliability C 7alidity ) ObEe%ti/ity #nswe": # Sensiti/ity Sensiti/ity is an att"ib$te of the inst"$ment that allow the "espondents to disting$ish diffe"en%es of the options

whe"e to %hoose f"om 9 Hhi%h of the following te"ms "efe" to the deg"ee to whi%h an inst"$ment meas$"es what it is s$pposed to be meas$"eQ # 7alidity @ eliability C
10 ?e plans fo" his sampling method Hhi%h sampling method gi/es e6$al %han%e to all $nits in the pop$lation to get pi%edQ # andom @ #%%idental C >$ota ) B$dgment #nswe": # andom andom sampling gi/es e6$al %han%e fo" all the elements in the pop$lation to be pi%ed as pa"t of the sample

11 aphael is inte"ested to lea"n mo"e abo$t t"ans%$lt$"al n$"sing be%a$se he is assigned at the family s$ites whe"e most patients %ome f"om diffe"ent %$lt$"es and %o$nt"ies Hhi%h of the following designs is app"op"iate fo" this st$dyQ # D"o$nded theo"y @ ,thnog"aphy C Case st$dy ) Phenomenology #nswe": @ ,thnog"aphy ,thnog"aphy is fo%$sed on patte"ns of beha/io" of sele%ted people within a %$lt$"e

12 !he n$"sing theo"ist who de/eloped t"ans%$lt$"al n$"sing theo"y is # )o"othea O"em @
1+ Hhi%h of the following statements best des%"ibes a phenomenologi%al st$dyQ # In/ol/es the des%"iption and inte"p"etation of %$lt$"al beha/io" @ Fo%$ses on the meaning of e-pe"ien%es as those who e-pe"ien%e it C In/ol/es an in=depth st$dy of an indi/id$al o" g"o$p ) In/ol/es %olle%ting and analy(ing data that aims to de/elop theo"ies g"o$nded in "eal=wo"ld obse"/ations #nswe": @ Fo%$ses on the meaning of e-pe"ien%es as those who e-pe"ien%e it Phenomenologi%al st$dy in/ol/es $nde"standing the meaning of e-pe"ien%es as those who e-pe"ien%ed the


phenomenon 1. ?e systemati%ally plans his sampling plan Sho$ld he de%ides to in%l$de whoe/e" patients a"e admitted d$"ing the st$dy he $ses what sampling methodQ # B$dgment @ #%%idental C andom ) >$ota #nswe": @ #%%idental #%%idental sampling is a non=p"obability sampling method whi%h in%l$des those who a"e at the site d$"ing data

%olle%tion 1 ?e finally de%ides to $se E$dgment sampling Hhi%h of the following a%tions of aphael is %o""e%tQ # Plans to in%l$de whoe/e" is the"e d$"ing his st$dy @ )ete"mines the diffe"ent nationality of patients f"e6$ently admitted and de%ides to get "ep"esentations samples f"om ea%h C #ssigns n$mbe"s fo" ea%h of the patients& pla%e these in a fishbowl and d"aw 10 f"om it ) )e%ides to get 20 samples f"om the admitted patients #nswe": @ )ete"mines the diffe"ent nationality of patients f"e6$ently admitted and de%ides to get "ep"esentations samples f"om ea%h B$dgment sampling in/ol/es in%l$ding samples a%%o"ding to the nowledge of the in/estigato" abo$t the pa"ti%ipants in the st$dy

15 ?e nows that %e"tain patients who a"e in a spe%iali(ed "esea"%h setting tend to "espond psy%hologi%ally to the %onditions of the st$dy !his is "efe""ed to as # @ias @ ?awtho"ne effe%t C ) ?alo ?o"nseffe%t effe%t #nswe": @ ?awtho"ne effe%t ?awtho"ne effe%t is based on the st$dy of ,lton
18 Hhi%h of the following items "efe" to the sense of %los$"e that aphael e-pe"ien%es when data %olle%tion %eases to yield any new info"mationQ # Sat$"ation @ P"e%ision C 'imitation ) ele/an%e #nswe": # Sat$"ation Sat$"ation is a%hie/ed when the in/estigato" %an not e-t"a%t new "esponses f"om the info"mants& b$t instead& gets the same "esponses "epeatedly

1 In 6$alitati/e "esea"%h the a%t$al analysis of data begins with: # sea"%h fo" themes @ /alidation of themati% analysis C wea/e the themati% st"ands togethe" ) 6$asi statisti%s #nswe": # sea"%h fo" themes !he in/estigato" sta"ts data analysis by looing fo" themes f"om the /e"batim "esponses of the info"mants

19 aphael is also inte"ested to now the %oping abilities of patients who a"e newly diagnosed to ha/e te"minal %an%e" Hhi%h of the following types of "esea"%h is app"op"iateQ # Phenomenologi%al @ ,thnog"aphi% C D"o$nded !heo"y


) Case St$dy #nswe": C D"o$nded !heo"y D"o$nded theo"y ind$%ti/ely de/elops a theo"y based on the obse"/ed p"o%e sses in/ol/ing sele%ted people

20 Hhi%h of the following titles of the st$dy is app"op"iate fo" this st$dyQ # 'i/ed ,-pe"ien%es of !e"minally=Ill Can%e" Patients @ Coping Sills of !e"minally=Ill Can%e" Patients in a Sele%ted ?ospital C !wo Case St$dies of !e"minally=Ill Patients in
21
22 Hhi%h of the following %odes of "esea"%h ethi%s "e6$i"es info"med %onsent in all %ases go/e"ning h$man s$bEe%tsQ # ?elsini )e%la"ation @ *$"embe"g Code C ) @elmont IC* Codeepo"t of ,thi%s #nswe": # ?elsini )e%la"ation ?elsini )e%la"ation is the fi"st inte"national attempt to set $p ethi%al standa"ds in "esea"%h in/ol/ing h$man

"esea"%h s$bEe%ts 2+ Hhi%h of the following ethi%al p"in%iples was *O! a"ti%$lated in the @elmont epo"tQ # @enefi%en%e @ espe%t fo" h$man dignity C B$sti%e ) *on=malefi%en%e #nswe": ) *on=malefi%en%e *on=malefi%en%e is not a"ti%$lated in the @elmont epo"t It only in%l$des benefi%en%e& "espe%t fo" h$man dignity and E$sti%e

Hhi%h oneof ofdest"$%ti/e the following %"ite"ia sho$ld be %onside"ed as a top p"io"ity in n$"sing %a"eQ 2. # #/oidan%e %hanges @ P"ese"/ation of life C #ss$"an%e of safety ) P"ese"/ation of integ"ity #nswe": @ P"ese"/ation of life !he p"ese"/ation of life at all %ost is a p"ima"y "esponsibility of the n$"se !his is embodied in the Code of ,thi%s fo" "egiste"ed n$"ses  @O* esol$tion 220 s 200.

2 Hhi%h of the following p"o%ed$"es ens$"es that the in/estigato" has f$lly des%"ibed to p"ospe%ti/e s$bEe%ts the nat$"e of the st$dy and the s$bEe%ts "ightsQ # )eb"iefing @ F$ll dis%los$"e C Info"med %onsent ) Co/e" data %olle%tion


#nswe": @ F$ll dis%los$"e F$ll dis%los$"e is gi/ing the s$bEe%ts of the "esea"%h info"mation that they dese"/e to now p"io " to the %ond$%t

of the st$dy 25 #fte" the "e/iew session has been %ompleted& a"en and the staff signed the do%$ment Hhi%h of the following is the p$"pose of thisQ # #g"ee abo$t the %ontent of the e/al$ation @ Signify disag"eement of the %ontent of the e/al$ation C )o%$ment that a"en and the staff "e/iewed the e/al$ation ) Se"/e as basis fo" f$t$"e e/al$ation #nswe": C )o%$ment that a"en and the staff "e/iewed the e/al$ation Signing time the do%$ment is done to se"/e as a p"oof that pe"fo"man%e "e/iew was %ond$%ted d$"ing that date and

28 Hhi%h of the following is *O! t"$e abo$t a hypothesisQ ?ypothesis is: # testable @ p"o/en C stated in a fo"m that it %an be a%%epted o" "eEe%ted ) states a "elationship between /a"iables #nswe": @ p"o/en ?ypothesis is not p"o/enW it is eithe" a%%epted o" "eEe%ted ?ypothesis is testable and is defined as a statement that p"edi%ts the "elationship between /a"iables

2 Hhi%h of the following meas$"es will best p"e/ent manip$lation of /$lne"able g"o$psQ # Se%$"e info"med %onsent @ Payment of stipends fo" s$bEe%ts C P"ote%t p"i/a%y of patient ) ,ns$"e %onfidentiality of data #nswe": # Se%$"e info"med %onsent Se%$"ing info"med %onsent will f"ee the "esea"%he" f"om being a%%$sed of manip$lating the s$bEe%ts be%a$se by so doing heGshe gi/es ample oppo"t$nity fo" the s$bEe%ts to weigh the ad/antagesGdisad/antages of being in%l$ded in the st$dy p"io" to gi/ing his %onsent !his is done witho$t any element of fo"%e& %oe"%ion& th"eat o" e/en

ind$%ement 29 Hhi%h of the following p"o%ed$"es ens$"es that
of the st$dy +0 !his te%hni6$e "efe"s to the $se of m$ltiple "efe"ents to d"aw %on%l$sions abo$t what %onstit$tes the t"$th # !"iang$lation @ ,-pe"iment C
+1 !he statement& *inety pe"%ent 90V of the "espondents a"e female staff n$"ses /alidates p"e/io$s "esea"%h findings Santos& 2001W eyes& 200 that the n$"sing p"ofession is la"gely a female dominated p"ofession is an e-ample of # impli%ation @ inte"p"etation


C analysis ) %on%l$sion #nswe": @ inte"p"etation Inte"p"etation in%l$des the infe"en%es of the "esea"%he" abo$ t the findings of the st$dy

+2 !he st$dy is said to be %ompleted when
#nswe": C !he "es$lts of the st$dyisisthe $sed by the n$"ses the hospital !he last step in the "esea"%h p"o%ess $tili(ation of thein"esea"%h findings

++ Sit$ation: Stephanie is a n$"se "esea"%he" of the Patient Ca"e Se"/i%es )i/ision She plans to %ond$%t a lite"at$"e sea"%h fo" he" st$dy Hhi%h of the following is the fi"st step in sele%ting app"op"iate mate"ials fo" he" "e/iewQ # !"a% down most of the "ele/ant "eso$"%es @ Copy "ele/ant mate"ials C O"gani(e mate"ials a%%o"ding to f$n%tion ) Synthesi(e lite"at$"e gathe"ed #nswe": # !"a% down most of the "ele/ant "eso$"%es !he fi"st step in the "e/iew of "elated lite"at$"e is to t"a% down "ele/ant so$"%es befo"e %opying these !he last step is to synthesi(e the lite"at$"e gathe"ed

+. She nows that the most impo"tant %atego"ies of info"mation in lite"at$"e "e/iew is the: # "esea"%h findings @ theo"eti%al f"amewo" C methodology ) opinions #nswe": # "esea"%h findings !he "esea"%h findings is the most impo"tant %atego"y of info"mation that the "esea"%he" sho$ld %opy be%a$se this will gi/e he" /al$able info"mation as to what has been dis%o/e"ed in past st$dies abo$t the same topi%

+ She also %onside"s a%%essing ele%t"oni% data bases fo" he" lite"at$"e "e/iew Hhi%h of the following is the most $sef$l ele%t"oni% database fo" n$"sesQ # CI*#?' @ <,)'I*, C ?ealthS!# ) ,<@#S, #nswe": # CI*#?' !his "efe"s to C$m$lati/e Inde- to *$"sing and #llied ?ealth 'ite"at$"e whi%h is a "i%h so$"%e fo" lite"at$"e "e/iew fo" n$"ses !he "est of the sites a"e fo" medi%ine& pha"ma%y and othe" health="elated sites

+5 Hhile "e/iewing Eo$"nal a"ti%les& Stephanie got inte"ested in "eading the b"ief s$mma"y of the a"ti%le pla%ed at the beginning of the Eo$"nal "epo"t Hhi%h of the following "efe"s to thisQ # Int"od$%tion @ P"efa%e C #bst"a%t ) @a%g"o$nd #nswe": C #bst"a%t #bst"a%t %ontains %on%ise des%"iption of the ba%g"o$nd of the st$dy& "esea"%h 6$estions& "esea"%h obEe%ti/es& methods& findings& impli%ations to n$"sing p"a%ti%e as well as eywo"ds $sed in the st$dy

+8 She notes down ideas that we"e de"i/ed f"om the des%"iption of an in/estigation w"itten by the pe"son who %ond$%ted it Hhi%h type of "efe"en%e so$"%e "efe"s to thisQ # Footnote @ @ibliog"aphy


C P"ima"y so$"%e ) ,ndnotes

#nswe": C P"ima"y so$"%e !his "efe"s to a p"ima"y so$"%e whi%h is a di"e%t a%%o$nt of the in/estigation done by the in/estigato" In %ont"ast to this is a se%onda"y so$"%e& whi%h is w"itten by someone othe" than the o"iginal "esea"%he"

+ She %ame a%"oss a st$dy whi%h is "efe""ed to as meta=analysis Hhi%h of the following statements best defines this type of st$dyQ # !"eats the findings f"om one st$dy as a single pie%e of data @ Findings f"om m$ltiple st$dies a"e %ombined to yield a data set whi%h is analy(ed as indi/id$al data C ep"esents an appli%ation of statisti%al p"o%ed$"es to findings f"om ea%h "epo"t ) !e%hni6$e fo" 6$antitati/ely %ombining and th$s integ"ating the "es$lts of m$ltiple st$dies on a gi/en topi% #nswe": ) !e%hni6$e fo" 6$antitati/ely %ombining and th$s integ"ating the "es$lts of m$ltiple st$dies on a gi/en topi% !ho$gh all the options a"e %o""e%t& the best definition is option ) be%a$se it %ombines 6$antitati/ely the "es$lts and at the same time it integ"ates the "es$lts of the diffe"ent st$dies as one finding

+9 !his ind of "esea"%h gathe"s data in detail abo$t a indi/id$al o" g"o$ps and p"esented in na""ati/e fo"m& whi%h is # Case st$dy @ ?isto"i%al C #nalyti%al ) ,-pe"imental #nswe": # Case st$dy Case st$dy fo%$ses on in=depth in/estigations of single entity o" small n$mbe" of entities It attempts to analy(e and $nde"stand iss$es of impo"tan%e to histo"y& de/elopment o" %i"%$mstan%es of the pe"son o" entity $nde" st$dy

.0 Stephanie is finished with the steps in the %on%ept$al phase when she has %ond$%ted the '#S! step& whi%h is # fo"m$lating and delimiting the p"oblem @ "e/iew of "elated lite"at$"e C de/elop a theo"eti%al f"amewo" ) fo"m$late a hypothesis #nswe": ) fo"m$late a hypothesis !he last step in the %on%ept$ali(ing phase of the "esea"%h p"o%ess is fo"m$lating a hypothesis !he "est a"e the fi"st th"ee steps in this phase

.1 She states the hypothesis of the st$dy Hhi%h of the following is a n$ll hypothesisQ # Infants who a"e b"eastfed ha/e the same weight as those who a"e bottle fed @ @ottle=fed infants ha/e lowe" weight than b"east=fed infants C C$ddled infants sleep longe" than those who a"e left by themsel/es to sleep ) Child"en of absentee pa"ents a"e mo"e p"one to e-pe"ien%e dep"ession than those who li/e with both pa"ents #nswe": # Infants who a"e b"eastfed ha/e the same weight as those who a"e bottle fed *$ll hypothesis p"edi%ts that the"e is no %hange& no diffe"en%e o" no "elationship between the /a"iables in the st$dy

.2 She notes that the dependent /a"iable in the hypothesis )$"ation of sleep of %$ddled infants is longe" than those infants who a"e not %$ddled by mothe"sT is # C$ddled infants @ )$"ation of sleep C Infants ) #bsen%e of %$ddling #nswe": @ )$"ation of sleep )$"ation of sleep is the êffe%tK dependent /a"iable of %$ddling ^%a$seK independent /a"iable

.+ Sit$ation: #"etha is a n$"se "esea"%he" in a te"tia"y hospital She is tased to %ond$%t a "esea"%h on the effe%ts of st"$%t$"ed dis%ha"ge plan fo" post=open hea"t s$"ge"y patients She states the signifi%an%e of the "esea"%h p"oblem Hhi%h of the following statements is the

fo" this st$dyQ # Imp"o/ement in patient %a"e @ )e/elopment of a theo"eti%al basis fo" n$"sing C In%"ease the a%%o$ntability of n$"ses ) Imp"o/es the image of n$"sing #nswe": # Imp"o/ement in patient %a"e !he $ltimate goal of %ond$%ting "esea"%h is to imp"o/e patient %a"e whi%h is a%hie/ed by enhan%ing the p"a%ti%e of n$"ses when they $tili(e "esea"%h "es$lts in thei" p"a%ti%e

.. ega"dless of the signifi%an%e of the st$dy& the feasibility of the st$dy needs to be %onside"ed Hhi%h of the following is %onside"ed a p"io"ityQ # #/ailability of "esea"%h s$bEe%ts @ @$dgeta"y allo%ation C !ime f"ame ) ,-pe"ien%e of the "esea"%he" #nswe": # #/ailability of "esea"%h s$bEe%ts #/ailability is the most impo"tant %"ite"ia to be %onside"ed by the "esea"%he" in dete"mining whethe" the st$dy is feasible o" not *o matte" how signifi%ant the st$dy may be if the"e a"e no a/ailable s$bEe%tsG"espondents& the st$dy %an not p$sh th"o$gh

.5 #"etha nows that a good "esea"%h p"oblem e-hibits the following %ha"a%te"isti%sW whi%h one is *O! in%l$dedQ # Clea"ly identified the /a"iablesGphenomenon $nde" %onside"ation @ Spe%ifies the pop$lation being st$died C Implies the feasibility of empi"i%al testing ) Indi%ates the hypothesis to be tested #nswe": ) Indi%ates the hypothesis to be tested *ot all st$dies "e6$i"e a hypothesis s$%h as 6$alitati/e st$dies& whi%h does not deal with /a"iables b$t with phenomenon o" %on%epts

.8 She states the p$"poses of the st$dy Hhi%h of the following des%"ibe the p$"pose of a st$dyQ 1 ,stablishes the gene"al di"e%tion of a st$dy 2 Capt$"es the essen%e of the st$dy + Fo"mally a"ti%$lates the goals of the st$dy . Sometimes wo"ded as an intent # 1& 2& + @ 2& +& . C 1& +& . ) 1& 2& +& . #nswe": ) 1& 2& +& . !he p$"poses of a "esea"%h st$dy %o/e"s all the options indi%ated

. She opts to $se inte"/iews in data %olle%tion In addition to /alidity& what is the othe"
#nswe": # #%%$"a%y #%%$"a%y and /alidity a"e the most se"io$s weanesses of the self="epo"t data !his is d$e to the fa%t that the "espondents sometimes do not want to tell the t"$th fo" fea" of being "eEe%ted o" in o"de" to please the

inte"/iewe" .9 She plans to s$bEe%t he" inst"$ment to p"etesting Hhi%h of the following is *O! a%hie/ed in doing p"etestingQ # )ete"mines how m$%h time it taes to administe" the inst"$ment pa%age @ Identify pa"ts that a"e diffi%$lt to "ead o" $nde"stand C )ete"mine the b$dgeta"y allo%ation fo" the st$dy


) )ete"mine if the meas$"es yield data with s$ffi%ient /a"iability #nswe": C )ete"mine the b$dgeta"y allo%ation fo" the st$dy )ete"mining b$dgeta"y allo%ation fo" the st$dy is not a p$"pose of doing a p"etesting of the inst"$ments !his is done at an ea"lie" stage of the design and planning phase

0 She tests the inst"$ment whethe" it loos as tho$gh it is meas$"ing app"op"iate %onst"$%ts Hhi%h of the following "efe"s to thisQ # Fa%e /alidity @ Content /alidity C Const"$%t 7alidity ) C"ite"ion="elated /alidity #nswe": # Fa%e /alidity Fa%e /alidity meas$"es whethe" the inst"$ment appea"s to be meas$"ing the app"op"iate %onst"$%t It is the easiest type of /alidity testing

1 Hhi%h of the following 6$estions wo$ld dete"mine the %onst"$%t /alidity of the inst"$mentQ # Hhat is this inst"$ment "eally meas$"ingQT @ ?ow "ep"esentati/e a"e the 6$estions on this test of the $ni/e"se of 6$estions on this topi%QT C )oes the 6$estion ased loos as tho$gh it is meas$"ing the app"op"iate %onst"$%tQT ) )oes the inst"$ment %o""elate highly with an e-te"nal %"ite"ionQ #nswe": # Hhat is this inst"$ment "eally meas$"ingQT Const"$%t /alidity aims to /alidate what the inst"$ment is "eally meas$"ing !he mo"e abst"a%t the %on%ept& the mo"e diffi%$lt to meas$"e the %onst"$%t

2 Hhi%h of the following e-pe"imental "esea"%h designs wo$ld be app"op"iate fo" this st$dy if she wants to find o$t a %a$se and effe%t "elationship between the st"$%t$"ed dis%ha"ge plan and %omplian%e to home %a"e "egimen among the s$bEe%tsQ # !"$e e-pe"iment @ >$asi e-pe"iment C Post=test only design ) Solomon fo$"=g"o$p #nswe": C Post=test only design Post= !est only design is app"op"iate be%a$se it is impossible to meas$"e the %omplian%e to home %a"e "egimen /a"iable p"io" to the dis%ha"ge of the patient f"om the hospital

+ One hypothesis that she fo"m$lated is Complian%e to home %a"e "egimen is g"eate" among patients who "e%ei/ed the st"$%t$"ed dis%ha"ge plan than those who "e%ei/ed /e"bal dis%ha"ge inst"$%tionsK Hhi%h is the independent /a"iable in this st$dyQ # St"$%t$"ed dis%ha"ge plan @ Complian%e to home %a"e "egimen C Post=open hea"t s$"ge"y patients ) D"eate" %omplian%e #nswe": # St"$%t$"ed dis%ha"ge plan St"$%t$"ed dis%ha"ge plan is the inte"/ention o" the ^%a$seK in the st$dy that "es$lts to an êffe%tK& whi%h is %omplian%e to home %a"e "egimen o" the dependent /a"iable

. Sit$ation : #lyssa plans to %ond$%t a st$dy abo$t n$"sing p"a%ti%e in the %o$nt"y She de%ides to "ef"esh he" nowledge abo$t the diffe"ent types of "esea"%h in o"de" to %hoose the most app"op"iate design fo" he" st$dy

 She %ame a%"oss s$"/eys& lie the So%ial Heathe" Station and P$lse #sia S$"/ey Hhi%h of the following is the p$"pose of this ind of "esea"%hQ # Obtains info"mation "ega"ding the p"e/alen%e& dist"ib$tion and inte""elationships of /a"iables within a pop$lation at a pa"ti%$la" time @ Det an a%%$"ate and %omplete data abo$t a phenomenon C )e/elop a tool fo" data gathe"ing ) Fo"m$late a f"amewo" fo" the st$dy #nswe": # Obtains info"mation "ega"ding the p"e/alen%e& dist"ib$tion and inte""elationships of /a"iables within a pop$lation at a pa"ti%$la" time


S$"/eys a"e done to gathe" info"mation on peopleKs a%tions& nowledge& intentions& opinions and attit$des

5 She will liely $se self="epo"t method Hhi%h of the following self="epo"t methods is the most "espe%ted method $sed in s$"/eysQ # Pe"sonal inte"/iews @ >$estionnai"es C !elephone inte"/iews ) ating S%ale #nswe": # Pe"sonal inte"/iews Pe"sonal inte"/iews is the best method of %olle%ting s$"/ey data be%a$se the 6$ality of info"mation they yield is highe" than othe" methods and be%a$se "elati/ely few people "ef$se to be inte"/iewed in pe"son

8 #lyssa "eads abo$t e-plo"ato"y "esea"%h Hhi%h of the following is the p$"pose of doing this type of "esea"%hQ # Ind$%ti/ely de/elops a theo"y based on obse"/ations abo$t p"o%esses in/ol/ing sele%ted people @
 She "e/iews 6$alitati/e design of "esea"%h Hhi%h of the following is t"$e abo$t ethnog"aphi% st$dyQ # )e/elops theo"ies that in%"ease the nowledge abo$t a %e"tain phenomenon @ Fo%$ses on the meanings of life e-pe"ien%es of people C )eals with patte"ns and e-pe"ien%es of a defined %$lt$"al g"o$p in a holisti% fashion ) In=depth in/estigation of a single entity #nswe": C )eals with patte"ns and e-pe"ien%es of a defined %$lt$"al g"o$p in a holisti% fashion ,thnog"aphi% "esea"%h deals with the %$lt$"al patte"ns and beliefs of %e"tain %$lt$"e g"o$ps

9 She nows that the p$"pose of doing ethnog"aphi% st$dy is to: # Unde"stand the wo"ld/iew of a %$lt$"al g"o$p @ St$dy the life e-pe"ien%es of people C )ete"mine the "elationship between /a"iables ) In/estigate intensi/ely a single entity #nswe": # Unde"stand the wo"ld/iew of a %$lt$"al g"o$p !he aim of ethnog"aphe"s is to lea"n f"om the membe"s of a %$lt$"al g"o$p by $nde"standing thei" way of life as they pe"%ei/e and li/e it

50 #lyssa wants to lea"n mo"e abo$t e-pe"imental design Hhi%h is the p$"pose of this "esea"%hQ # !est the %a$se and effe%t "elationship among the /a"iable $nde" a %ont"olled sit$ation @ Identify the /a"iables in the st$dy C P"edi%ts the f$t$"e based on %$""ent inte"/ention ) )es%"ibe the %ha"a%te"isti%s& opinions& attit$des o" beha/io"s of %e"tain pop$lation abo$t a %$""ent iss$e o" e/ent #nswe": # !est the %a$se and effe%t "elationship among the /a"iable $nde" a %ont"olled sit$ation ,-pe"imental "esea"%h is a 'e/el III in/estigation whi%h dete"mines the %a$se and effe%t "elationship between

/a"iables 51 She nows that the"e a"e th"ee elements of e-pe"imental "esea"%h Hhi%h is *O! in%l$dedQ #

52 #lyssa nows that the"e a"e times when only manip$lation of st$dy /a"iables is possible and the elements of %ont"ol o" "andomi(ation a"e not attendant Hhi%h type of "esea"%h is "efe""ed to thisQ # Field st$dy @ >$asi=e-pe"iment C Solomon=Fo$" g"o$p design ) Post=test only design #nswe": @ >$asi=e-pe"iment >$asi=e-pe"iment is done when "andomi(ation and %ont"ol of the /a"iables a"e not possible

5+ One of the "elated st$dies that she "eads is a phenomenologi%al "esea"%h Hhi%h of the following 6$estions is answe"ed by this type of 6$alitati/e "esea"%hQ # T Hhatisisthe theeffe%t way of this %$lt$"al @ Hhat oflife the of inte"/ention tog"o$pQT the dependent /a"iableQT C Hhat the essen%e of the phenomenon is as e-pe"ien%ed by these peopleQT ) Hhat is the %o"e %atego"y that is %ent"al in e-plaining what is going on in that so%ial s%eneQT #nswe": C Hhat the essen%e of the phenomenon is as e-pe"ien%ed by these peopleQT Phenomenologi%al "esea"%h deals with the meaning of e-pe"ien%es as those who e-pe"ien%ed the phenomenon $nde"stand it

5. Othe" st$dies a"e %atego"i(ed a%%o"ding to the time f"ame Hhi%h of the following "efe"s to a st$dy of /a"iables in the p"esent whi%h is lined to a /a"iable that o%%$""ed in the pastQ # P"ospe%ti/e design @ et"ospe%ti/e design C C"oss se%tional st$dy ) 'ongit$dinal st$dy #nswe": @ et"ospe%ti/e design et"ospe%ti/e st$dies a"e done in o"de" to establish a %o""elation between p"esent /a"iables and the ante%edent fa%to"s that ha/e %a$sed it

5 Sit$ation : ?a""y a new "esea"%h staff of the esea"%h and )e/elopment )epa"tment of a te"tia"y hospital is tased to %ond$%t a "esea"%h st$dy abo$t the in%"eased in%iden%e of noso%omial infe%tion in the hospital Hhi%h of the following ethi%al iss$es sho$ld he %onside" in the %ond$%t of his st$dyQ 1 Confidentiality of info"mation gi/en to him by the s$bEe%ts 2 Self=dete"mination whi%h in%l$des the "ight to withd"aw f"om the st$dy g"o$p + P"i/a%y o" the "ight not to be e-posed p$bli%ly . F$ll dis%los$"e abo$t the st$dy to be %ond$%ted # 1& 2& + @ 1& +& . C 2& +& . ) 1& 2& +& . #nswe": ) 1& 2& +& . !his in%l$des all the options as these a"e the fo$" basi% "ights of s$bEe%ts fo" "esea"%h

55 Hhi%h of the following is the best tool fo" data gathe"ingQ # Inte"/iew s%hed$le @ >$estionnai"e C Use of labo"ato"y data ) Obse"/ation #nswe": C Use of labo"ato"y data In%iden%e of noso%omial infe%tion is best %olle%ted th"o$gh the $se of biophysiologi% meas$"es& pa"ti%$la"ly in /it"o meas$"ements& hen%e labo"ato"y data is essential

58 )$"ing data %olle%tion& ?a""y en%o$nte"s a patient who "ef$ses to tal to him Hhi%h of the following is a limitation of the st$dyQ # PatientKs "ef$sal to f$lly di/$lge info"mation @ Patients with histo"y of fe/e" and %o$gh C Patients admitted o" who sees %ons$ltation at the , and do%to"s offi%es


) Conta%ts of patients with histo"y of fe/e" and %o$gh #nswe": # PatientKs "ef$sal to f$lly di/$lge info"mation PatientKs "ef$sal to di/$lge info"mation is a limitation be%a$se it is beyond the %ont"ol of ?a""y

5 Hhat type of "esea"%h is app"op"iate fo" this st$dyQ # )es%"ipti/e= %o""elational @ ,-pe"iment C >$asi=e-pe"iment ) ?isto"i%al #nswe": # )es%"ipti/e= %o""elational )es%"ipti/e= %o""elational st$dy is the most app"op"iate fo" this st$dy be%a$se it st$dies the /a"iables that %o$ld be the ante%edents of the in%"eased in%iden%e of noso%omial infe%tion

59 In the statement& F"e6$ent hand washing of health wo"e"s de%"eases the in%iden%e of noso%omial infe%tions among post=s$"ge"y patientsT& the dependent /a"iable is # in%iden%e of noso%omial infe%tions @ de%"eases C f"e6$ent hand washing ) post=s$"ge"y patients #nswe": # in%iden%e of noso%omial infe%tions !he dependent /a"iable is the in%iden%e of noso%omial infe%tion& whi%h is the o$t%ome o" effe%t of the independent /a"iable& f"e6$ent hand washing

80 ?a""y nows that he has to p"ote%t the "ights of h$man "esea"%h s$bEe%ts Hhi%h of the following a%tions of ?a""y ens$"es anonymityQ # eep the identities of the s$bEe%t se%"et @ Obtain info"med %onsent C P"o/ide e6$al t"eatment to all the s$bEe%ts of the st$dy ) elease findings only to the pa"ti%ipants of the st$dy #nswe": # eep the identities of the s$bEe%t se%"et eeping the identities of the "esea"%h s$bEe%t se%"et will ens$"e anonymity be%a$se this will hinde" p"o/iding lin between the info"mation gi/en to whoe/e" is its so$"%e

81 ?e is o"iented to the $se of ele%t"oni% databases fo" n$"sing "esea"%h Hhi%h of the following will she liely a%%essQ # <,)'I*, @ *ational Instit$te of *$"sing esea"%h C #me"i%an Bo$"nal of *$"sing ) Inte"national Co$n%il of *$"ses #nswe": @ *ational Instit$te of *$"sing esea"%h *ational Instit$te fo" *$"sing esea"%h is a $sef$l so$"%e of info"mation fo" n$"sing "esea"%h !he "est of the options may be helpf$l b$t *I* is the most $sef$l site fo" n$"ses

82 ?e de/elops methods fo" data gathe"ing Hhi%h of the following %"ite"ia of a good inst"$ment "efe"s to the ability of the inst"$ment to yield the same "es$lts $pon its "epeated administ"ationQ # 7alidity @ Spe%ifi%ity C Sensiti/ity ) eliability #nswe": ) eliability eliability is %onsisten%y of the "esea"%h inst"$ment It "efe"s to the "epeatability of the inst"$ment in e-t"a%ting the same "esponses $pon its "epeated administ"ation

8+ ?a""y is awa"e of the impo"tan%e of %ont"olling th"eats to inte"nal /alidity fo" e-pe"imental "esea"%h& whi%h in%l$de the following e-amples ,;C,P!: # ?isto"y @

) )esign #nswe": ) )esign )esign is not a th"eat to inte"nal /alidity of the inst"$ment E$st lie the othe" options

8. ?is %olleag$e ass abo$t the e-te"nal /alidity of the "esea"%h findings Hhi%h of the "esponses of ?a""y is app"op"iateQ !he "esea"%h findings %an be # gene"ali(ed to othe" settings o" samples @ shown to "es$lt only f"om the effe%t of the independent /a"iable C "efle%ted as "es$lts of e-t"aneo$s /a"iables ) f"ee of sele%tion biases #nswe": # gene"ali(ed to othe" settings o" samples ,-te"nal /alidity "efe"s to the gene"ali(ability of "esea"%h findings to othe" settings o" samples !his is an iss$e of impo"tan%e to e/iden%e=based n$"sing p"a%ti%e

NURSING RESEARCH Part 2 Sit0ati#$ 1 Ao$ a"e fo"t$nate to be %hosen as pa"t of the "esea"%h team in the hospital # "e/iew of the

following I

1 # p"ofessional n$" se %an do "es ea"%h fo" /a"ied "easons e-%ept: a

P"ofessional ad/an%ement th"o$gh "esea"%h pa"ti%ipation b !o /alidate "es$lts of new n$"sing modalities % Fo" finan%ial gains d !o imp"o/e n$"sing %a"e 2 ,a%h n$"se pa"ti%ipant was ased to identify a p"oblem #fte" the identifi%ation of the "esea"%h p"oblem& whi%h of the following sho$ld be doneQ a b % d

+ Hhi%h of the fo llowing %omm$ni%ate the "es$lts of the "esea"%h to the "eade"s !hey fa%ilitate the des%"iption of the data a b % d

?ypothesis Statisti%s esea"%h p"oblem !ables and g"aphs

a b % d

 In the /al$es: 8& & & 92& 90& what is the meanQ a b % d

2 . 8 90

9 In the /al$es: 0& 0& 0& 2& 2& 90& 90& 100& what is the modeQ a b % d

0 2 90 

10 In the /al $es: 0& 0& 10& 10 & 2& 5& 100& 200& what is the medianQ a b % d

812 22 10 and 2 82

. In 6$antitati/e data& whi%h of the fo llowing is des%"ibed as the distan%e in the s%o"ing $nits of the /a"iable f"om the highest to the lowe"Q a b % d

F"e6$en%y
 !his e-p"esses the /a"iability of the data in "efe"en%e to the mean It p"o/i des as with a n$me"i%al estimate of how fa"& on the a/e"age the sepa"ate obse"/ation a"e f"om the mean: a b % d

Sit0ati#$ 2 S$"/ey and statisti%s a"e impo"tant pa"t if "esea"%h that is ne%essa"y to e-plain the %ha"a%te"isti%s of the pop$lation

5 #%%o"ding to H?O statisti%s on the homeless pop$lation a"o$nd the wo"ld& whi%h of the following g"o$ps of people in the wo"ld disp"opo"tionately "ep"esents the homeless pop$lationQ a b % d

?ispani%s #sians #f"i%an #me"i%ans Ca$%asians

8 #ll b$t one of the following in not a meas$"e of %ent"al tenden%y:

11 )"aw lots& lotte"y& table of "andom n$mb e"s o" a sampling that ens$"es that ea%h element of the pop$lation has an e6$al and independent %han%e of being %hosen is %alled: a b % d

Cl$ste" Simple St"atified Systemati%

12 #n in/estigato" wants to dete"mine some of the p"oblems e-pe"ien%ed by diabeti% %lients when $sing ins$lin p$mp !he in/estigato" went to a %lini% whe"e he pe"sonally nows se/e"al diabeti% %lients ha/ing p"oblem with ins$lin p$mp !he type of sampling done by the in/estigato" is %alled: a b % d

P"obability P$"posi/e Snowball In%idental

1+ If the "esea"%he" implemented a new st"$%t$"ed %o$nseling p"og"am with a "andomi(ed g"o$p of s$bEe%t and a "o$tine %o$nseling p"og"am with anothe" "andomi(ed g"o$p of s$bEe%t& the "esea"%h is $tili(ing whi%h designQ a b % d

>$asi e-pe"imental ,-pe"imental Compa"ati/e

1. Hhi%h of the following is not t"$e abo$ t a p$"e e-pe"imental "esea"%hQ a !he"e is a %ont"ol g"o$p b !he"e is an e-pe"imental g"o$p % Sele%tion of s$bEe%ts in the %ont"ol g"o$p is "andomi(ed d !he"e is a %a "ef$l sele%tion of s$bEe%ts in the e-pe"imental g"o$p 1 !he "esea"%he" implemented a medi%ation "egimen $sing a new type of %ombination d"$gs to mani% patients while anothe" g"o$p of mani% patients "e%ei/es the "o$tine d"$gs !he "esea"%he" howe/e" handpi%ed the e-pe"imental g"o$p fo" they a"e the %lients with m$ltiple episodes if bipola" diso"de" !he "esea"%he" $tili(ed whi%h "esea"%h designQ a b % d

>$asi e-pe"imental P$"e e-pe"imental Phenomenologi%al 'ongit$dinal

Sit0ati#$ 3 #s a n$"se& yo$ a"e e-pe%ted to pa"ti%ipate in initiating o" pa"ti%ipating in the %ond$%t of "esea"%h st$dies to imp"o/e n$"sing p"a%ti%e Ao$ ha/e to be $pdated on the latest t"ends and iss$es affe%ting the p"ofession and the best p"a%ti%es a""i/ed at by the p"ofession

15 Ao$ a"e inte" ested to st$dy the effe%t s of mediation and "ela-ation on the pain e-pe"ien%ed by %an%e" patients Hhat type of /a"iable is painQ a b % d

)ependent Co""elational Independent )emog"aphi%

18 Ao$ wo$ld lie to %ompa"e the s$ppo"t system of patient with %h"oni% illness and those with a%$te illness ?ow will yo$ best state yo$" p"oblemQ a

# des%"ipti/e st$dy to %ompa"e the s$ppo"t systems of patients with %h"oni% illness and those with a%$te illness in te"ms of demog"aphi% data and nowledge abo$t inte"/ention b !he effe%ts of the types of s$ppo"t system of patients with %h"oni% illness and those with a%$te illness % # %ompa"ati/e analysis of the s$ppo"t system of patients with %h"oni% illness and those with a%$te illness d # st$dy to %o mpa"e the s$ ppo"t system of patients with %h"oni% illness and those with a%$te illness e Hhat a"e the diffe"en%es of the s$ppo"t system being "e%ei/ed by patient with %h"oni% illness and patients with a%$te illnessQ

1 Ao$ wo$ld lie to %ompa"e the s$ppo"t system of patients with %h"oni% illness to those with a%$te illness Conside"ing that the hypothesis was: Clients with %h"oni% illness ha/e lesse" s$ppo"t system than %lients with a%$te illnessT Hhat type of "esea"%h is thisQ a b % d

)es%"ipti/e Co""elational& non e-pe"imental ,-pe"imental >$asi e-pe"imental

19 In any "esea"%h st$dy whe"e indi/id$al pe"sons a"e in/ol/ed& it is impo"tant that an info"med %onsent of the st$dy is obtained !he following a"e essential info"mati on abo$t the %onsent that yo$ sho$ld dis%lose to the p"ospe%ti/e s$bEe%ts e-%ept: a Consent to in%omplete dis%los$"e b )es%"iption of benefits& "iss& and dis%omfo"ts % ,-planation of p"o%ed$"e d #ss$"an%e of ano nymity and %onfidentiality 20 In the hypothesis: !he $tili(ation of te%hnology in tea%hing imp"o/es the "etention and attention of the n$"sing st$dents&T whi%h is the dependent /a"iableQ a b % d

Utili(ation of te%hnology Imp"o/ement in the "etention and attention *$"sing st $dents !ea%hing

Sit0ati#$ 4 Ao$ a"e an a%ti/ely p"a%ti%ing n$"se who has E$st finished yo$" g"ad$ate st$dies Ao$ lea"ned the /al$e of "esea"%h and wo$ld lie to $tili(e the nowledge and sills gained in the appli%ation of "esea"%h to the n$"sing se"/i%e !he following 6$estions apply to "esea"%h

21 Hhi%h type of "esea"%h in6$i"y in/estigates the iss$es of h$man %omple-ity eg $nde"standing the h$man e-pe"tiseQ a 'ogi%al position b *at$"alisti% in6$i"y % Positi/ism d >$antitati/e esea"%h 22 Hhi%h of the following st$dies is based on 6$antitati/e "esea"%hQ a

# st$dy e-amining the be"ea/ement p"o%ess in spo$ses of %lients with te"minal %an%e" b # st$dy e-plo"ing fa%to"s infl$en%ing weight %ont"ol beha/io" % # st$dy meas$"ing the effe%ts of sleep dep"i/ation on wo$nd healing d # st$dy e-amining %lientKs feel ing befo"e& d$"ing and afte" a bone ma""ow aspi"ation 2+ Hhi%h of the following st$dies is based on 6$alitati/e "esea"%hQ


a

# st$dy e-amining %lients "ea%tions to st"ess afte" open hea"t s$"ge"y b # st$dy meas$"ing n$t"ition and weight lossGgain in %lients with %an%e" % # st$dy e-amining o-ygen le/els afte" endot"a%heal s$%tioning d # st$dy meas$"ing diffe"en%es in blood p"ess$"e befo"e& d$"ing and afte" a p"o%ed$"e 2. #n  yea" old %l ient in a n$"sing home tells a n$"se& I signed the pape"s fo" that "esea"%h st$dy be%a$se the do%to" was so insistent and I want him to %ontin$e taing %a"e of meT Hhi%h %lient "ight is being /iolatedQ a b % d

ight of self dete"mination ight to p"i/a%y and %onfidentiality ight to f$ll dis%los$"e ight not to be ha"med

2 # s$pposition o" system of ideas that is p"oposed to e-plain a gi/en phenomenonT& best defines: a b % d

# pa"adigm # %on%ept # theo"y # %on%ept$al f"amewo"

a b % d

29 Faye "esea"%hed in the de/elopment of a new way to meas$"e intelligen%e by %"eating a 100=item 6$estionnai"e that will assess the %ogniti/e sills of an indi/id$al !he design best s$ited fo" this st$dy is: a b % d

25
Compa"ati/e Co""elational ,-pe"imental >$alitati/e

28 od"igo was always eating high fat diet Ao$ want to dete"mine if what will be the effe%t of high %holeste"ol food to od"igo in the ne-t 10 yea"s Ao$ will $se: a b % d

Compa"ati/e Co""elational ?isto"i%al 'ongit$dinal

2 Comm$nity # was sele%ted "andomly as well as Comm$nity @& n$"se C"ystal %ond$%ted tea%hing to Comm$nity # and assessed if Comm$nity # will ha/e a bette" stat$s than Comm$nity @ !his is an e-ample of:

?isto"i%al
+0 Bay ,mman $elle is %ond$ %ting a "esea"%h st$dy on how alph& an #I)S %lient li/es his life # design s$ited fo" this is: a b % d

?isto"i%al Case st$dy Phenomenologi%al ,thnog"aphi%

+1
Sit0ati#$ 5
Compa"ati/e Co""elational ,-pe"imental >$alitati/e

?isto"i%al

b Case st$dy % Phenomenologi%al d ,thnog"aphi% +2
Phenomenologi%al Case st$dy *on e-pe"imental S$"/ey

++
?isto"i%al Case st$dy Phenomenologi%al ,thnog"aphi%

+. Be((a and Benny "es ea"%hed abo$t !@ X its t"ansmission& %a$sati/e agent and fa%to"s& t"eatment& signs and symptoms& as well as medi%ation and all othe" in=depth info"mation abo$t t$be"%$losis !his st$dy is best s$ited fo" whi%h "esea"%h designQ a

?isto"i%al


b Case st$dy % Phenomenologi%al d ,thnog"aphi%

+8 Hhi%h of the fol lowing $s$ally "efe"s to the independent /a"iables in doing "esea"%hQ

&'# )iana& #"lene& and Sally a"e to %ond$%t a st$dy abo$t "elationship of the n$mbe" of family membe"s in the ho$sehold and the ele%t"i%ity bill& whi%h of the following is the best "esea"%h design s$ited fo" this st$dyQ 1 2 + .  5

)es%"ipti/e ,-plo"ato"y ,-planato"y Co""elational Compa"ati/e ,-pe"imental

a b % d e

1 and . 2 and  + and 5 1 and  2 and .

es$lt Ca$se O$tp$t ,ffe%t

+ !he "e%ipients of e-pe"imental t"eatment in an e-pe"imental design o" the indi/id$als to be obse"/ed in a non=e-pe"imental design a"e %alled: a b % d

Setting S$bEe%ts !"eatment Sample

+9 !he de/i%e o" te%hni6$es that 7in( employs to %olle%t data is %alled:

Sit0ati#$ ; #s a n$"se "esea"%he"& 7in( m$st ha/e a /e"y good $nde"st anding of the %ommon te"ms of %on%ept $sed in "esea"%h

+5 !he info" mation that an in/estigato" lie 7in( %olle%ts f"om the s$bEe%ts o" pa"ti%ipants in a "esea"%h st$dy is $s$ally %alled: a b % d

a b % d

a b % d

Sample Inst"$ment ?ypothesis Con%ept

.0 !he $se of anothe" pe"sonKs ideas o" wo"dings witho$t gi/ing app"op"iate %"edit "es$lts f"om ina%%$"ate o" in%omplete att"ib$tion of mate"ials to its "eso$"%es Hhi%h of the following is "efe""ed to when anothe" pe"sonKs idea is inapp"op"iately %"edited as oneKs ownQ

?ypothesis )ata 7a"iable Con%ept

a b % d

Plagia"ism >$otation #ss$mption Pa"aph"ase

Suggested Answer ey C@))@ @#@#) @@@)# #,##@ @C##C @)C@C #))@) @@@@#

COMPREHENSIVE EXAMINATION Part 1 1 # woman in a %hild bea"ing age "e%ei/es a "$bella /a%%ination *$"se Boy wo$ld gi/e he" whi%h of the following inst"$%tionsQ


a ef"ain f"om eating eggs o" egg p"od$%ts fo" 2. ho$"s b #/oid ha/ing se-$al inte"%o$"se % )onKt get p"egnant at least + months d #/oid e-pos$"e to s$n 2 Bonas who is diagnosed with en%ephalitis is $nde" the t"eatment of

d I will %ome ba% on Hednesday& same time& to "ead the "es$lt 1+ # male %lient had $nde"gone

% 'i/e atten$ated d Plasma de"i/ati/es 25 @$dgeting is $nde" in whi%h pa"t of management p"o%essQ a )i"e%ting b Cont"olling % O"gani(ing d Planning 28 !ime table showing planned wo" days and shifts of n$"sing pe"sonnel is: a Staffing b S%hed$le % S%hed$ling d Planning 2 # fo"%e within an indi/id$al that infl$en%es the st"ength of beha/io"Q a $estions that a"e answe"able only by %hoosing an option f"om a set of gi/en alte"nati/es a"e nown asQ a S$"/ey b Close ended % >$estionnai"e d )emog"aphi% ++ # "esea"%he" that maes a gene"ali(ation based on obse"/ations of an indi/id$alKs beha/io" is said to be whi%h type of "easoning: a Ind$%ti/e b 'ogi%al % Illogi%al d )ed$%ti/e +. !he balan%e of a "esea"%hKs benefit /s its "iss to the s$bEe%t is: a #nalysis b is=benefit "atio % Pe"%entile d

+ Flo"en%e nightingale is bo"n on: a F"an%e b @"itain % US d Italy +9 ObEe%ti/e data is also %alled: a Co/e"t b O/e"t % Infe"en%e d ,/al$ation .0 #n e-ample of s$bEe%ti/e data is: a Si(e of wo$nds b 7S % 'etha"gy d !he statement of patient 

b 1 ilog"ams % 100 g"ams d 1 ilog"ams 1 #fte" deli/e"y of a baby gi"l *$"se Dina e-amines the $mbili%al %o"d and e-pe%ts to find a %o"d to: a !wo a"te"ies and two /eins b One a"te"y and one /ein % !wo a"te"ies and one /ein d One a"te"y and two /eins 2

b F"e6$ent inte"nal e-amination I, % CS d Ute"ine atomy 5+ On 2nd postpa"t$m day& whi%h height wo$ld yo$ e-pe%t to find the f$nd$s in a woman who has had a %aesa"ian bi"thQ a 1 finge" abo/e $mbili%$s b 2 finge"s abo/e $mbili%$s % 2 finge"s below $mbili%$s d 1 finge" below $mbili%$s 5. Hhi%h of the following %"ite"ia allows *$"se "is to pe"fo"m home deli/e"iesQ a *o"mal findings d$"ing assessment b P"e/io$s CS % )iabetes histo"y d ?ype"tensi/e histo"y 5 *$"se Ca"la is awa"e that one of the following /a%%ines is done by int"am$s%$la" I< inEe%tionQ a
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 10

d Sent"ong sigla mo/ement 8 @aby

d . yea"s 8 Hhi%h of the following info"mation %annot be seen in the PC identifi%ation %a"dQ a egist"ation )ate b 'i%ense *$mbe" % )ate of #ppli%ation d Signat$"e of PC %hai"pe"son  @"eastfeeding is being enfo"%ed by mil %ode o": a ,O 1 b # 8500 % # 5800 d P) 995 9 Self go/e"nan%e& ability to %hoose o" %a""y o$t de%ision witho$t $nd$e p"ess$"e o" %oe"%ion f"om anyone: a 7e"a%ity b #$tonomy % Fidelity d @enefi%en%e 90 # male patient %omplained be%a$se his s%hed$led s$"ge"y was %an%elled be%a$se of ea"th6$ae !he hospital pe"sonnel may be e-%$sed be%a$se of: a Do/e"nan%e b espondent s$pe"io" % Fo"%e maEe$"e d es ipsa lo6$ito" 91 @eing on time& meeting deadlines and %ompleting all s%hed$led d$ties is what /i"t$eQ a Fidelity b #$tonomy % 7e"a%ity d Confidentiality 92 !his 6$ality is being demonst"ated by *$"se on who "aises the side "ails of a %onf$sed and diso"iented patientQ a esponsibility b eso$"%ef$lness % #$tonomy d P"$den%e 9+ Hhi%h of the following is fo"mal %ontin$ing ed$%ationQ a Confe"en%e b ,n"ollment in g"ad$ate s%hool % ef"eshe" %o$"se d Semina" 9. !he @S* %$""i%$l$m p"epa"es the g"ad$ates to be%omeQ a *$"se gene"alist b *$"se spe%ialist % P"ima"y health n$"se d Clini%al inst"$%to" 9 )isposal of medi%al "e%o"ds in go/e"nment hospitalGinstit$tions m$st be done in %lose %oo"dination with what agen%yQ a )epa"tment of ?ealth b e%o"ds

d I""igation of *D! 99 )$"ing the e/ening "o$nd *$"se !ina saw <" !o"alba meditating and afte"wa"ds sta"ted singing p"aye"f$l hymns Hhat wo$ld be the best "esponse of *$"se !inaQ a Call the attention of the %lient and en%o$"age to sleep b epo"t the in%iden%e to head n$"se % espe%t the %lientKs a%tion d )o%$ment the sit$ation 100 In %a"ing fo" a dying %lient& yo$ sho$ld pe"fo"m whi%h of the following a%ti/ities a )o not "es$s%itate b #ssist %lient to pe"fo"m #)' % ,n%o$"age to e-e"%ise d #ssist %lient towa"ds a pea%ef$l death 101 !he *$"se is awa"e that the ability to ente" into the life of anothe" pe"son and pe"%ei/e his %$""ent feelings and thei" meaning is nown: a @elongingness b Den$ineness % ,mpathy d espe%t 102 !he te"mination phase of the *P is best des%"ibed one of the following: a e/iew p"og"ess of the"apy and attainment of goals b ,-plo"ing the %lientKs tho$ghts& feelings and %on%e"ns % Identifying and sol/ing patients p"oblem d ,stablishing "appo"t 10+ )$"ing the p"o%ess of %o%aine withd"awal& the physi%ian o"de"s whi%h of the following: a ?alope"idol ?aldol b Imip"amine !of"anil % @en(t"opine Cogentin d )ia(epam 7ali$m 10. !he n$"se is awa"e that %o%aine is %lassified as: a ?all$%inogen b Psy%ho stim$lant % #n-iolyti% d *a"%oti% 10 In %omm$nity health n$"sing& it is the most impo"tant "is fa%to" in the de/elopment of mental illnessQ a Sepa"ation of pa"ents b Politi%al p"oblems % Po/e"ty d Se-$al ab$se 105 #ll of the following a"e %ha"a%te"isti%s of %"isis e-%ept a !he %lient may be%ome "esisti/e and a%ti/e in stopping the %"isis b It is self=limiting fo" .=5 wees % It is $ni6$e in e/e"y indi/id$al d It may also affe%t the family of the %lient 108 F"e$d states that tempe" tant"$ms is obse"/ed in whi%h of the following: a O"al b #nal % Phalli% d 'aten%y 10 !he n$"se is awa"e that ego de/elopment begins d$"ing: a !oddle" pe"iod b P"es%hool age % S%hool age d Infan%y 109 Sit$ation: # 19 yea" old n$"sing st$dent has lost +5 lbs fo" . wees ?e" pa"ents b"o$ght he" to the hospital fo" medi%al e/al$ation !he diagnosis was #*O,;I# *,7OS# !he P"ima"y gain of a %lient with ano"e-ia ne"/osa is: a Height loss b Height gain % ed$%e an-iety d #tt"a%ti/e appea"an%e 110 !he n$"se is awa"e that the p"ima"y n$"sing diagnosis fo" the %lient is: a #lte"ed n$t"ition : less than body "e6$i"ement b #lte"ed n$t"ition : mo"e than body "e6$i"ement % Impai"ed tiss$e integ"ity

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1+

d is fo" maln$t"ition 111 #fte" 1. days in the hospital& whi%h finding indi%ates that he" %ondition in imp"o/ingQ a She tells the n$"se that she had no idea that she is thin b She a""i/es ea"lie" than s%hed$led time of g"o$p the"apy % She tells the n$"se that she eat + times o" mo"e in a day d She gained . lbs in two wees 112 !he n$"se is awa"e that ata"a%ti%s o" psy%hi% ene"gi(e"s a"e also nown as: a #nti mani% b #nti dep"essants % #ntipsy%hoti%s d #nti an-iety 11+ nown as mood ele/ato"s: a #nti dep"essants b #ntipsy%hoti%s % #nti mani% d #nti an-iety 11. !he p"io"ity of %a"e fo" a %lient with #l(heime"Ks disease is a ?elp %lient de/elop %oping me%hanism b ,n%o$"age to lea"n new hobbies and inte"est % P"o/ide him stim$lating en/i"onment d Simplify the en/i"onment to eliminate the need to mae %ho"es 11 #$tism is diagnosed at: a Infan%y b + yea"s old %  yea"s old d S%hool age 115 !he %ommon %ha"a%te"isti% of a$tism %hild is: a Imp$lsiti/ity b Self dest"$%ti/eness % ?ostility d Hithd"awal 118 !he n$"se is awa"e that the most %ommon indi%ation in $sing ,C! is: a S%hi(oph"enia b @ipola" % #no"e-ia *e"/osa d )ep"ession 11 # the"apy that fo%$ses on he"e and now p"in%iple to p"omote self=a%%eptan%eQ a Destalt the"apy b Cogniti/e the"apy % @eha/io" the"apy d Pe"sonality the"apy 119 # %lient has many i""ational tho$ghts !he goal of the"apy is to %hange he": a Pe"sonality b Comm$ni%ation % @eha/io" d Cognition 120 !he app"op"iate n$t"ition fo" @ipola" I diso"de"& in mani% phase is: a 'ow fat& low sodi$m b 'ow %alo"ie& high fat % Finge" foods& high in %alo"ie d Small f"e6$ent feedings 121 Hhi%h of the following a%ti/ity wo$ld be best fo" a dep"essed %lientQ a Chess b @asetball % Swimming d Finge" painting 122 !he n$"se is awa"e that %lients with se/e"e dep"ession& possess whi%h defense me%hanism: a Int"oEe%tion b S$pp"ession % ep"ession d P"oEe%tion 12+ *$"se Bohn is awa"e that self m$tilation among @ipola" diso"de" patients is a means of: a O/e"%oming fea" of fail$"e b O/e"%oming feeling of inse%$"ity % elie/ing dep"ession

COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1.

d elie/ing an-iety 12. Hhi%h of the following may %a$se an in%"ease in the %ystitis symptomsQ a Hate" b O"ange E$i%e % Coffee d
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1

1+5 !he one filing the %"iminal %a"e against an a%%$sed pa"ty is said to be theQ a D$ilty b #%%$sed % Plaintiff d Hitness 1+8 # male %lient has a standing )* o"de" ?e then s$ddenly stopped b"eathing and yo$ a"e at his bedside Ao$ wo$ld: a Call the physi%ian b Stay with the %lient and do nothing % Call anothe" n$"se d Call the family 1+ !he #*# "e%ogni(ed n$"sing info"mati%s he"alding its establishment as a new field in n$"sing d$"ing what yea"Q a 199. b 1992 % 2000 d 2001 1+9 Hhen is the fi"st %e"tifi%ation of n$"sing info"mati%s gi/enQ a 1990=199+ b 2001=2002 % 199.=1995 d 200=200 1.0 !he n$"se is assessing a female %lient with possible diagnosis of osteoa"th"itis !he most signifi%ant "is fa%to" fo" osteoa"th"itis is: a Obesity b a%e % Bob d #ge 1.1 # male %lient %omplains of /e"tigo *$"se @ea anti%ipates that the %lient may ha/e a p"oblem with whi%h po"tion of the ea"Q a !ympani% memb"anes b Inne" ea" % #$"i%le d ,-te"nal ea" 1.2 Hhen pe"fo"ming Hebe"Ks test& *$"se osean e-pe%ts that this %lient will hea" a On $naffe%ted side b 'onge" th"o$gh bone than ai" %ond$%tion % On affe%ted side by bone %ond$%tion d @y neithe" bone o" ai" %ond$%tion 1.+ !oy with a tentati/e diagnosis of myasthenia g"a/is is admitted fo" diagnosti% mae $p

% !h"omb$s fo"mation d
COMPRENSIVE EXAMINATION Part 2


1 # .+=yea"=old #f"i%an #me"i%an male is adm itted with si%le %ell an emia !he n$" se plans to asse ss %i"%$lation in the lowe" e-t"emities e/e"y 2 ho$"s Hhi%h of the following o$t%ome %"ite"ia wo$ld the n$"se $seQ #@ody tempe"at$"e of 99RF o" less @!oes mo/ed in a%ti/e "ange of motion CSensation "epo"ted when soles of feet a"e to$%hed )Capilla"y "efill of  + se%onds 2 # +0=yea"=old male f"om ?aiti is b"o$ght to the eme"gen%y depa"tment in si%le %ell %"isis Hhat is the best position fo" this %lientQ #Side=lying with nees fle-ed @nee=%hest C?igh Fowle"s with nees fle-ed )Semi=Fowle"s with legs e-tended on the bed + # 2=yea"=old male is adm itted in si% le %ell %"isis Hhi%h of the fo llowing inte"/entions wo$ld be of highest p"io"ity fo" this %lientQ #!aing ho$"ly blood p"ess$"es with me%hani%al %$ff @ ,n%o$"aging fl$id intae of at least 200m' pe" ho$" C Position in high Fowle"s with nee gat%h "aised )#dministe"ing !ylenol as o"de"ed . Hhi%h of the following foods wo$ld the n$"se en%o$"age the %lient in si%le %ell %"isis to eatQ #Pea%hes @Cottage %heese CPopsi%le )'ima beans  # newly admitted %lient has si%le %ell %"isis !he n$"se is pl anning %a"e based on as sessment of the %lient !he %lient is %omplaining of se/e"e pain in his feet and hands !he p$lse o-imet"y is 92 Hhi%h of the following inte"/entions wo$ld be implemented fi"stQ #ss$me that the"e a"e o"de"s fo" ea%h inte"/ention ##dE$st the "oom tempe"at$"e @Di/e a bol$s of I7 fl$ids CSta"t O2 )#dministe" mepe"idine )eme"ol 8mg I7 p$sh !he n$"se is inst"$%ting a %lient with i"on=defi%ien%y anemia Hhi%h of the following meal plans wo$ld the n$"se e-pe%t the %lient to sele%tQ #oast beef& gelatin salad& g"een beans& and pea%h pie @ Chi%en salad sandwi%h& %oleslaw& F"en%h f"ies& i%e %"eam C ,gg salad on wheat b"ead& %a""ot sti%s& lett$%e salad& "aisin pie )Po" %hop& %"eamed potatoes& %o"n& and %o%on$t %ae 8 Clients with si%le %ell anemia a"e ta$ght to a/oid a%ti/ities that %a$se hypo-ia and hypo-emia Hhi%h of the following a%ti/ities wo$ld the n$"se "e%ommendQ ## family /a%ation in the o%y
COMPREHENSIVE NURSING REVIEW by R. C. REÑA | 1

@LI will wea" s$ppo"t hose when I am $pL CLI will $se an ele%t"i% "a(o" fo" sha/ingL )LI will eat foods low in i"onL 12 # ++=yea"=old male is be ing e/al$ated fo" pos sible a%$te le$emia Hhi%h of th e following wo$ld the n$"se in6$i"e abo$t as a pa"t of the assessmentQ #!he %lient %olle%ts stamps as a hobby @ !he %lient "e%ently lost his Eob as a postal wo"e" C !he %lient had "adiation fo" t"eatment of ?odgins disease as a teenage" )!he %lients b"othe" had le$emia as a %hild 1+ #n #f" i%an #me "i%an %lient is admi tted wit h a%$t e le$emia !he n$"se is ass essing fo" sig ns and symptoms of bleeding Hhe"e is the best site fo" e-amining fo" the p"esen%e of pete%hiaeQ #!he abdomen @ !he tho"aC!he ea"lobes )!he soles of the feet 1. # %lient with a%$te le$emia is admitted to the on%ology $nit Hhi%h of the fo llowing wo$ld be most impo"tant fo" the n$"se to in6$i"eQ #L?a/e yo$ noti%ed a %hange in sleeping habits "e%entlyQL @ L?a/e yo$ had a "espi"ato"y infe%tion in the last 5 monthsQL CL?a/e yo$ lost weight "e%entlyQL )L?a/e yo$ noti%ed %hanges in yo$" ale"tnessQL 1 Hhi%h of the following wo$ld be the p"io"ity n$"sing diagnosis fo" the ad$lt %lient with a%$te le$emiaQ #O"al m$%o$s memb"ane& alte"ed "elated to %hemothe"apy @ is fo" inE$"y "elated to th"ombo%ytopenia CFatig$e "elated to the disease p"o%ess )Inte""$pted family p"o%esses "elated to life=th"eatening illness of a family membe" 15 # 21=yea"=old male with ?odgins lymphoma is a sen io" at the lo%al $ni/e"sity ?e is e ngaged to be ma""ied and is to begin a new Eob $pon g"ad$ation Hhi%h of the following diagnoses wo$ld be a p"io"ity fo" this %lientQ #Se-$al dysf$n%tion "elated to "adiation the"apy @ #nti%ipato"y g"ie/ing "elated to te"minal illness C!iss$e integ"ity "elated to p"olonged bed "est )Fatig$e "elated to %hemothe"apy 18 # %lient has a$toimm$ne th"ombo%ytopeni% p$"p$"a !o dete"mine the %lients "esponse to t"eatment& the n$"se wo$ld monito": #Platelet %o$nt @Hhite blood %ell %o$nt CPotassi$m le/els )Pa"tial p"oth"ombin time P!! 1 !he home health n$"se is /isiting a %lient with a$toimm$ne th"ombo%ytopeni% p$"p$"a #!P !he %lients platelet %o$nt %$""ently is 0& It will be most impo"tant to tea%h the %lient and family abo$t: #@leeding p"e%a$tions @P"e/ention of falls CO-ygen the"apy )Conse"/ation of ene"gy 19 # %lient wit h a pit$ita"y t$mo" has had a t"ansphenoidal hyp osphe%tomy Hhi%h of the following inte"/entions wo$ld be app"op"iate fo" this %lientQ #Pla%e the %lient in !"endelenb$"g position fo" post$"al d"ainage @ ,n%o$"age %o$ghing and deep b"eathing e/e"y 2 ho$"s C,le/ate the head of the bed +0R ),n%o$"age the 7alsal/a mane$/e" fo" bowel mo/ements 20 !he %lient wit h a histo"y of diab etes insipid$s is admi tted with poly $"ia& polydipsia& and mental %onf$sion !he p"io"ity inte"/ention fo" this %lient is: #

#@lood p"ess$"e @!empe"at$"e CO$tp$t )Spe%ifi% g"a/ity 2+ # %lient with #ddisons disease has been admitted with a histo"y of na$ sea and /omiting fo" the pa st + days !he %lient is "e%ei/ing I7 gl$%o%o"ti%oids Sol$=
!he %lient is adm itted to the hosp ital with hyp e"tensi/e %"ises )ia(o-ide ?ype"stat is o"d e"ed )$"ing administ"ation& the n$"se sho$ld: #Utili(e an inf$sion p$mp @Che% the blood gl$%ose le/el C Pla%e the %lient in !"endelenb$"g position )Co/e" the sol$tion with foil 2 !he 5=month=old %lient with a /ent"al septal defe%t is "e%ei /ing )igitalis fo" "eg$ lation of his hea "t "ate Hhi%h finding sho$ld be "epo"ted to the do%to"Q #@lood p"ess$"e of 125G0 @@lood gl$%ose of 110mgGd' C?ea"t "ate of 50bpm )espi"ato"y "ate of +0 pe" min$te 29 !he %lient admitted with angina is gi/en a p"es%"iption fo" nit"ogly%e"ine !he %lient sho$ld be inst"$%ted to: #eplenish his s$pply e/e"y + months @!ae one e/e"y 1 min$tes if pain o%%$"s C 'ea/e the medi%ation in the b"own bottle )C"$sh the medi%ation and tae with wate" +0 !he %lient is inst"$%ted "ega"ding foods that a"e low in fat and %holeste"ol Hhi%h diet sele%tion is lowest in sat$"ated fatsQ #

)!ail of Spen%e !he physi%ian o"de"s lisinop"il Jest"il and f$"os emide 'asi- to be admin iste"ed %on%omitantly to the %lient with hype"tension !he n$"se sho$ld: #>$estion the o"de" @#dministe" the medi%ations C#dministe" sepa"ately )Conta%t the pha"ma%y +. !he best method of e/al$ating the amo$nt of pe"iphe"al edema is: #Heighing the %lient daily @
+

!he n$"se is tea %hing basi% infant %a"e to a g"o $p of fi" st=time pa"ents !he n$ "se sho$ld e-plain that a sponge bath is "e%ommended fo" the fi"st 2 wees of life be%a$se: #*ew pa"ents need time to lea"n how to hold the baby @!he $mbili%al %o"d needs time to sepa"ate C *ewbo"n sin is easily t"a$mati(ed by washing )!he %han%e of %hilling the baby o$tweighs the benefits of bathing +9 # %lient with le$ emia is "e%ei /ing !"imet"e-ate #fte" "e/iewing the %lien ts %ha"t& the phy si%ian o"de"s Hell%o/o"in le$%o/o"in %al%i$m !he "ationale fo" administe"ing le$%o/o"in %al%i$m to a %lient "e%ei/ing !"imet"e-ate is to: #!"eat i"on=defi%ien%y anemia %a$sed by %hemothe"ape$ti% agents @C"eate a syne"gisti% effe%t that sho"tens t"eatment time C In%"ease the n$mbe" of %i"%$lating ne$t"ophils )e/e"se d"$g to-i%ity and p"e/ent tiss$e damage .0 # .=month=old is b"o$ ght to th e well=baby %lini% fo" imm$ni(ation In add ition to the )P ! and pol io /a%%ines& the baby sho$ld "e%ei/e: #?ib tite" @<$mps /a%%ine C?epatitis @ /a%%ine )<< .1 !he physi%ian has p"es%"ibed *e-i$m esomep"a(ole fo" a %lient with e"osi/e gast"itis !he n$"se sho$ld administe" the medi%ation: #+0 min$tes befo"e meals @Hith ea%h meal CIn a single dose at bedtime )+0 min$tes afte" meals .2 # %lient on the psy%hiat"i% $nit is in an $n%ont"olled "age and is th"eatening othe" %lients and staff Hhat is the most app"op"iate a%tion fo" the n$"se to taeQ #Call se%$"ity fo" assistan%e and p"epa"e to sedate the %lient @ !ell the %lient to %alm down and as him if he wo$ld lie to play %a"ds C !ell the %lient that if he %ontin$es his beha/io" he will be p$nished )'ea/e the %lient alone $ntil he %alms down .+ Hhen the n$"se %he%s the f$nd$s of a %lient on the fi"st postpa"t$m day& she notes that the f$nd$s is fi"m& is at the le/el of the $mbili%$s& and is displa%ed to the "ight !he ne-t a%tion the n$"se sho$ld tae is to: #Che% the %lient fo" bladde" distention @#ssess the blood p"ess$"e fo" hypotension


C )ete"mine whethe" an o-yto%i% d"$g was gi/en )Che% fo" the e-p$lsion of small %lots .. # %lient is admitted to the hospital with a tempe"at$"e of 99RF& %omplaints of blood=tinged hemoptysis& fatig$e& and night sweats !he %lients symptoms a"e %onsistent with a diagnosis of: #Pne$monia @ea%tion to anti/i"al medi%ation C!$be"%$losis )S$pe"infe%tion d$e to low C). %o$nt . !he %lient is seen in the %lini% fo" t"eatment of mig"aine head a%hes !he d"$g Imi t"e- s$ mat"iptan s$%%inate is p"es%"ibed fo" the %lient Hhi%h of the following in the %lients histo"y sho$ld be "epo"ted to the do%to"Q #)iabetes @P"in(metals angina CCan%e" )Cl$ste" heada%hes .5 !he %lient with s$ spe%ted meningitis is adm itted to the $ni t !he do% to" is pe" fo"ming an asses sment to dete"mine meningeal i""itation and spinal ne"/e "oot inflammation # positi/e e"nigs sign is %ha"ted if the n$"se notes: #Pain on fle-ion of the hip and nee @ *$%hal "igidity on fle-ion of the ne% C Pain when the head is t$"ned to the left side ))i((iness when %hanging positions .8 !he %lient with #l (heime"s disease is bein g assisted with a%t i/ities of daily li /ing when the n$"s e notes that the %lient $ses he" toothb"$sh to b"$sh he" hai" !he n$"se is awa"e that the %lient is e-hibiting: ##gnosia @#p"a-ia C#nomia )#phasia . !he %lient with dementia is e-pe"ien%ing %onf$sion late in the afte"noon and befo"e bedtime !he n$"se is awa"e that the %lient is e-pe"ien%ing what is nown as: #Ch"oni% fatig$e synd"ome @ *o"mal aging CS$ndowning ))el$sions .9 !he %lient with %onf$sion says to the n$"se& LI ha/ ent had anything to eat all day long Hhen a"e they going to b"ing b"eafastQL !he n$"se saw the %lient in the day "oom eating b"eafast with othe" %lients +0 min$tes befo"e this %on/e"sation Hhi%h "esponse wo$ld be best fo" the n$"se to maeQ #LAo$ now yo$ had b"eafast +0 min$tes agoL @ LI am so so""y that they didnt get yo$ b"eafast Ill "epo"t it to the %ha"ge n$"seL C LIll get yo$ some E$i%e and toast Ho$ld yo$ lie something elseQL )LAo$ will ha/e to wait a whileW l$n%h will be he"e in a little whileL 0 !he do%to" has p"es%"ibed ,-elon "i/astigmine fo" the %lient with #l(heime"s disease Hhi%h side effe%t is most often asso%iated with this d"$gQ #U"ina"y in%ontinen%e @?eada%hes CConf$sion )*a$sea 1 # %lient is admitted to the labo" and deli/e"y $nit in a%ti/e labo" )$"ing e-amination& the n$ "se notes a pap$la" lesion on the pe"ine$m Hhi%h initial a%tion is most app"op"iateQ #)o%$ment the finding @epo"t the finding to the do%to" CP"epa"e the %lient fo" a C=se%tion )Contin$e p"ima"y %a"e as p"es%"ibed 2 # %lient with a diagnosis of ?P7 is at "is fo" whi%h of the followingQ #?odgins lymphoma @Ce"/i%al %an%e" C<$ltiple myeloma )O/a"ian %an%e" + )$"ing the initial inte"/iew& the %lient "epo"ts that she has a lesion on the pe"ine$m F$"the" in/estigation "e/eals a small bliste" on the /$l/a that is painf$l to to$%h !he n$"se is awa"e that the most liely so$"%e of the lesion is: #Syphilis @?e"pes CDono""hea )Condylomata


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# %lient /is iting a family pla nning %lini% is s$spe%ted of ha/ ing an S!I  !he best dia gnosti% test fo" t"eponema pallid$m is: #7ene"eal )isease esea"%h 'ab 7)' @apid plasma "eagin P CFlo"es%ent t"eponemal antibody F!# )!haye"=

##lte"ation in %e"eb"al tiss$e pe"f$sion @Fl$id /ol$me defi%it CIneffe%ti/e ai"way %lea"an%e )#lte"ation in senso"y pe"%eption 5 !he home health n$"se is /isiting an 1=yea"=old with osteogenesis impe"fe%ta Hhi%h info"mation obtained on the /isit wo$ld %a$se the most %on%e"nQ !he %lient: #'ies to play football @)"ins se/e"al %a"bonated d"ins pe" day C?as two siste"s with si%le %ell t"a%t )Is taing a%etaminophen to %ont"ol pain 55 !he n$"se wo"ing the o"gan t"ansplant $nit is %a"ing fo" a %lient with a white blood %ell %o$nt of )$"ing e/ening /isitation& a /isito" b"ings a baset of f"$it Hhat a%tion sho$ld the n$"se taeQ ##llow the %lient to eep the f"$it @ Pla%e the f"$it ne-t to the bed fo" easy a%%ess by the %lient COffe" to wash the f"$it fo" the %lient )!ell the family membe"s to tae the f"$it home 58 !he n$"se is %a"ing fo" the %lient following a la"ynge%tomy when s$ddenly the %lient be%omes non"esponsi/e and pale& with a @P of 90G.0 systoli% !he initial n$"ses a%tion sho$ld be to: #Pla%e the %lient in !"endelenb$"g position @ In%"ease the inf$sion of )e-t"ose in no"mal saline C #dministe" at"opine int"a/eno$sly )

8

!he %lient is admitted following "epai" of a f"a%t$"ed tibia and %ast appli%ation Hhi%h n$"sing assessment sho$ld be "epo"ted to the do%to"Q #Pain beneath the %ast @ Ha"m toes CPedal p$lses wea and "apid )Pa"esthesia of the toes 85 !he %lient is ha/i ng an a"t e"iog"am )$"ing the p"o %ed$"e& the %lie nt tells the n$ "se& LIm feei ng "eally hotL Hhi%h "esponse wo$ld be bestQ #LAo$ a"e ha/ing an alle"gi% "ea%tion I will get an o"de" fo" @enad"ylL @ L!hat feeling of wa"mth is no"mal when the dye is inEe%tedL C L!hat feeling of wa"mth indi%ates that the %lots in the %o"ona"y /essels a"e dissol/ingL )LI will tell yo$" do%to" and let him e-plain to yo$ the "eason fo" the hot feeling that yo$ a"e e-pe"ien%ingL 88 !he n$"se is obse"/ing se/e"al health%a"e wo"e"s p"o/iding %a"e Hhi%h a%tion by the health%a"e wo"e" indi%ates a need fo" f$"the" tea%hingQ #!he n$"sing assistant wea"s glo/es while gi/ing the %lient a bath @ !he n$"se wea"s goggles while d"awing blood f"om the %lient C !he do%to" washes his hands befo"e e-amining the %lient )!he n$"se wea"s glo/es to tae the %lients /ital signs 8 !he %lient is ha/ing ele%t"o%on/$lsi/e the"apy fo" t"eatment of se/e"e dep"ession Hhi%h of the following indi%ates that the %lients ,C! has been effe%ti/eQ #!he %lient loses %ons%io$sness @!he %lient /omits C !he %lients ,CD indi%ates ta%hy%a"dia )!he %lient has a g"and mal sei($"e 89 !he =yea"=old is being tested fo" ente"obiasis pin wo"ms !o %ol le%t a spe%imen fo" assessment of pinwo"ms& the n$"se sho$ld tea%h the mothe" to: #,-amine the pe"ianal a"ea with a flashlight 2 o" + ho$"s afte" the %hild is asleep @ S%"ape the sin with a pie%e of %a"dboa"d and b"ing it to the %lini% CObtain a stool spe%imen in the afte"noon )@"ing a hai" sample to the %lini% fo" e/al$ation 0

!he n$"se is tea%hing the mothe" "ega"ding t"eatment fo" ente"obiasis Hhi%h inst"$%tion sho$ld be gi/en "ega"ding the medi%ationQ #!"eatment is not "e%ommended fo" %hild"en less than 10 yea"s of age @!he enti"e family sho$ld be t"eated C

)#sing the 'P* to %ontin$e the post=op %a"e Hhi%h n$"se sho$ld be assigned to %a"e fo" the postpa"tal %lient with p"ee%lampsiaQ #!he * with 2 wees of e-pe"ien%e in postpa"t$m @ !he * with + yea"s of e-pe"ien%e in labo" and deli/e"y C!he * with 10 yea"s of e-pe"ien%e in s$"ge"y )!he * with 1 yea" of e-pe"ien%e in the neonatal intensi/e %a"e $nit 8 Hhi%h info"mation sho$ld be "epo"ted to the state @oa"d of *$"singQ #!he fa%ility fails to p"o/ide lite"at$"e in both Spanish and ,nglish @ !he na"%oti% %o$nt has been in%o""e%t on the $nit fo" the past + days C !he %lient fails to "e%ei/e an itemi(ed a%%o$nt of his bills and se"/i%es "e%ei/ed d$"ing his hospital stay )!he n$"sing assistant assigned to the %lient with hepatitis fails to feed the %lient and gi/e the bath  !he n$"se is s$s pe%ted of %ha "ting medi%ation administ"ation that he did no t gi/e #fte" tal ing to the n$"se& the %ha"ge n$"se sho$ld: #Call the @oa"d of *$"sing @File a fo"mal "ep"imand C!e"minate the n$"se )Cha"ge the n$"se with a to"t 9 !he home health n$"se is planning fo" the days /isits Hhi%h %lient sho$ld be seen fi"stQ #!he 8=yea"=old who had a gast"e%tomy + wees ago and has a P,D t$be @!he =month=old dis%ha"ged 1 wee ago with pne$monia who is being t"eated with amo-i%illin li6$id s$spension C !he 0=yea"=old with <S# being t"eated with 7an%omy%in /ia a PICC line )!he +0=yea"=old with an e-a%e"bation of m$ltiple s%le"osis being t"eated with %o"tisone /ia a %ent"ally pla%ed /eno$s %athete" 90 !he eme"gen%y "oom is flooded with %lients inE$"ed in a to"nado Hhi%h %lients %an be assigned to sha"e a "oom in the eme"gen%y depa"tment d$"ing the disaste"Q ## s%hi(oph"eni% %lient ha/ing /is$al and a$dito"y hall$%inations and the %lient with $l%e"ati/e %olitis @!he %lient who is 5 months p"egnant with abdominal pain and the %lient with fa%ial la%e"ations and a b"oen a"m C # %hild whose p$pils a"e fi-ed and dilated and his pa"ents& and a %lient with a f"ontal head inE$"y 5

)!he %lient who a""i/es with a la"ge p$n%t$"e wo$nd to the abdomen and the %lient with %hest pain !he n$"se is %a"ing fo" a 5=yea"=old %lient admitted with a diagnosis of %onE$n%ti/itis @efo"e administe"ing eyed"ops& the n$"se sho$ld "e%ogni(e that it is essential to %onside" whi%h of the followingQ #!he eye sho$ld be %leansed with wa"m wate"& "emo/ing any e-$date& befo"e instilling the eyed"ops @ !he %hild sho$ld be allowed to instill his own eyed"ops C !he mothe" sho$ld be allowed to instill the eyed"ops )If the eye is %lea" f"om any "edness o" edema& the eyed"ops sho$ld be held 92 !he n$"se is di s%$ssing meal planning with th e mothe" of a 2=yea "=old toddle" Hhi%h of the fol lowing statements& if made by the mothe"& wo$ld "e6$i"e a need fo" f$"the" inst"$%tionQ #LIt is oay to gi/e my %hild white g"ape E$i%e fo" b"eafastL @ L

)7omiting and dia""hea !he n$"se is %a"ing fo" a %lient admitted with epiglottis @e%a$se of the possibility of %omplete obst"$%tion of the ai"way& whi%h of the following sho$ld the n$"se ha/e a/ailableQ #Int"a/eno$s a%%ess s$pplies @# t"a%heostomy set C Int"a/eno$s fl$id administ"ation p$mp )S$pplemental o-ygen 9 # 2=yea"=old %li ent with D"a /es dis ease is admi tted to the $nit Hhat wo$ ld the n$" se e-p e%t the admitting assessment to "e/ealQ #@"ady%a"dia @)e%"eased appetite C,-ophthalmos )Height gain 99 !he n$"se is p"o /iding dieta"y inst"$%tions to th e mothe" of an =yea "=old %hild diagnosed with %elia% disease Hhi%h of the following foods& if sele%ted by the mothe"& wo$ld indi%ate he" $nde"standing of the dieta"y inst"$%tionsQ #?am sandwi%h on whole=wheat toast @Spaghetti and meatballs C?amb$"ge" with et%h$p )Cheese omelet 100 !he n$"se is %a"ing fo" an 0=yea"=old with %h"oni% b"on%hitis Upon the mo"ning "o$nds& the n$"se finds an O2 sat of 85V Hhi%h of the following a%tions sho$ld the n$"se tae fi"stQ #*otify the physi%ian @e%he% the O2 sat$"ation le/el in 1 min$tes C#pply o-ygen by mas )#ssess the %hilds p$lse 101 # g"a/ida III pa"a 0 is ad mitted to the labo" and deli/e"y $nit !he do%to" pe"fo"ms an amniotomy Hhi%h obse"/ation wo$ld the n$"se be e-pe%ted to mae afte" the amniotomyQ #Fetal hea"t tones 150bpm @# mode"ate amo$nt of st"aw=%olo"ed fl$id 98

C# small amo$nt of g"eenish fl$id )# small segment of the $mbili%al %o"d 102 !he %lient is admitted to the $nit # /aginal e-am "e/eals that she is 2%m dilated Hhi%h of the following statements wo$ld the n$"se e-pe%t he" to maeQ #LHe ha/e a name pi%ed o$t fo" the babyL @LI need to p$sh when I ha/e a %ont"a%tionL CLI %ant %on%ent"ate if anyone is to$%hing meL )LHhen %an I get my epid$"alQL 10+ !he %lient is ha/in g fetal hea" t "ates of 90X110bpm d$"ing the %ont "a%tions !he fi"s t a%tion the n$"s e sho$ld tae is: #eposition the monito" @!$"n the %lient to he" left side C#s the %lient to amb$late )P"epa"e the %lient fo" deli/e"y 10. In e/al$ating the effe%ti/eness of I7 Pito%in fo" a %lient with se%onda"y dysto%ia& the n$"se sho$ld e-pe%t: ## painless deli/e"y @Ce"/i%al effa%ement CInf"e6$ent %ont"a%tions )P"og"essi/e %e"/i%al dilation 10 # /aginal e-am "e/e als a footl ing b"ee%h p"esentation !he n$"se sho$ld tae whi %h of the following a%tions at this timeQ ##nti%ipate the need fo" a Caesa"ean se%tion @#pply the fetal hea"t monito" CPla%e the %lient in Den$ Pe%to"al position )Pe"fo"m an $lt"aso$nd e-am 105 # /aginal e-am "e/eals that the %e"/i- is .%m dilated& with inta%t memb"anes and a fetal hea"t tone "ate of 150X180bpm !he n$"se de%ides to apply an e-te"nal fetal monito" !he "ationale fo" this implementation is: #!he %e"/i- is %losed @!he memb"anes a"e still inta%t C !he fetal hea"t tones a"e within no"mal limits )!he %ont"a%tions a"e intense eno$gh fo" inse"tion of an inte"nal monito" 108 !he following a"e all n$"sing diagnoses app"op"iate fo" a g"a/ida 1 pa "a 0 in labo" Hhi%h one wo$ld be most app"op"iate fo" the p"imag"a/ida as she %ompletes the ea"ly phase of labo"Q #Impai"ed gas e-%hange "elated to hype"/entilation @ #lte"ation in pla%ental pe"f$sion "elated to mate"nal position


C Impai"ed physi%al mobility "elated to fetal=monito"ing e6$ipment )Potential fl$id /ol$me defi%it "elated to de%"eased fl$id intae 10 #s the %lie nt "ea%hes %m dil ation& the n$" se notes late de%e le"ations on the feta l monito" !he F? baseline is 15X18bpm with /a"iability of 0X2bpm Hhat is the most liely e-planation of this patte"nQ #!he baby is asleep @!he $mbili%al %o"d is %omp"essed C!he"e is a /agal "esponse )!he"e is $te"opla%ental ins$ffi%ien%y 109 !he n$"se notes /a"i able de%ele"ations on the fetal monito" st"ip  !he most app "op"iate initi al a%tio n wo$ld be to: #*otify he" do%to" @ Sta"t an I7 Ceposition the %lient )eadE$st the monito" 110 Hhi%h of the following is a %ha"a%te"isti% of a "eass$"ing fetal hea"t "ate patte"nQ ## fetal hea"t "ate of 180X10bpm @# baseline /a"iability of 2X+bpm COmino$s pe"iodi% %hanges )#%%ele"ation of F? with fetal mo/ements 111 !he "ationale fo" inse"ting a F"en%h %athete" e/e"y ho$" fo" the %lient with epid$"al anesthesia is: #!he bladde" fills mo"e "apidly be%a$se of the medi%ation $sed fo" the epid$"al @ ?e" le/el of %ons%io$sness is s$%h that she is in a t"an%elie state C !he sensation of the bladde" filling is diminished o" lost )She is emba""assed to as fo" the bedpan that f"e6$ently 112 # %lient in the family planning %lini% ass the n$"se abo$t the most liely time fo" he" to %on%ei/e !he n$"se e-plains that %on%eption is most liely to o%%$" when: #,st"ogen le/els a"e low @'$teni(ing ho"mone is high C!he endomet"ial lining is thin )!he p"ogeste"one le/el is low 11+ # %lient tells the n$"se that she plans to $se the "hythm method of bi"th %ont"ol !he n$"se is awa"e that the s$%%ess of the "hythm method depends on the: ##ge of the %lient @F"e6$en%y of inte"%o$"se Ceg$la"ity of the menses )ange of the %lients tempe"at$"e 11. # %lient with diab etes ass the n$"s e fo" ad/i%e "ega"ding methods of bi"th %ont"ol Hhi%h met hod of bi"th %ont"ol is most s$itable fo" the %lient with diabetesQ #Int"a$te"ine de/i%e @O"al %ont"a%epti/es C)iaph"agm )Cont"a%epti/e sponge 11 !he do%to" s$spe%ts that the %lie nt has an e%top i% p"egnan%y Hhi%h symptom is %onsistent with a diagnosis of e%topi% p"egnan%yQ #Painless /aginal bleeding @#bdominal %"amping C!h"obbing pain in the $ppe" 6$ad"ant )S$dden& stabbing pain in the lowe" 6$ad"ant 115 !he n$"se is tea%hing a p"egnant %lient abo$t n$t"itional needs d$"ing p"egnan%y Hhi%h men$ sele%tion will best meet the n$t"itional needs of the p"egnant %lientQ #?amb$"ge" pattie& g"een beans& F"en%h f"ies& and i%ed tea @ oast beef sandwi%h& potato %hips& baed beans& and %ola C @aed %hi%en& f"$it %$p& potato salad& %oleslaw& yog$"t& and i%ed tea )Fish sandwi%h& gelatin with f"$it& and %offee 118 !he %lient with hype"emesis g"a/ida"$m is at "is fo" de/eloping: #espi"ato"y alalosis witho$t dehyd"ation @

#?ypogly%emi%& small fo" gestational age @?ype"gly%emi%& la"ge fo" gestational age C?ypogly%emi%& la"ge fo" gestational age )?ype"gly%emi%& small fo" gestational age 120 Hhi%h of the following inst"$%tions sho$ld be in%l$ded in the n$"ses tea%hing "ega"ding o"al %ont"a%epti/esQ #Height gain sho$ld be "epo"ted to the physi%ian @ #n alte"nate method of bi"th %ont"ol is needed when taing antibioti%s C If the %lient misses one o" mo"e pills& two pills sho$ld be taen pe" day fo" 1 wee )Changes in the menst"$al flow sho$ld be "epo"ted to the physi%ian 121 !he n$"se is dis%$ssing b"eastfeeding with a postpa"t$m %lient @"eastfeeding is %ont"aindi%ated in the postpa"t$m %lient with: #)iabetes @Positi/e ?I7 C?ype"tension )!hy"oid disease 122 # %lient is admit ted to the labo" and deli/ e"y $nit %om plaining of /agin al bleeding with /e"y litt le dis%omfo"t !he n$"ses fi"st a%tion sho$ld be to: ##ssess the fetal hea"t tones @Che% fo" %e"/i%al dilation CChe% fo" fi"mness of the $te"$s )Obtain a detailed histo"y 12+ # %lient telephones the eme"gen%y "oom stating that she thins that she is in labo" !he n$"se sho$ld tell the %lient that labo" has p"obably beg$n when: #?e" %ont"a%tions a"e 2 min$tes apa"t @She has ba% pain and a bloody dis%ha"ge C She e-pe"ien%es abdominal pain and f"e6$ent $"ination )?e" %ont"a%tions a"e  min$tes apa"t 12. !he n$"se is tea%hing a g"o$p of p"enatal %lients abo$t the effe%ts of %iga"ette smoe on fetal de/elopment Hhi%h %ha"a%te"isti% is asso%iated with babies bo"n to mothe"s who smoed d$"ing p"egnan%yQ #'ow bi"th weight @'a"ge fo" gestational age C P"ete"m bi"th& b$t app"op"iate si(e fo" gestation )D"owth "eta"dation in weight and length 12 !he physi%ian has o" de"ed an inEe %tion of hoD am fo" the pos tpa"t$m %lient whose bl ood type is # negati/e b$t whose baby is O positi/e !o p"o/ide postpa"t$m p"ophyla-is& hoDam sho$ld be administe"ed: #Hithin 82 ho$"s of deli/e"y @Hithin 1 wee of deli/e"y CHithin 2 wees of deli/e"y )Hithin 1 month of deli/e"y 125 #fte" the physi%ian pe"fo"ms an amniotomy& the n$"ses fi"st a%tion sho$ld be to assess the: #)eg"ee of %e"/i%al dilation @Fetal hea"t tones CClients /ital signs )Clients le/el of dis%omfo"t 128 # %lient is admitted to the labo" and deli/e"y $nit !he n$"se pe"fo"ms a /aginal e-am and dete"mines that the %lients %e"/i- is %m dilated with 8V effa%ement @ased on the n$"ses assessment the %lient is in whi%h phase of labo"Q ##%ti/e @'atent C!"ansition ),a"ly 12 # newbo"n with na"%oti% abstinen%e synd"ome is admitted to the n$"se"y *$"sing %a"e of the newbo"n sho$ld in%l$de: #!ea%hing the mothe" to p"o/ide ta%tile stim$lation @ H"apping the newbo"n sn$gly in a blanet CPla%ing the newbo"n in the infant seat )Initiating an ea"ly infant=stim$lation p"og"am 129 # %lient ele%ts to ha/e epid$"al anesthesia to "elie/e the dis%omfo"t of labo" Following the initiation of epid$"al anesthesia& the n$"se sho$ld gi/e p"io"ity to: #Che%ing fo" %e"/i%al dilation @ Pla%ing the %lient in a s$pine position C Che%ing the %lients blood p"ess$"e )Obtaining a fetal hea"t "ate 1+0 !he n$"se is awa"e that the best way to p"e/ent post= ope"ati/e wo$nd infe%tion in the s$"gi%al %lient is to:


##dministe" a p"es%"ibed antibioti% @Hash he" hands fo" 2 min$tes befo"e %a"e CHea" a mas when p"o/iding %a"e )#s the %lient to %o/e" he" mo$th when she %o$ghs 1+1 !he elde"ly %lient is admitted to the eme"gen%y "oom Hhi%h symptom is the %lient with a f"a%t$"ed hip most liely to e-hibitQ #Pain @)isalignment CCool e-t"emity )#bsen%e of pedal p$lses 1+2 !he n$"se nows that a 50=yea"=old female %lients s$s%eptibility to osteopo"osis is most liely "elated to: #'a% of e-e"%ise @?o"monal dist$"ban%es C'a% of %al%i$m )Deneti% p"edisposition 1++ # 2=yea"=old is admitted fo" "epai" of a f"a%t$"ed fem$" and is pla%ed in @"yants t"a%tion Hhi%h finding by the n$"se indi%ates that the t"a%tion is wo"ing p"ope"lyQ #!he infant no longe" %omplains of pain @!he b$tto%s a"e 1R off the bed C!he legs a"e s$spended in the t"a%tion )!he pins a"e se%$"ed within the p$lley 1+. # %lient with a f"a%t$"ed hip has bee n pla%ed in @$%s t"a%tion Hhi%h statement is t"$e "ega "ding balan%ed seletal t"a%tionQ @alan%ed seletal t"a%tion: #Utili(es a Steinman pin @e6$i"es that both legs be se%$"ed CUtili(es i"s%hne" wi"es )Is $sed p"ima"ily to heal the f"a%t$"ed hips 1+ !he %lient is admitted fo" an open "ed$%tion inte"nal fi-ation of a f"a%t$"ed hip Immediately following s$"ge"y& the n$"se sho$ld gi/e p"io"ity to assessing the: #Se"$m %olle%tion )a/ol d"ain @Clients pain C*$t"itional stat$s )Immobili(e" 1+5 Hhi%h statement made by the family membe" %a"ing fo" the %lient with a pe"%$taneo$s gast"ostomy t$be indi%ates $nde"standing of the n$"ses tea%hingQ #LI m$st fl$sh the t$be with wate" afte" feedings and %lamp the t$beL @LI m$st %he% pla%ement fo$" times pe" dayL C LI will "epo"t to the do%to" any signs of indigestionL )LIf my fathe" is $nable to swallow& I will dis%ontin$e the feeding and %all the %lini%L 1+8 !he n$"se is assessing the %lient with a total nee "epla%ement 2 ho$"s post=ope"ati/e Hhi%h info"mation "e6$i"es notifi%ation of the do%to"Q #@leeding on the d"essing is +%m in diamete" @!he %lient has a tempe"at$"e of 5RF C!he %lients hemato%"it is 25V )!he $"ina"y o$tp$t has been 50 d$"ing the last 2 ho$"s 1+ !he n$"se is %a"in g fo" the %lient with a =yea"=old diagnosis of pl$mbism Hhi%h info"mation in the health histo"y is most liely "elated to the de/elopment of pl$mbismQ #!he %lient has t"a/eled o$t of the %o$nt"y in the last 5 months @ !he %lients pa"ents a"e silled stained=glass a"tists C!he %lient li/es in a ho$se b$ilt in 1 )!he %lient has se/e"al b"othe"s and siste"s 1+9 # %lient with a total hip "epla%ement "e6$i"es spe%ial e6$ipment Hhi%h e6$ipment wo$ld assist the %lient with a total hip "epla%ement with a%ti/ities of daily li/ingQ #?igh=seat %ommode @e%line" C !,*S $nit )#bd$%tion pillow 1.0 #n elde"ly %lient with an abdominal s$"ge"y is admitted to the $nit following s$"ge"y In anti%ipation of %ompli%ations of anesthesia and na"%oti% administ"ation& the n$"se sho$ld: ##dministe" o-ygen /ia nasal %ann$la @?a/e na"%an nalo-ane a/ailable CP"epa"e to administe" blood p"od$%ts )P"epa"e to do %a"dio"es$s%itation 1.1 Hhi%h "oommate wo$ld be mos t s$itable fo" the 5=y ea"=old male with a f"a%t $"ed fem$" in $ss ells t"a%tionQ


#15=yea"=old female with s%oliosis @12=yea"=old male with a f"a%t$"ed fem$" C10=yea"=old male with sa"%oma )5=yea"=old male with osteomylitis 1.2 # %lient with oste oa"th"itis has a p"es%"iption fo" Celeb"e- %ele%o-ib Hhi%h inst"$%tion sho$ld be in%l$ded in the dis%ha"ge tea%hingQ #!ae the medi%ation with mil @epo"t %hest pain C emain $p"ight afte" taing fo" +0 min$tes )#llow 5 wees fo" optimal effe%ts 1.+ # %lient with a f"a%t$"ed tibia has a plaste"=of=Pa"is %ast applied to immobili(e the f"a%t$"e Hhi%h a%tion by the n$"se indi%ates $nde"standing of a plaste"=of=Pa"is %astQ !he n$"se: #?andles the %ast with the finge"tips @Petals the %ast C)"ies the %ast with a hai" d"ye" )#llows 2. ho$"s befo"e bea"ing weight 1.. !he teenage" with a fibe"glass %ast ass the n$"se if it will be oay to allow his f"iends to a$tog"aph his %ast Hhi%h "esponse wo$ld be bestQ #LIt will be al"ight fo" yo$" f"iends to a$tog"aph the %astL @ L@e%a$se the %ast is made of plaste"& a$tog"aphing %an weaen the %astL C LIf they dont $se %hal to a$tog"aph& it is oayL )L#$tog"aphing o" w"iting on the %ast in any fo"m will ha"m the %astL 1. !he n$"se is assigned to %a"e fo" the %lient with a Steinmen pin )$"ing pin %a"e& she notes that the 'P* $ses ste"ile glo/es and >=tips to %lean the pin Hhi%h a%tion sho$ld the n$"se tae at this timeQ ##ssisting the 'P* with opening ste"ile pa%ages and pe"o-ide @ !elling the 'P* that %lean glo/es a"e allowed C !elling the 'P* that the "egiste"ed n$"se sho$ld pe"fo"m pin %a"e )#sing the 'P* to %lean the weights and p$lleys with pe"o-ide 1.5 # %hild with s%oliosis has a spi%a %ast applied Hhi%h a%tion spe%ifi% to the spi%a %ast sho$ld be taenQ #Che% the bowel so$nds @#ssess the blood p"ess$"e COffe" pain medi%ation )Che% fo" swelling 1.8 !he %lient with a %e"/i%al f"a%t$"e is pla%ed in t"a%tion Hhi%h type of t"a%tion will be $tili(ed at the time of dis%ha"geQ #$ssells t"a%tion @@$%s t"a%tion C?alo t"a%tion )C"$t%hfield tong t"a%tion 1. # %lient with a total nee "epla%ement has a CP< %ontin$o$s passi/e motion de/i%e applied d$"ing the post=ope"ati/e pe"iod Hhi%h statement made by the n$"se indi%ates $nde"standing of the CP< ma%hineQ #LUse of the CP< will pe"mit the %lient to amb$late d$"ing the the"apyL @ L!he CP< ma%hine %ont"ols sho$ld be positioned distal to the siteL C LIf the %lient %omplains of pain d$"ing the the"apy& I will t$"n off the ma%hine and %all the do%to"L )LUse of the CP< ma%hine will alle/iate the need fo" physi%al the"apy afte" the %lient is dis%ha"gedL 1.9 # %lient with a f"a%t$"ed hip is being ta$ght %o""e%t $se of the wale" !he n$"se is awa"e that the %o""e%t $se of the wale" is a%hie/ed if the: #Palms "est lightly on the handles @,lbows a"e fle-ed 0R CClient wals to the f"ont of the wale" )Client %a""ies the wale" 10 Hhen assessing a labo"ing %lient& the n$"se finds a p"olapsed %o"d !he n$"se sho$ld: ##ttempt to "epla%e the %o"d @Pla%e the %lient on he" left side C,le/ate the %lients hips )Co/e" the %o"d with a d"y& ste"ile ga$(e 11 !he n$"se is %a"ing fo" a +0=yea"=old male admitted with a stab wo$nd Hhile in the eme"gen%y "oom& a %hest t$be is inse"ted Hhi%h of the following e-plains the p"ima"y "ationale fo" inse"tion of %hest t$besQ #!he t$be will allow fo" e6$ali(ation of the l$ng e-pansion @ Chest t$bes se"/e as a method of d"aining blood and se"o$s fl$id and assist in "einflating the l$ngs C Chest t$bes "elie/e pain asso%iated with a %ollapsed l$ng )Chest t$bes assist with %a"dia% f$n%tion by stabili(ing l$ng e-pansion 12 # %lient who deli/ e"ed this mo" ning tells the n$"se th at she plan s to b"eastfeed he" baby  !he n$"se is awa"e that s$%%essf$l b"eastfeeding is most dependent on the: #

@Infants bi"th weight CSi(e of the mothe"s b"east )

#!he"e is no need to tae thy"oid medi%ation be%a$se the fet$ss thy"oid p"od$%es a thy"oid=stim$lating ho"mone @eg$lation of thy"oid medi%ation is mo"e diffi%$lt be%a$se the thy"oid gland in%"eases in si(e d$"ing p"egnan%y C It is mo"e diffi%$lt to maintain thy"oid "eg$lation d$"ing p"egnan%y d$e to a slowing of metabolism )Fetal g"owth is a""ested if thy"oid medi%ation is %ontin$ed d$"ing p"egnan%y 15. !he n$"se is "esponsible fo" pe"f o"ming a neona tal assessment on a f$ll=te"m infant #t 1 min$te& the n$"se %o$ld e-pe%t to find: ##n api%al p$lse of 100 @#n absen%e of ton$s CCyanosis of the feet and hands )Ba$ndi%e of the sin and s%le"a 15 # %lient with si%le %ell anemia is admitted to the labo" and deli/e"y $nit d$"ing the fi"st phase of labo" !he n$"se sho$ld anti%ipate the %lients need fo": #S$pplemental o-ygen @Fl$id "est"i%tion C@lood t"ansf$sion ))eli/e"y by Caesa"ean se%tion 155 # %lient with diabetes has an o"de" fo" $lt"asonog"aphy P"epa"ation fo" an $lt"aso$nd in%l$des: #In%"easing fl$id intae @'imiting amb$lation C#dministe"ing an enema )Hithholding food fo"  ho$"s 158 #n infant who weighs  po$nds at bi"th wo$ld be e-pe%ted to weigh how many po$nds at 1 yea"Q #1. po$nds @ 15 po$nds C 1 po$nds )2. po$nds 15 # p"egnant %lient with a histo"y of al%ohol addi%tion is s%hed$led fo" a nonst"ess test !he nonst"ess test: #)ete"mines the l$ng mat$"ity of the fet$s @

CCimetadine +00mg PO 6id )

#Ca$se dia""hea @Change the %olo" of he" $"ine CCa$se mental %onf$sion )Ca$se %hanges in taste 18 Hhi%h of the following tests sho$ld be pe"fo"med befo"e beginning a p"es%"iption of #%%$taneQ #Che% the %al%i$m le/el @Pe"fo"m a p"egnan%y test C

19 !he %lient with en$"esis is being ta$ght "ega"ding bladde" "et"aining !he n$"se sho$ld ad/ise the %lient to "ef"ain f"om d"ining afte": #1900 @1200 C1000 )0800 199 Hhi%h of the following diet inst"$%tions sho$ld be gi/en to the %lient with "e%$""ing $"ina"y t"a%t infe%tionsQ #In%"ease intae of meats @#/oid %it"$s f"$its CPe"fo"m pe"i%a"e with hyd"ogen pe"o-ide ))"in a glass of %"anbe""y E$i%e e/e"y day 200 !he physi%ian has p"es%"ibed *P? ins$lin fo" a %lient with diabetes mellit$s Hhi%h statement indi%ates that the %lient nows when the pea a%tion of the ins$lin o%%$"sQ #LI will mae s$"e I eat b"eafast within 2 ho$"s of taing my ins$linL @ LI will need to %a""y %andy o" some fo"m of s$ga" with me all the timeL C LI will eat a sna% a"o$nd th"ee o%lo% ea%h afte"noonL )LI %an sa/e my desse"t f"om s$ppe" fo" a bedtime sna%L 201 # %lient with pne$ma%ystis %a"ini pne$monia is "e%ei/ing t"imet"e-ate !he "ationale fo" administe"ing le$%o/o"in %al%i$m to a %lient "e%ei/ing

)7is$al dist$"ban%es %an be %o""e%ted with p"es%"iption glasses 209 # %lient on the postpa"t$m $nit has a p"o%toepisiotomy !he n$"se sho$ld anti%ipate administe"ing whi%h medi%ationQ #)$l%ola- s$pposito"y @)o%$sate sodi$m Cola%e C

220 # %lient with an abdominal %hole%yste%tomy "et$"ns f"om s$"ge"y with a Ba%son=P"att d"ain !he %hief p$"pose of the Ba%son=P"att d"ain is to: #P"e/ent the need fo" d"essing %hanges @ed$%e edema at the in%ision CP"o/ide fo" wo$nd d"ainage )eep the %ommon bile d$%t open 221 !he n$"se is pe"fo "ming an init ial assessment of a newbo"n Ca$%asian male deli /e"ed at +2 wees gestation !he n$"se %an e-pe%t to find the p"esen%e of: #

)L!he pain and it%hing a"e d$e to the infe%tion yo$ had befo"e the s$"ge"yL 2+1 # %lient with %an%e" of the pan%"eas has $nde"gone a Hhipple p"o%ed$"e !he n$"se is awa"e that d$"ing the Hhipple p"o%ed$"e& the do%to" will "emo/e the: #?ead of the pan%"eas @ P"o-imal thi"d se%tion of the small intestines CStoma%h and d$oden$m ),sophag$s and EeE$n$m 2+2 !he physi%ian has o"de "ed a minimal=ba%te"ia diet fo" a %lient with ne$t"openia !he %lien t sho$ld be ta$ght to a/oid eating: #F"$its @Salt CPeppe" )et%h$p 2++ # %lient is dis%h a"ged home with a p"es%"iption fo" Co$m adin sodi$m wa"fa"in !he %lient sho$ld be inst"$%ted to: #?a/e a P"otime done monthly @,at mo"e f"$its and /egetables C)"in mo"e li6$ids )#/oid %"owds 2+. !he n$"se is assisting the physi%ian with "emo/al of a %ent"al /eno$s %athete" !o fa%ilitate "emo/al& the n$"se sho$ld inst"$%t the %lient to: #Pe"fo"m the 7alsal/a mane$/e" as the %athete" is ad/an%ed @ !$"n his head to the left side and hype"e-tend the ne% C!ae slow& deep b"eaths as the %athete" is "emo/ed )!$"n his head to the "ight while maintaining a sniffing position 2+ # %lient has an o"de" fo" st"eptoinase @efo"e administe"ing the medi%ation& the n$"se sho$ld assess the %lient fo": ##lle"gies to pineapples and bananas @ # histo"y of st"epto%o%%al infe%tions CP"io" the"apy with phenytoin )# histo"y of al%ohol ab$se !he n$"se is p"o/iding dis%ha"ge tea%hing fo" the %lient with le$emia !he %lient sho$ld be told to a/oid: #Using oil= o" %"eam=based soaps @Flossing between the teeth C!he intae of salt )Using an ele%t"i% "a(o" 2+8 !he n$"se is %hang ing the tie s of the %lient with a t"a%heotomy !he safe st method of %hang ing the t"a%heotomy ties is to: ##pply the new tie befo"e "emo/ing the old one @?a/e a helpe" p"esent C ?old the t"a%heotomy with the nondominant hand while "emo/ing the old tie )#s the do%to" to s$t$"e the t"a%heostomy in pla%e 2+ !he n$"se is monito"ing a %lient following a l$ng "ese%tion !he ho$"ly o$tp$t f"om the %hest t$be was +00m' !he n$"se sho$ld gi/e p"io"ity to: #!$"ning the %lient to the left side @

2.1 !he toddle" is admitted with a %a"dia% anomaly !he n$"s e is awa"e that the infan t with a /ent"i%$la" septal defe%t will: #!i"e easily @D"ow no"mally C*eed mo"e %alo"ies )@e mo"e s$s%eptible to /i"al infe%tions 2.2 !he n$"se is monito"ing a %lient with a histo"y of stillbo"n infants !he n$"se is awa"e that a nonst"ess test %an be o"de"ed fo" this %lient to: #)ete"mine l$ng mat$"ity @
#Inst"$%t the %lient to p$sh @Pe"fo"m a /aginal e-am C!$"n off the Pito%in inf$sion )Pla%e the %lient in a semi=Fowle"s position 2.. !he n$"se notes the following on the ,CD monito" !he n$"se wo$ld e/al$ate the %a"dia% a""hythmia as:

##t"ial fl$tte" @# sin$s "hythm C7ent"i%$la" ta%hy%a"dia )#t"ial fib"illation 2. # %lient with %lotting diso"de" has an o"de" to %ontin$e 'o/eno- eno-apa"in inEe%tions afte" dis%ha"ge !he n$"se sho$ld tea%h the %lient that 'o/eno- inEe%tions sho$ld:


#@e inEe%ted into the deltoid m$s%le @@e inEe%ted into the abdomen C#spi"ate afte" the inEe%tion )Clea" the ai" f"om the sy"inge befo"e inEe%tions 2.5 !he n$"se has a p"eop o"de" to administe" 7ali$m dia(epam 10mg and Phene"gan p"ometha(ine 2mg !he %o""e%t method of administe"ing these medi%ations is to: ##dministe" the medi%ations togethe" in one sy"inge @#dministe" the medi%ation sepa"ately C #dministe" the 7ali$m& wait  min$tes& and then inEe%t the Phene"gan )>$estion the o"de" be%a$se they %annot be gi/en at the same time 2.8 # %lient with f"e6$ent $"ina"y t"a%t infe%tions ass the n$"se how she %an p"e/ent the "eo%%$""en%e !he n$"se sho$ld tea%h the %lient to: #)o$%he afte" inte"%o$"se @7oid e/e"y + ho$"s CObtain a $"inalysis monthly )Hipe f"om ba% to f"ont afte" /oiding 2. Hhi%h tas sho$ld be assigned to the n$"sing assistantQ #Pla%ing the %lient in se%l$sion @ ,mptying the Foley %athete" of the p"ee%lampti% %lient CFeeding the %lient with dementia )#mb$lating the %lient with a f"a%t$"ed hip 2.9 !he %lient has "e% ently "et$"ned f"om ha/in g a thy"oide%tomy !he n$"s e sho$ld eep whi% h of the following at the bedsideQ ## t"a%heotomy set @# padded tong$e blade C#n endot"a%heal t$be )#n ai"way 20 !he physi%ian has o"de"ed a histoplasmosis test fo" the elde"ly %lient !he n$"se is awa" e that histoplasmosis is t"ansmitted to h$mans by: #Cats @)ogs C!$"tles )@i"ds


A$s-!rs a$% Rati#$a+!s #r C#6*r!/!$si8! E
1 #nswe" ) is %o""e%t It is impo"tant to assess the e-t"emities fo" blood /essel o%%l$sion in the %lient with si%le %ell anemia be%a$se a %hange in %apilla"y "efill wo$ld indi%ate a %hange in %i"%$lation @ody tempe"at$"e& motion& and sensation wo$ld not gi/e info"mation "ega"ding pe"iphe"al %i"%$lationW the"efo"e& answe"s #& @& and C a"e in%o""e%t 2 #nswe" ) is %o""e%t Pla%ing the %lient in semi=Fowle"Ks position p"o/ides the best o-ygenation fo" this %lient Fle-ion of the hips and nees& whi%h in%l$des the nee=%hest position& impedes %i"%$lation and is not %o""e%t positioning fo" this %lient !he"efo"e& answe"s #& @& and C a"e in%o""e%t + #nswe" @ is %o""e%t It is impo"tant to eep the %lient in si%le %ell %"isis hyd"ated to p"e/ent f$"the" si%ling of the blood #nswe" # is in%o""e%t be%a$se a me%hani%al %$ff pla%es too m$%h p"ess$"e on the a"m #nswe" C is in%o""e%t be%a$se "aising the nee gat%h impedes %i"%$lation #nswe" ) is in%o""e%t be%a$se !ylenol is too mild an analgesi% fo" the %lient in %"isis . #nswe" C is %o""e%t ?yd"ation is impo"tant in the %lien t with si%le %ell disease to p"e/ent th"omb$s fo"mation Popsi%les& gelatin& E$i%e& and p$dding ha/e high fl$id %ontent !he foods in answe"s #& @& and ) do not aid in hyd"ation and a"e& the"efo"e& in%o""e%t  #nswe" C is %o""e%t !he most p"ominent %lini%al manifestation of si%le %ell %"isis is pain ?owe/e"& the p$lse o-imet"y indi%ates that o-ygen le/els a"e lowW th$s& o-ygenation taes p"e%eden%e o/e" pain "elief #nswe" # is in%o""e%t be%a$se altho$gh a wa"m en/i"onment "ed$%es pain and minimi(es si%ling& it wo$ld not be a p"io"ity #nswe" @ is in%o""e%t be%a$se altho$gh hyd"ation is impo"tant& it wo$ld not "e6$i"e a bol$s #nswe" ) is in%o""e%t be%a$se )eme"ol is a%idifying to the blood and in%"eases si%ling 5 #nswe" C is %o""e%t ,gg yols& wheat b"ead& %a""ots& "aisins& and g"een& leafy /egetables a"e all high in i"on& whi%h is an impo"tant mine"al fo" this %lient oast beef& %abbage& and po" %hops a"e also high in i"on& b$t the side dishes a%%ompanying these %hoi%es a"e notW the"efo"e& answe"s #& @& and ) a"e in%o""e%t 8 #nswe" ) is %o""e%t !aing a t"ip to the m$se$m is the only answe" that does not pose a th"eat # family /a%ation in the o%y

1 #nswe" # is %o""e%t !he no"mal platelet %o$nt is 120&000X.00&000 @leeding o%%$"s in %lients with low platelets !he p"io"ity is to p"e/ent and minimi(e bleeding O-ygenation in answe" C is impo"tant& b$t platelets do not %a""y o-ygen #nswe"s @ and ) a"e of lesse" p"io"ity and a"e in%o""e%t in this instan%e 19 #nswe" C is %o""e%t ,le/ating the head of the bed +0R a/oids p"es s$"e on the sella t$"% i%a and alle/iates heada%hes #nswe"s #& @& and ) a"e in%o""e%t be%a$se !"endelenb$"g& 7alsal/a mane$/e"& and %o$ghing all in%"ease the int"a%"anial p"ess$"e 20 #nswe" @ is %o""e%t !he la"ge amo$nt of fl$id loss %an %a$se fl$id and ele%t"olyte imbalan%e that sho$ld be %o""e%ted !he loss of ele%t"olytes wo$ld be "efle%ted in the /ital signs

#nswe" ) is in%o""e%t be%a$se %he%ing fo" pitting edema is less "eliable than meas$"ing with a pape" tape meas$"e + #nswe" ) is %o""e%t Clients with "adi$m implants sho$ld ha/e %lose %onta%t limited to +0 min$tes pe" /isit !he gene"al "$le is limiting time spent e-posed to "adi$m& p$tting distan%e between people and the "adi$m so$"%e& and $sing lead to shield against the "adi$m !ea%hing the family membe" these p"in%iples is e-t"emely impo"tant #nswe"s #& @& and C a"e not empatheti% and do not add"ess the 6$estionW the"efo"e& they a"e in%o""e%t +5 #nswe" @ is %o""e%t !he %lient with a fa%ial st"oe will ha/e diffi %$lty swallowing and %hewing& and the foods in answe" @ p"o/ide the least amo$nt of %hewing !he foods in answe"s #& C& and ) wo$ld "e6$i"e mo"e %hewing and& th$s& a"e in%o""e%t +8 #nswe" # is %o""e%t *o/alog ins$lin onsets /e"y 6$i%ly& so food sho$ld be a/ailable within 10X1 min$tes of taing the ins$lin #nswe" @ does not add"ess a pa"ti%$la" type of ins$lin& so it is in%o""e%t *P? ins$lin peas in X12 ho$"s& so a sna% sho$ld be eaten at the e-pe%ted pea time It may not be + pm as stated in answe" C #nswe" ) is in%o""e%t be%a$se the"e is no need to sa/e the desse"t $ntil bedtime + #nswe" @ is %o""e%t !he $mbili%al %o"d needs time to d"y and fall of f befo"e p$tting the infant in the t$b #ltho$gh answe"s #& C& and ) might be impo"tant& they a"e not the p"ima"y answe" to the 6$estion +9 #nswe" ) is %o""e%t 'e$%o/o"in is the antido te fo"

+ #nswe" @ is %o""e%t # lesion that is painf$l is most liely a he"peti% lesion # %han%"e lesion asso%iated with syphilis is not painf$l& so answe" # is in%o""e%t Condylomata lesions a"e painless wa"ts& so answe" ) is in%o""e%t In answe" C& gono""hea does not p"esent as a lesion& b$t is e-hibited by a yellow dis%ha"ge . #nswe" C is %o""e%t Flo"es%ent t"eponemal antibody F!# is the test fo" t"epone ma pallid$m 7)' and P a"e s%"eening tests done fo" syphilis& so answe"s # and @ a"e in%o""e%t !he !haye"=

p"ima"y "esponsibility fo" the n$"se to en%o$"age the mothe" to %onsent o" e-plain the %onse6$en%es& so answe"s @ and C a"e in%o""e%t 8+ #nswe" @ is %o""e%t !he n$"se sho$ld be most %on%e"ned with la"yngeal edema be%a$se of the a"ea of b$"n !he ne-t p"io"ity sho$ld be answe" #& as well as hyponat"emia and hypoalemia in C and )& b$t these answe"s a"e not of p"ima"y %on%e"n so a"e in%o""e%t 8. #nswe" ) is %o""e%t !he %lient wit h ano"e-ia shows the most imp" o/ement by weight gai n Sele%ting a balan%ed diet does little good if the %lient will not eat& so answe" # is in%o""e%t !he hemato%"it might imp"o/e by se/e"al means& s$%h as blood t"ansf$sion& b$t that does not indi%ate imp"o/ement in the ano"e-i% %onditionW the"efo"e& answe" @ is in%o""e%t !he tiss$e t$"go" indi%ates fl$id stasis& not imp"o/ement of ano"e-ia& so answe" C is in%o""e%t 8 #nswe" ) is %o""e%t #t this time& pain beneath th e %ast is no"mal !he %lie ntKs toes sho$ld be wa"m to the to$%h& and p$lses sho$ld be p"esent Pa"esthesia is not no"mal and might indi%ate %ompa"tment synd"ome !he"efo"e& #nswe"s #& @& and C a"e in%o""e%t 85 #nswe" @ is %o""e%t It is no"mal fo" the %lient to ha/e a wa"m sensation when dye is inEe%ted #nswe"s #& C& and ) indi%ate that the n$"se belie/es that the hot feeling is abno"mal& so they a"e in%o""e%t 88 #nswe" ) is %o""e%t It is not ne%essa "y to wea" glo/es to ta e the /ital sign s of the %lient If the %lien t has a%ti/e infe%tion with methi%illin="esistant staphylo%o%%$s a$"e$s& glo/es sho$ld be wo"n !he health%a"e wo"e"s in answe"s #& @& and C indi%ate nowledge of infe%tion %ont"ol by thei" a%tions 8 #nswe" ) is %o""e%t )$"ing ,C!& the %lient will ha/ e a g"and mal sei(e !his indi%ates %ompletion of the ele%t"o%on/$lsi/e the"apy #nswe"s #& @& and C do not indi%ate that the ,C! has been effe%ti/e& so a"e in%o""e%t 89 #nswe" # is %o""e%t Infe%tion with pinwo"ms begins when the eggs a"e ingested o" inhaled !he eggs hat%h in the $ppe" intestine and mat$"e in 2X wees !he females then mate and mig"ate o$t the an$s& whe"e they lay $p to 18&000 eggs !his %a$ses intense it%hing !he mothe" sho$ld be told to $se a flashlight to e-amine the "e%tal a"ea abo$t 2X+ ho$"s afte" the %hild is asleep Pla%ing %lea" tape on a tong$e blade will allow the eggs to adhe"e to the tape !he spe%imen sho$ld then be b"o$ght in to be e/al$ated !he"e is no need to s%"ap the sin& %olle%t a stool spe%imen& o" b"ing a sample of hai"& so answe"s @& C& and ) a"e in%o""e%t 0 #nswe" @ is %o""e%t ,"te"obiasis& o" pinwo"ms& is t"eated with 7e"mo- meben da(ole o" #ntiminth py"antel pamoate !he enti"e family sho$ld be t"eated to ens$"e that no eggs "emain @e%a$se a single t"eatment is $s$ally s$ffi%ient& the"e is $s$ally good %omplian%e !he family sho$ld then be tested again in 2 wees to ens$"e that no eggs "emain #nswe"s #& C& and ) a"e in%o""e%t statements 1 #nswe" # is %o""e%t !he p"egnant n$"se sho$ld not be assigned to any %lient with "adioa%ti/ity p"esent !he %lient "e%ei/ing linea" a%%ele"ato" the"apy t"a/els to the "adi$m depa"tment fo" the"apy !he "adiation stays in the depa"tment& so the %lient is not "adioa%ti/e !he %lients in answe"s @& C& and ) pose a "is to the p"egnant n$"se !hese %lients a"e "adioa%ti/e in /e"y small doses& espe%ially $pon "et$"ning f"om the p"o%ed$"es Fo" app"o-imately 82 ho$"s& the %lients sho$ld dispose of $"ine and fe%es in spe%ial %ontaine"s and $se plasti% spoons and fo"s 2 #nswe" # is %o""e%t !he %lient with C$shingKs disease has ad"eno %o"ti%al hype"se%"etion !his in%"ease in the le/el of %o"tisone %a$ses the %lient to be imm$ne s$pp"essed In answe" @& the %lient with diabetes poses no "is to othe" %lients !he %lient in answe" C has an in%"ease in g"owth ho"mone and poses no "is to himself o" othe"s !he %lient in answe" ) has hype"thy"oidism o" my-edema and poses no "is to othe"s o" himself + #nswe" ) is %o""e%t !he n$"se %o$ld be %ha"ged with malp"a%ti%e& whi%h is failing to pe"fo"m& o" pe"fo"ming an a%t that %a$ses ha"m to the %lient Di/ing the infant an o/e"dose falls into this %atego"y #nswe"s #& @& and C a"e in%o""e%t be%a$se they apply to othe" w"ongf$l a%ts *egligen%e is failing to pe"fo"m %a"e fo" the %lientW a to"t is a w"ongf$l a%t %ommitted on the %lient o" thei" belongingsW and assa$lt is a /iolent physi%al o" /e"bal atta% . #nswe" ) is %o""e%t !he li%ensed p"a%ti%al n$"se sho$ld not be assigned to begin a blood t"ansf$sion !he li%ensed p"a%ti%al n$"se %an inse"t a Foley %athete"& dis%ontin$e a nasogast"i% t$be& and %olle%t sp$t$m spe%imenW the"efo"e& answe"s #& @& and C a"e in%o""e%t  #nswe" @ is %o""e%t !he /ita l signs a"e abno" mal and sho$ld be "epo"ted immediately Cont in$ing to monito" the /ital signs %an "es$lt in dete"io"ation of the %lientKs %ondition& maing answe" # in%o""e%t #sing the %lient how he feels in answe" C will only p"o/ide s$bEe%ti/e data& and the n$"se in answe" ) is not the best n$"se to assign be%a$se this %lient is $nstable 5 #nswe" @ is %o""e%t !he n$"s e with + yea"s of e-pe"ien%e in labo" and deli /e"y nows the most abo$ t possible %ompli%ations in/ol/ing p"ee%lampsia !he n$"se in answe" # is a new n$"se to the $nit& and the n$"ses in answe"s C and ) ha/e no e-pe"ien%e with the postpa"t$m %lient 8 #nswe" @ is %o""e%t !he Boint Commission on #%%"editation of ?ospitals will p"obably be inte" ested in the p"oblems in answe"s # and C !he fail$"e of the n$"sing assistant to %a"e fo" the %lient with hepatitis might "es$lt in te"mination& b$t is not of inte"est to the Boint Commission  #nswe" @ is %o""e%t !he ne-t a%tion afte" dis%$ssing the p"oblem with the n$"se is to do%$ment the in%ident by filing a fo"mal "ep"imand If the beha/io" %ontin$es o" if ha"m has "es$lted to the %lient& the n$"se may be te"minated and "epo"ted to the @oa"d of *$"sing& b$t these a"e not the fi"st a%tions "e6$ested in the stem # to"t is a w"ongf$l a%t to the %lient o" his belongings and is not indi%ated in this instan%e !he"efo"e& #nswe"s #& C& and ) a"e in%o""e%t


9 #nswe" ) is %o""e%t !he %lient at highest "is fo" %ompli %ations is the %lient with m$lt iple s%le"osis who is being t"eated with %o"tisone /ia the %ent"al line !he othe"s a"e mo"e stable <S# is methi%illin="esistant staphylo%o%%$s a$"e$s 7an%omy%in is the d"$g of %hoi%e and is gi/en at s%hed$led times to maintain blood le/els of the d"$g !he %lients in answe"s #& @& and C a"e mo"e stable and %an be seen late" 90 #nswe" @ is %o""e%t !he p"egnant %lien t and the %lient with a b"oen a"m and fa%ial la%e"at ions a"e the best %hoi%es fo" pla%ing in the same "oom !he %lients in answe"s #& C& and ) need to be pla%ed in sepa"ate "ooms d$e to the se"io$s nat$"es of thei" inE$"ies 91 #nswe" # is %o""e%t @efo"e instilling eyed"ops& the n$"se sho$l d %leanse the a"ea with wat e" # 5=yea"=ol d %hild is not de/elopmentally "eady to instill his own eyed"ops& so answe" @ is in%o""e%t #ltho$gh the mothe" of the %hild %an instill the eyed"ops& the a"ea m$st be %leansed befo"e administ"ation& maing answe" C in%o""e%t #ltho$gh the eye might appea" to be %lea"& the n$"se sho$ld instill the eyed"ops& as o"de"ed& so answe" ) is in%o""e%t 92 #nswe" C is %o""e%t ememb e" the #@Cs ai"way& b"eathing& %i"%$lation when answe"i ng this 6$estion #nswe" C is %o""e%t be%a$se a hotdog is the si(e and shape of the %hildKs t"a%hea and poses a "is of aspi"ation #nswe"s #& @& and C a"e in%o""e%t be%a$se white g"ape E$i%e& a g"illed %heese sandwi%h& and i%e %"eam do not pose a "is of aspi"ation fo" a %hild 9+ #nswe" C is %o""e%t !he n$"se sho$ld en%o$"age "ooming=in to p"omote pa"ent=%hild atta%hment It is oay fo" the pa"ents to be in the "oom fo" assessment of the %hild #llowing the %hild to ha/e items that a"e familia" to him is allowed and en%o$"agedW the"efo"e& answe"s # and @ a"e in%o""e%t #nswe" ) is not pa"t of the n$"seKs "esponsibilities 9. #nswe" @ is %o""e%t !he hea"ing aid sho$ ld be sto"ed in a wa"m& d"y pla%e It sho$ld be %lean ed daily b$t sho$ld not be moldy& so answe" # is in%o""e%t # toothpi% is inapp"op"iate to $se to %lean the aidW the toothpi% might b"ea off in the hea"ing aide& maing answe" C in%o""e%t Changing the batte"ies weely& as in answe" )& is not ne%essa"y 9 #nswe" C is %o""e%t #lways "ememb e" yo$" #@Cs ai"way& b"eathing& %i"%$lation when sele%ting an answe" #ltho$gh answe"s @ and ) might be app"op"iate fo" this %hild& answe" C sho$ld ha/e the highest p"io"ity #nswe" # does not apply fo" a %hild who has $nde"gone a tonsille%tomy 95 #nswe" # is %o""e %t If the %hil d has ba%t e"ial pne$m onia& a high fe/e" is $s$ally p"esen t @a%te"ial pne$monia $s$ally p"esents with a p"od$%ti/e %o$gh& not a nonp"od$%ti/e %o$gh& maing answe" @ in%o""e%t hinitis is often seen with /i"al pne$monia& and /omiting and dia""hea a"e $s$ally not seen with pne$monia& so answe"s C and ) a"e in%o""e%t 98 #nswe" @ is %o""e%t Fo" a %hild with epiglo ttis and the possib ility of %omplete obst"$%tion of the ai"way & eme"gen%y t"a%heostomy e6$ipment sho$ld always be ept at the bedside Int"a/eno$s s$pplies& fl$id& and o-ygen will not t"eat an obst"$%tionW the"efo"e& answe"s #& C& and ) a"e in%o""e%t 9 #nswe" C is %o""e%t ,-oph thalmos p"ot"$sion of eyeballs often o%%$"s with hype "thy"oidism !he %lient with hype"thy"oidism will often e-hibit ta%hy%a"dia& in%"eased appetite& and weight lossW the"efo"e& answe"s #& @& and ) a"e in%o""e%t 99 #nswe" ) is %o""e%t !he %hi ld with %elia% disease sho$ld be on a gl$t en=f"ee diet #nswe"s #& @& and C all %ontain gl$ten& while answe" ) gi/es the only %hoi%e of foods that does not %ontain gl$ten 100#nswe" C is %o""e%t emembe" the #@Cs ai"way& b"eathing& %i"%$lation when answe"ing this 6$estion @efo"e notifying the physi%ian o" assessing the p$lse& o-ygen sho$ld be applied to in%"ease the o-ygen sat$"ation& so answe"s # and ) a"e in%o""e%t !he no"mal o-ygen sat$"ation fo" a %hild is 92VX100V& maing answe" @ in%o""e%t 101#nswe" @ is %o""e%t #n amniotomy is an a"tifi%ial "$pt$"e of memb"anes and no"mal amnioti% fl$id is st"aw= %olo"ed and odo"less Fetal hea"t tones of 150 indi%ate ta%hy%a"dia& and g"eenish fl$id is indi%ati/e of me%oni$m& so answe"s # and C a"e in%o""e%t If the n$"se notes the $mbili%al %o"d& the %lient is e-pe"ien%ing a p"olapsed %o"d& so answe" ) is in%o""e%t and wo$ld need to be "epo"ted immediately 102#nswe" ) is %o""e%t )ilation of 2%m ma"s the end of the latent phase of labo" #nswe" # is a /ag$e answe"& answe" @ indi%ates the end of the fi"st stage of labo"& and answe" C indi%ates the t"ansition phase 10+#nswe" @ is %o""e%t !he no"mal fetal hea"t "ate is 120X150bpmW 100X110bpm is b"ady%a"dia !he fi"st a%tion wo$ld be to t$"n the %lient to the left side and apply o-ygen #nswe" # is not indi%ated at this time #nswe" C is not the best a%tion fo" %lients e-pe"ien%ing b"ady%a"dia !he"e is no data to indi%ate the need to mo/e the %lient to the deli/e"y "oom at this time 10.#nswe" ) is %o""e%t !he e-pe%ted effe%t of Pito%in is %e"/i%al dilation Pito%in %a$ses mo"e intense %ont"a%tions& whi%h %an in%"ease the pain& maing answe" # in%o""e%t Ce"/i%al effa%ement is %a$sed by p"ess$"e on the p"esenting pa"t& so answe" @ is in%o""e%t #nswe" C is opposite the a%tion of Pito%in 10#nswe" @ is %o""e%t #pplying a fetal hea"t monito" is the %o""e%t a%tion at this time !he"e is no need to p"epa"e fo" a Caesa"ean se%tion o" to pla%e the %lient in Den$ Pe%to"al position nee=%hest& so answe"s # and C a"e in%o""e%t #nswe" ) is in%o""e%t be%a$se the"e is no need fo" an $lt"aso$nd based on the finding 105#nswe" @ is %o""e%t !he n$"se de%ides to apply an e-te"nal monito" be%a$se the memb"anes a"e inta%t #nswe"s #& C& and ) a"e in%o""e%t !he %e"/i- is dilated eno$gh to $se an inte"nal monito"& if ne%essa"y #n inte"nal monito" %an be applied if the %lient is at 0=station Cont"a%tion intensity has no bea"ing on the appli%ation of the fetal monito" 108#nswe" ) is %o""e%t Clients admitted in labo" a"e told not to eat d$"ing labo"& to a/oid na$sea and /omiting I%e %hips may be allowed& b$t this amo$nt of fl$id might not be s$ffi%ient to p"e/ent fl$id /ol$me defi%it In


answe" #& impai"ed gas e-%hange "elated to hype"/entilation wo$ld be indi%ated d$"ing the t"ansition phase #nswe"s @ and C a"e not %o""e%t in "elation to the stem 10#nswe" ) is %o""e%t !his info"mation indi%ates a late de%ele"ation !his type of de%ele"ation is %a$sed by $te"opla%ental la% of o-ygen #nswe" # has no "elation to the "eadings& so itKs in%o""e%tW answe" @ "es$lts in a /a"iable de%ele"ationW and answe" C is indi%ati/e of an ea"ly de%ele"ation 109#nswe" C is %o""e%t !he initial a%tion by the n$"se obse"/ing a late de%ele"ation sho$ld t$"n the %lient to the sideYp"efe"ably& the left side #dministe"ing o-ygen is also indi%ated #nswe" # might be ne%essa"y b$t not befo"e t$"ning the %lient to he" side #nswe" @ is not ne%essa"y at this time #nswe" ) is in%o""e%t be%a$se the"e is no data to indi%ate that the monito" has been applied in%o""e%tly 110#nswe" ) is %o""e%t #%%ele"ations with mo/ement a"e no"mal #nswe"s #& @& and C indi%ate omino$s findings on the fetal hea"t monito" 111#nswe" C is %o""e%t ,pid$"al anest hesia de%"eases the $"ge to /oid and sensation of a f$ll bladde" # f$ll bladde" will de%"ease the p"og"ession of labo" #nswe"s #& @& and ) a"e in%o""e%t fo" the stem 112#nswe" @ is %o""e%t '$teni(ing ho"mone "eleased by the pit$ita"y is "esponsible fo" o/$lation #t abo$t day 1.& the %ontin$ed in%"ease in est"ogen stim$lates the "elease of l$teni(ing ho"mone f"om the ante"io" pit$ita"y !he '? s$"ge is "esponsible fo" o/$lation& o" the "elease of the dominant folli%le in p"epa"ation fo" %on%eption& whi%h o%%$"s within the ne-t 10X12 ho$"s afte" the '? le/els pea #nswe"s #& C& and ) a"e in%o""e%t be%a$se est"ogen le/els a"e high at the beginning of o/$lation& the endomet"ial lining is thi%& not thin& and the p"ogeste"one le/els a"e high& not low 11+#nswe" C is %o""e%t !he s$%%ess of the "hythm method of bi"th %ont"ol is dependent on the %lientKs menses being "eg$la" It is not dependent on the age of the %lient& f"e6$en%y of inte"%o$"se& o" "ange of the %lientKs tempe"at$"eW the"efo"e& answe"s #& @& and ) a"e in%o""e%t 11.#nswe" C is %o""e%t !he best method of bi"th %ont"ol fo" the %lient with diabetes is the diaph"agm # pe"manent int"a$te"ine de/i%e %an %a$se a %ontin$ing inflammato"y "esponse in diabeti%s that sho$ld be a/oided& o"al %ont"a%epti/es tend to ele/ate blood gl$%ose le/els& and %ont"a%epti/e sponges a"e not good at p"e/enting p"egnan%y !he"efo"e& answe"s #& @& and ) a"e in%o""e%t 11#nswe" ) is %o""e%t !he signs of an e%topi% p"egnan%y a"e /ag$e $ntil the fallopian t$be "$pt$"es !he %lient will %omplain of s$dden& stabbing pain in the lowe" 6$ad"ant that "adiates down the leg o" $p into the %hest Painless /aginal bleeding is a sign of pla%enta p"e/ia& abdominal %"amping is a sign of labo"& and th"obbing pain in the $ppe" 6$ad"ant is not a sign of an e%topi% p"egnan%y& maing answe"s #& @& and C in%o""e%t 115#nswe" C is %o""e%t #ll of the %hoi%es a"e tasty& b$t the p"egnant %lient needs a diet that is balan%ed and has in%"eased amo$nts of %al%i$m #nswe" # is la%ing in f"$its and mil #nswe" @ %ontains the potato %hips& whi%h %ontain a la"ge amo$nt of sodi$m #nswe" C %ontains meat& f"$it& potato salad& and yog$"t& whi%h has abo$t +50mg of %al%i$m #nswe" ) is not the best diet be%a$se it la%s /egetables and mil p"od$%ts 118#nswe" @ is %o""e%t !he %lient with hype"emesis has pe"sistent na$sea and /omiting Hith /omiting %omes dehyd"ation Hhen the %lient is dehyd"ated& she will ha/e metaboli% a%idosis #nswe"s # and C a"e in%o""e%t be%a$se they a"e "espi"ato"y dehyd"ation #nswe" ) is in%o""e%t be%a$se the %lient will not be in alalosis with pe"sistent /omiting 11#nswe" @ is %o""e%t !he most definiti/e diagnosis of p"egnan%y is the p"esen%e of fetal hea"t tones !he signs in answe"s #& C& and ) a"e s$bEe%ti/e and might be "elated to othe" medi%al %onditions #nswe"s # and C may be "elated to a hydatidifo"m mole& and answe" ) is often p"esent befo"e menses o" with the $se of o"al %ont"a%epti/es 119#nswe" C is %o""e%t !he infant of a diabeti% mothe" is $s$ally la"ge fo" gestational age #fte" bi"th& gl$%ose le/els fall "apidly d$e to the absen%e of gl$%ose f"om the mothe" #nswe" # is in%o""e%t be%a$se the infant will not be small fo" gestational age #nswe" @ is in%o""e%t be%a$se the infant will not be hype"gly%emi% #nswe" ) is in%o""e%t be%a$se the infant will be la"ge& not small& and will be hypogly%emi%& not hype"gly%emi% 120#nswe" @ is %o""e%t Hhen the %lient is taing o"al %ont"a%epti/es and begins antibioti%s& anothe" method of bi"th %ont"ol sho$ld be $sed #ntibioti%s de%"ease the effe%ti/eness of o"al %ont"a%epti/es #pp"o-imately X10 po$nds of weight gain is not $n$s$al& so answe" # is in%o""e%t If the %lient misses a bi"th %ont"ol pill& she sho$ld be inst"$%ted to tae the pill as soon as she "emembe"s the pill #nswe" C is in%o""e%t If she misses two& she sho$ld tae twoW if she misses mo"e than two& she sho$ld tae the missed pills b$t $se anothe" method of bi"th %ont"ol fo" the "emainde" of the %y%le #nswe" ) is in%o""e%t be%a$se %hanges in menst"$al flow a"e e-pe%ted in %lients $sing o"al %ont"a%epti/es Often these %lients ha/e lighte" menses 121#nswe" @ is %o""e%t Clients with ?I7 sho$ld not b"eastfeed be%a$se the infe%tion %an be t"ansmitted to the baby th"o$gh b"east mil !he %lients in answe"s #& C& and )Ythose with diabetes& hype"tension& and thy"oid diseaseY%an be allowed to b"eastfeed 122#nswe" # is %o""e%t !he symptoms of painless /aginal bleed ing a"e %onsistent with pla%enta p"e/ia #nswe"s @& C& and ) a"e in%o""e%t Ce"/i%al %he% fo" dilation is %ont"aindi%ated be%a$se this %an in%"ease the bleeding Che%ing fo" fi"mness of the $te"$s %an be done& b$t the fi"st a%tion sho$ld be to %he% the fetal hea"t tones # detailed histo"y %an be done late" 12+#nswe" ) is %o""e%t !he %lient sho$ld be ad/ised to %ome to the labo" and deli/e"y $nit when the %ont"a%tions a"e e/e"y  min$tes and %onsistent She sho$ld also be told to "epo"t to the hospital if she e-pe"ien%es "$pt$"e of memb"anes o" e-t"eme bleeding She sho$ld not wait $ntil the %ont"a%tions a"e e/e"y 2 min$tes o" $ntil she has bloody dis%ha"ge& so answe"s # and @ a"e in%o""e%t #nswe" C is a /ag$e answe" and %an be "elated to a $"ina"y t"a%t infe%tion


12.#nswe" # is %o""e%t Infants of mothe"s who smoe a"e often low in bi"th weight Infants who a"e la"ge fo" gestational age a"e asso%iated with diabeti% mothe"s& so answe" @ is in%o""e%t P"ete"m bi"ths a"e asso%iated with smoing& b$t not with app"op"iate si(e fo" gestation& maing answe" C in%o""e%t D"owth "eta"dation is asso%iated with smoing& b$t this does not affe%t the infant lengthW the"efo"e& answe" ) is in%o""e%t 12#nswe" # is %o""e%t !o p"o/ide p"ote%tion against antibody p"od$%tion& hoDam sho$ld be gi/en within 82 ho$"s !he answe"s in @& C& and ) a"e too late to p"o/ide antibody p"ote%tion hoDam %an also be gi/en d$"ing p"egnan%y 125#nswe" @ is %o""e%t Hhen the memb"anes "$pt$"e& the"e is often a t"ansient d"op in the fetal hea"t tones !he hea"t tones sho$ld "et$"n to baseline 6$i%ly #ny alte"ation in fetal hea"t tones& s$%h as b"ady%a"dia o" ta%hy%a"dia& sho$ld be "epo"ted #fte" the fetal hea"t tones a"e assessed& the n$"se sho$ld e/al$ate the %e"/i%al dilation& /ital signs& and le/el of dis%omfo"t& maing answe"s #& C& and ) in%o""e%t 128#nswe" # is %o""e%t !he a%ti/e phase of labo" o%%$"s when the %lient is dilated .X8%m !he latent o" ea"ly phase of labo" is f"om 1%m to +%m in dilation& so answe"s @ and ) a"e in%o""e%t !he t"ansition phase of labo" is X10%m in dilation& maing answe" C in%o""e%t 12#nswe" @ is %o""e%t !he infant of an addi%ted mothe" will $nde"go withd"awal Sn$gly w"apping the infant in a blanet will help p"e/ent the m$s%le i""itability that these babies often e-pe"ien%e !ea%hing the mothe" to p"o/ide ta%tile stim$lation o" p"o/ide fo" ea"ly infant stim$lation a"e in%o""e%t be%a$se he is i""itable and needs 6$iet and little stim$lation at this time& so answe"s # and ) a"e in%o""e%t Pla%ing the infant in an infant seat in answe" C is in%o""e%t be%a$se this will also %a$se mo/ement that %an in%"ease m$s%le i""itability 129#nswe" C is %o""e%t Following epid$"al anesthesia& the %lient sho$ld be %he%ed fo" hypotension and signs of sho% e/e"y  min$tes fo" 1 min$tes !he %lient %an be %he%ed fo" %e"/i%al dilation late" afte" she is stable !he %lient sho$ld not be positioned s$pine be%a$se the anesthesia %an mo/e abo/e the "espi"ato"y %ente" and the %lient %an stop b"eathing Fetal hea"t tones sho$ld be assessed afte" the blood p"ess$"e is %he%ed !he"efo"e& answe"s #& @& and ) a"e in%o""e%t 1+0#nswe" @ is %o""e%t !he best way to p"e/ent post=ope"ati/e wo$nd infe%tion is hand washing Use of p"es%"ibed antibioti%s will t"eat infe%tion& not p"e/ent infe%tions& maing answe" # in%o""e%t Hea"ing a mas and asing the %lient to %o/e" he" mo$th a"e good p"a%ti%es b$t will not p"e/ent wo$nd infe%tionsW the"efo"e& answe"s C and ) a"e in%o""e%t 1+1#nswe" @ is %o""e%t !he %lient with a hip f"a%t$"e will most liely ha/e disalignment #nswe"s #& C& and ) a"e in%o""e%t be%a$se all f"a%t$"es %a$se pain& and %oolness of the e-t"emities and absen%e of p$lses a"e indi%ati/e of %ompa"tment synd"ome o" pe"iphe"al /as%$la" disease 1+2#nswe" @ is %o""e%t #fte" menopa$se& women la% ho"mones ne%essa"y to abso"b and $tili(e %al%i$m )oing weight=bea"ing e-e"%ises and taing %al%i$m s$pplements %an help to p"e/ent osteopo"osis b$t a"e not %a$ses& so answe"s # and C a"e in%o""e%t @ody types that f"e6$ently e-pe"ien%e osteopo"osis a"e thin Ca$%asian females& b$t they a"e not most liely "elated to osteopo"osis& so answe" ) is in%o""e%t 1++#nswe" @ is %o""e%t !he infantKs hips sho$ld be off the bed app"o-imately 1R in @"yantKs t"a%tion #nswe" # is in%o""e%t be%a$se this does not indi%ate that the t"a%tion is wo"ing %o""e%tly& no" does C #nswe" ) is in%o""e%t be%a$se @"yantKs t"a%tion is a sin t"a%tion& not a seletal t"a%tion 1+.#nswe" # is %o""e%t @alan%ed seletal t"a%tion $ses pins and s%"ews # Steinman pin goes th"o$gh la"ge bones and is $sed to stabili(e la"ge bones s$%h as the fem$" #nswe" @ is in%o""e%t be%a$se only the affe%ted leg is in t"a%tion i"s%hne" wi"es a"e $sed to stabili(e small bones s$%h as finge"s and toes& as in answe" C #nswe" ) is in%o""e%t be%a$se this type of t"a%tion is not $sed fo" f"a%t$"ed hips 1+#nswe" # is %o""e%t @leeding is a %ommon %ompli%ation of o"thopedi% s$"ge"y !he blood=%olle%tion de/i%e sho$ld be %he%ed f"e6$ently to ens$"e that the %lient is not hemo""haging !he %lientKs pain sho$ld be assessed& b$t this is not life=th"eatening Hhen the %lient is in less dange"& the n$t"itional stat$s sho$ld be assessed and an immobili(e" is not $sedW th$s& answe"s @& C& and ) a"e in%o""e%t 1+5#nswe" # is %o""e%t !he %lientKs family membe" sho$ld be ta$ght to fl$sh the t$be afte" ea%h feeding and %lamp the t$be !he pla%ement sho$ld be %he%ed befo"e feedings& and indigestion %an o%%$" with the P,D t$be& E$st as it %an o%%$" with any %lient& so answe"s @ and C a"e in%o""e%t

1+9#nswe" # is %o""e%t !he e6$ipment that %an help with a%ti/ities of daily li/ing is the high=seat %ommode !he hip sho$ld be ept highe" than the nee !he "e%line" is good be%a$se it p"e/ents 90R fle-ion b$t not daily a%ti/ities # !,*S !"ans%$taneo$s ,le%t"i%al *e"/e Stim$lation $nit helps with pain management and an abd$%tion pillow is $sed to p"e/ent add$%tion of the hip and possibly dislo%ation of the p"osthesisW the"efo"e& answe"s @& C& and ) a"e in%o""e%t 1.0#nswe" @ is %o""e%t *a"%an is the antidote fo" na"%oti% o/e"dose If hypo-ia o%%$"s& the %lient sho$ld ha/e o-ygen administe"ed by mas& not %ann$la !he"e is no data to s$ppo"t the administ"ation of blood p"od$%ts o" %a"dio"es$s%itation& so answe"s #& C& and ) a"e in%o""e%t 1.1#nswe" @ is %o""e%t !he 5=yea"=old sho$ld ha/e a "oommate as %lose to the same age as possible& so the 12= yea"=old is the best mat%h !he 10=yea"=old with sa"%oma has %an%e" and will be t"eated with %hemothe"apy that maes him imm$ne s$pp"essed& the 5=yea"=old with osteomylitis is infe%ted& and the %lient in answe" # is too old and is femaleW the"efo"e& answe"s #& C& and ) a"e in%o""e%t 1.2#nswe" @ is %o""e%t Co- II inhibito"s ha/e been asso%iated with hea"t atta%s and st"oes #ny %hanges in %a"dia% stat$s o" signs of a st"oe sho$ld be "epo"ted immediately& along with any %hanges in bowel o" bladde" habits be%a$se bleeding has been lined to $se of Co- II inhibito"s !he %lient does not ha/e to tae the medi%ation with mil& "emain $p"ight& o" allow 5 wees fo" optimal effe%t& so answe"s #& C& and ) a"e in%o""e%t 1.+#nswe" ) is %o""e%t # plaste"=of=Pa"is %ast taes 2. ho$"s to d"y& and the %lient sho$ld not bea" weight fo" 2. ho$"s !he %ast sho$ld be handled with the palms& not the finge"tips& so answe" # is in%o""e%t Petaling a %ast is %o/e"ing the end of the %ast with %ast batting o" a so%& to p"e/ent sin i""itation and flaing of the sin $nde" the %ast& maing answe" @ in%o""e%t !he %lient sho$ld be told not to d"y the %ast with a hai" d"ye" be%a$se this %a$ses hot spots and %o$ld b$"n the %lient !his also %a$ses $ne6$al d"yingW th$s& answe" C is in%o""e%t 1..#nswe" # is %o""e%t !he"e is no "eason that the %lientKs f"iends sho$ld not be allowed to a$tog"aph the %astW it will not ha"m the %ast in any way& so answe"s @& C& and ) a"e in%o""e%t 1.#nswe" # is %o""e%t !he n$"se is pe"fo"ming the pin %a"e %o""e%tly when she $ses ste"ile glo/es and >=tips # li%ensed p"a%ti%al n$"se %an pe"fo"m pin %a"e& the"e is no need to %lean the weights& and the n$"se %an help with opening the pa%ages b$t it isnKt "e6$i"edW the"efo"e& answe"s @& C& and ) a"e in%o""e%t 1.5#nswe" # is %o""e%t # body %ast o" spi%a %ast e-tends f"om the $ppe" abdomen to the nees o" below @owel so$nds sho$ld be %he%ed to ens$"e that the %lient is not e-pe"ien%ing a pa"alyti% ille$s Che%ing the blood p"ess$"e is a t"eatment fo" any %lient& offe"ing pain medi%ation is not %alled fo"& and %he%ing fo" swelling isnKt spe%ifi% to the stem& so answe"s @& C& and ) a"e in%o""e%t 1.8#nswe" C is %o""e%t ?alo t"a%tion will be o"de"ed fo" the %lient with a %e"/i%al f"a%t$"e $ssellKs t"a%tion is $sed fo" bones of the lowe" e-t"emities& as is @$%Ks t"a%tion C"$%hfield tongs a"e $sed while in the hospital and the %lient is immobileW the"efo"e& answe"s #& @& and ) a"e in%o""e%t 1.#nswe" @ is %o""e%t !he %ont"olle" fo" the %ontin$o$s passi/e=motion de/i%e sho$ld be pla%ed away f"om the %lient

1#nswe" @ is %o""e%t !he %lient "e%ei/ing Pito%in sho$ld be monito"ed fo" de%ele"ations !he"e is no asso%iation with Pito%in $se and hypogly%emia& mate"nal hype""efle-ia& o" fetal mo/ementW the"efo"e& answe"s #& C& and ) a"e in%o""e%t 15#nswe" ) is %o""e%t Fetal de/elopment depends on ade6$ate n$t"ition and ins$lin "eg$lation Ins$lin needs in%"ease d$"ing the se%ond and thi"d t"imeste"s& ins$lin "e6$i"ements do not mode"ate as the p"egnan%y p"og"esses& and ele/ated h$man %ho"ioni% gonadot"ophin ele/ates ins$lin needs& not de%"eases themW the"efo"e& answe"s #& @& and C a"e in%o""e%t 18#nswe" # is %o""e%t # %alm en/i"onment is needed to p"e/ent sei($"e a%ti/ity #ny stim$ lation %an p"e%ipitate sei($"es Obtaining a diet histo"y sho$ld be done late"& and administe"ing an analgesi% is not indi%ated be%a$se the"e is no data in the stem to indi%ate pain !he"efo"e& answe"s @ and C a"e in%o""e%t #ssessing the fetal hea"t tones is impo"tant& b$t this is not the highest p"io"ity in this sit$ation as stated in answe" ) 1#nswe" # is %o""e%t !he %lient who is age .2 is at "is fo" fetal anomalies s$%h as )own synd"ome and othe" %h"omosomal abe""ations #nswe"s @& C& and ) a"e in%o""e%t be%a$se the %lient is not at highe" "is fo" "espi"ato"y dist"ess synd"ome o" pathologi%al Ea$ndi%e& and !$"ne"Ks synd"ome is a geneti% diso"de" 19#nswe" C is %o""e%t !he %lient with a missed abo"tion will ha/e ind$%tion of labo" P"ostin , is a fo"m of p"ostaglandin $sed to soften the %e"/i-

182#nswe" @ is %o""e%t Clients with %hest pain %an be t"eated with nit"ogly%e"in& a beta blo%e" s$%h as p"opanolol& o" 7a"apamil !he"e is no indi%ation fo" an antibioti% s$%h as #mpi%illin& so answe"s #& C& and ) a"e in%o""e%t 18+#nswe" @ is %o""e%t #nti=inflammato"y d"$gs sho$ld be taen with meals to a/oid stoma%h $pset #nswe"s #& C& and ) a"e in%o""e%t Clients with "he$matoid a"th"itis sho$ld e-e"%ise& b$t not to the point of pain #lte"nating hot and %old is not ne%essa"y& espe%ially be%a$se wa"m& moist soas a"e mo"e $sef$l in de%"easing pain Height=bea"ing a%ti/ities s$%h as waling a"e $sef$l b$t is not the best answe" fo" the stem 18.#nswe" ) is %o""e%t

antibioti%s a"e $sed with this test and the %lient sho$ld "emain still only when inst"$%ted& so answe"s C and ) a"e not spe%ifi% to this test 190#nswe" ) is %o""e%t Clients taing #mphote"i%in @ sho$ld be monito"ed fo" li/e"& "enal& and bone ma""ow f$n%tion be%a$se this d"$g is to-i% to the idneys and li/e"& and %a$ses bone ma""ow s$pp"ession Ba$ndi%e is a sign of li/e" to-i%ity and is not spe%ifi% to the $se of #mphote"i%in @ Changes in /ision a"e not "elated& and na$sea is a side effe%t& not a sign of to-i%ityW no" is $"ina"y f"e6$en%y !h$s& answe"s #& @& and C a"e in%o""e%t 191#nswe" C is %o""e%t !he %lient with %hest pain sho$ld be seen fi"st be%a$se this %o$ld indi%ate a myo%a"dial infa"%tion !he %lient in answe" # has a blood gl$%ose within no"mal limits !he %lient in answe" @ is maintained on blood p"ess$"e medi%ation !he %lient in answe" ) is in no dist"ess 192#nswe" @ is %o""e%t Pan%"eati% en(ymes sho$ld be gi/en with meals fo" optimal effe%ts !hese en(ymes assist the body in digesting needed n$t"ients #nswe"s #& C& and ) a"e in%o""e%t methods of administe"ing pan%"eati% en(ymes 19+#nswe" C is %o""e%t !he lens allows light to pass th"o$gh the p$pil and fo%$s light on the "etina !he lens does not stim$late the "etina& assist with eye mo/ement& o" magnify small obEe%ts& so answe"s #& @& and ) a"e in%o""e%t 19.#nswe" C is %o""e%t

209#nswe" @ is %o""e%t !he %lient with a p"otoepisiotomy will need stool softene"s s$%h as do%$sate sodi$m S$pposito"ies a"e gi/en only with an o"de" f"om the do%to"&

228#nswe" ) is %o""e%t ?emodialysis wo"s by $sing a dialy(ing memb" ane to filte" waste that has a%%$m$lated in the blood It does not pass wate" th"o$gh a dialy(ing memb"ane no" does it eliminate plasma p"oteins o" lowe" the p?& so answe"s #& @& and C a"e in%o""e%t 22#nswe" @ is %o""e%t !he %lient who is imm$ne=s$pp"essed and is e-posed to measles sho$ld be t"eated with medi%ations to boost his imm$nity to the /i"$s #n antibioti% o" anti/i"al will not p"ote%t the %lient and it is too late to pla%e the %lient in isolation& so answe"s #& C& and ) a"e in%o""e%t 229#nswe" ) is %o""e%t !he %lient with <S# sho$ld be pla%ed in isolation Dlo/es& a gown& and a mas sho$ld be $sed when %a"ing fo" the %lient and hand washing is /e"y impo"tant !he doo" sho$ld "emain %losed& b$t a negati/e=p"ess$"e "oom is not ne%essa"y& so answe"s # and @ a"e in%o""e%t <S# is sp"ead by %onta%t with blood o" body fl$id o" by to$%hing the sin of the %lient It is %$lt$"ed f"om the nasal passages of the %lient& so the %lient sho$ld be inst"$%ted to %o/e" his nose and mo$th when he snee(es o" %o$ghs It is not ne%essa"y fo" the %lient to wea" the mas at all timesW the n$"se sho$ld wea" the mas& so answe" C is in%o""e%t 2+0#nswe" @ is %o""e%t Pain "elated to phantom limb synd"ome is d$e to pe"iphe"al ne"/o$s system inte""$ption #nswe" # is in%o""e%t be%a$se phantom limb pain %an last se/e"al months o" indefinitely #nswe" C is in%o""e%t be%a$se it is not psy%hologi%al It is also not d$e to infe%tions& as stated in answe" ) 2+1#nswe" # is %o""e%t )$"ing a Hhipple p"o%ed$"e the head of the pan%"eas& whi%h is a pa"t of the stoma%h& the EeE$n$m& and a po"tion of the stoma%h a"e "emo/ed and "eanastomosed #nswe" @ is in%o""e%t be%a$se the p"o-imal thi"d of the small intestine is not "emo/ed !he enti"e stoma%h is not "emo/ed& as in answe" C& and in answe" )& the esophag$s is not "emo/ed 2+2#nswe" C is %o""e%t Peppe" is not p"o%essed and %ontains ba%te"ia #nswe"s #& @& and ) a"e in%o""e%t be%a$se f"$its sho$ld be %ooed o" washed and peeled& and salt and et%h$p a"e allowed 2++#nswe" # is %o""e%t Co$madin is an anti%oag$lant One of the tests fo" bleeding time is a P"otime !his test sho$ld be done monthly ,ating mo"e f"$its and /egetables is not ne%essa"y& and da"=g"een /egetables %ontain /itamin & whi%h in%"eases %lotting& so answe" @ is in%o""e%t )"ining mo"e li6$ids and a/oiding %"owds is not ne%essa"y& so answe"s C and ) a"e in%o""e%t 2+.#nswe" # is %o""e%t !he %lient who is ha/ing a %ent"al /eno$s %athete" "emo/ed sho$ld be told to hold his b"eath and bea" down !his p"e/ents ai" f"om ente"ing the line #nswe"s @& C& and ) will not fa%ilitate "emo/al 2+#nswe" @ is %o""e%t Clients with a histo"y of st"epto%o%%al infe%tions %o$ld ha/e antibodies that "ende" the st"eptoinase ineffe%ti/e !he"e is no "eason to assess the %lient fo" alle"gies to pineapples o" bananas& the"e is no %o""elation to the $se of phenytoin and st"eptoinase& and a histo"y of al%ohol ab$se is also not a fa%to" in the o"de" fo" st"eptoinaseW the"efo"e& answe"s #& C& and ) a"e in%o""e%t 2+5#nswe" @ is %o""e%t !he %lient who is imm$ne=s$pp"essed and has bone ma""ow s$pp"ession sho$ld be ta$ght not to floss his teeth be%a$se platelets a"e de%"eased Using oils and %"eam=based soaps is allowed& as is eating salt and $sing an ele%t"i% "a(o"W the"efo"e& answe"s #& C& and ) a"e in%o""e%t 2+8#nswe" # is %o""e%t !he best method and safest way to %hange the ties of a t"a%heotomy is to apply the new ones befo"e "emo/ing the old ones ?a/ing a helpe" is good& b$t the helpe" might not p"e/ent the %lient f"om %o$ghing o$t the t"a%heotomy #nswe" C is not the best way to p"e/ent the %lient f"om %o$ghing o$t the t"a%heotomy #sing the do%to" to s$t$"e the t"a%heotomy in pla%e is not app"op"iate 2+#nswe" ) is %o""e%t !he o$tp$t of +00m' is indi%ati/e of hemo""hage and sho$ld be "epo"ted immediately #nswe" # does nothing to help the %lient

ne%essa"y to wait to inEe%t the se%ond medi%ation 7ali$m is an antian-iety medi%ation& and Phene"gan is $sed as an antiemeti% 2.8#nswe" @ is %o""e%t 7oiding e/e"y + ho$"s p"e/ents stagnant $"ine f"om %olle%ting in the bladde"& whe"e ba%te"ia %an g"ow )o$%hing is not "e%ommended and obtaining a $"inalysis monthly is not ne%essa"y& maing answe"s # and C in%o""e%t !he %lient sho$ld p"a%ti%e wiping f"om f"ont to ba% afte" /oiding and bowel mo/ements& so answe" ) is in%o""e%t 2.#nswe" C is %o""e%t Of these %lients& the one who sho$ld be assigned to the %a"e of the n$"sing assistant is the %lient with dementia Only an * o" the physi%ian %an pla%e the %lient in se%l$sion& so answe" # is in%o""e%t !he n$"se sho$ld empty the Foley %athete" of the p"ee%lampti% %lient be%a$se the %lient is $nstable& maing answe" @ in%o""e%t # n$"se o" physi%al the"apist sho$ld amb$late the %lient with a f"a%t$"ed hip& so answe" ) is in%o""e%t 2.9#nswe" # is %o""e%t !he %lient who has "e%ently had a thy"oide%tomy is at "is fo" t"a%heal edema # padded tong$e blade is $sed fo" sei($"es and not fo" the %lient with t"a%heal edema& so answe" @ is in%o""e%t If the %lient e-pe"ien%es t"a%heal edema& the endot"a%heal t$be o" ai"way will not %o""e%t the p"oblem& so answe"s C and ) a"e in%o""e%t 20#nswe" ) is %o""e%t ?istoplasmosis is a f$ng$s %a""ied by bi"ds It is not t"ansmitted to h$mans by %ats& dogs& o" t$"tles !he"efo"e& answe"s #& @& and C a"e in%o""e%t

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