RN exams medical-surgical practice questions set 7

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The correct answer is D: Encourage the client to identify potential sources of emotional support. This is the most helpful action because it focuses on providing the client with practical support to cope with her chronic sorrow. By identifying potential sources of emotional support, the client can strengthen her support network and feel less isolated in dealing with her husband's terminal illness. Option A: Questioning the client about her knowledge of cancer treatment options is not the most appropriate action in this scenario as it does not directly address the client's emotional needs related to chronic sorrow. Option B: Questioning the client about her husband's prognosis may increase the client's distress and anxiety, which is not beneficial in supporting her emotional well-being. Option C: Determining the means used by the client to cope with loss in the past is important but may not be the most immediate and practical step in addressing the client's current emotional needs.

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The healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques in a patient with acute gastrointestinal bleeding (GIB) requiring urgent intervention. This approach involves directly visualizing the bleeding site and applying methods such as clipping, coagulation, or band ligation to stop the bleeding. Endoscopic hemostasis is considered the gold standard for managing acute GIB as it allows for both diagnostic and therapeutic intervention in real-time, offering a targeted and effective way to control bleeding and prevent recurrent episodes. Administering proton pump inhibitors (PPIs) may help in reducing gastric acid secretion and promoting ulcer healing but is not the primary intervention for actively bleeding patients. Implementing strict bed rest may be necessary in some cases to minimize physical exertion, but it is not the primary intervention to manage acute GIB. Transfusion of fresh frozen plasma to correct coagulopathy may be necessary if

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The correct answer is D: Prepare his room before his arrival so that he feels expected and welcome. This is the best choice because it demonstrates a proactive and thoughtful approach to welcoming the new resident. By preparing the room in advance, the nursing assistant shows consideration and care for the resident's comfort and well-being. This action helps create a positive first impression by making the resident feel valued and welcomed. Incorrect choices: A: Placing personal items where the NA thinks they look best may not align with the resident's preferences and could make the resident feel uncomfortable. B: Completing the admission process quickly may prioritize efficiency over the resident's emotional needs, potentially leading to a rushed and impersonal interaction. C: Allowing the resident to introduce himself to everyone in the facility puts the burden of initiating social interactions on the resident, which may not be ideal for someone new and unfamiliar with the environment.

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Hydrogel dressing is the correct answer for an arterial ulcer with a pale pink base, minimal drainage, and no infection. Arterial ulcers, caused by poor blood flow, often present as dry or minimally exudative wounds, and hydrogel provides essential moisture to rehydrate the wound bed, promoting autolytic debridement and healing. Its water- or glycerin-based composition suits this scenario, preventing desiccation while supporting tissue regeneration. Transparent film offers protection but lacks moisture donation, making it better for superficial, dry wounds, not arterial ulcers needing hydration. Calcium alginate is highly absorbent, ideal for heavy exudate, not minimal drainage, and could dry out this wound further. Silver-impregnated dressing targets infection, unnecessary here without signs of bacterial involvement. Hydrogel's hydrating properties align perfectly with the ulcer's characteristics, fostering an optimal healing environment without overwhelming the wound or surrounding skin.

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The skin's role in homeostasis includes temperature control, making 'thermal regulation by skin blood flow dilation or constriction'. The hypothalamus signals skin vessels to vasoconstrict e.g., conserving heat in cold (temp up 1°C) or vasodilate e.g., shedding heat in warmth (temp down 2°C) per Baranoski and Ayello (2004). , 'synthesis of vitamin K,' is false; skin makes vitamin D via UV e.g., 10 minutes sun yields 1000 IU not K, which liver produces. , 'elimination of carbon dioxide,' is lungs' job e.g., 35-45 mmHg CO2 exhaled, not skin. , 'glucose regulation by Langerhans cells,' misattributes; pancreatic islets, not skin's Langerhans (immune cells), manage glucose e.g., insulin drops 100 mg/dL. Skin's sweat and blood flow e.g., dilating vessels in 90°F heat regulate temp, a nurse's focus in fever or hypothermia. Unlike lungs or pancreas, skin's thermal role is dynamic, immediate, and measurable, aligning with essentials in *Wound Care Essentials*, making the accurate function.

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Rationale for Correct Answer (E): E: Surgery is the correct answer. Surgery is not typically used as a primary therapy for autoimmune diseases. Autoimmune diseases are usually treated with medications such as immuno-suppressive drugs (A), anti-inflammatory drugs (B), and targeted therapies like anti-TNF (C) and anti-CD20 (D) to manage symptoms and control the immune response. Surgery is only considered in specific cases when other treatments have failed or for complications related to the autoimmune disease. Therefore, surgery is not a standard therapy for autoimmune diseases. Summary of Incorrect Choices: A: Immuno-suppressive drugs like cortisone are commonly used in autoimmune disease treatment. B: Aspirin is an anti-inflammatory drug that can help manage symptoms in some autoimmune diseases. C: Anti-TNF therapy targets specific molecules involved in the immune response in autoimmune diseases. D: Anti-CD20 therapy targets B cells to modulate the immune response in autoimmune diseases.

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The correct answer is D: Teach the parents signs of overstimulation, such as turning the face away or stiffening and extending the extremities and fingers. Rationale: 1. Teaching parents signs of overstimulation empowers them to recognize and respond to their infant's cues effectively. 2. Parents can then modify the environment or interactions to reduce overstimulation, hence decreasing oxygen use. 3. This intervention promotes parental involvement in the care of the preterm infant, fostering a supportive and nurturing environment. 4. By educating parents, the nursing staff can work collaboratively with families to optimize the infant's care and well-being. Summary: A: Grouping care activities may help with rest but does not directly address overstimulation and increased oxygen use. B: Keeping charts on top of the incubator is irrelevant to addressing overstimulation. C: Providing a soft report does not directly address overstimulation or involve parents in recognizing signs.

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The correct answer is D. The nurse should assess the patient with a repaired right femoral shaft fracture complaining of tightness in the calf first. This could indicate a potential complication like deep vein thrombosis (DVT), which is a serious condition requiring immediate attention to prevent further harm. Assessing for DVT is crucial as it can lead to pulmonary embolism if left untreated. Choice A is incorrect as facial pain in a patient with a repaired mandibular fracture, while important, does not pose an immediate life-threatening risk. Choice B is incorrect as an externally rotated leg in a patient with an unrepaired intracapsular left hip fracture may indicate a hip dislocation, but it is not as urgent as assessing for a potential DVT. Choice C is incorrect as wrist swelling and deformity in a patient with an unrepaired Colles’ fracture, while concerning, does not require immediate attention compared to the potential complication of DVT in the patient with the femoral shaft

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In a patient with acute gastrointestinal bleeding requiring urgent intervention, the healthcare team should prioritize performing endoscopic hemostasis with mechanical or thermal techniques. Endoscopy allows for direct visualization of the source of bleeding in the gastrointestinal tract, enabling targeted interventions such as clipping, cauterization, or injection of epinephrine to achieve hemostasis. This approach is effective in managing acute bleeds and can help stop the bleeding quickly, reducing the need for more invasive procedures or surgeries. Administering proton pump inhibitors (PPIs) may be considered for acid-related bleeding, but it is not the primary intervention for acute bleeding requiring urgent management. Strict bed rest may not be necessary and can increase the risk of complications such as deep vein thrombosis. Transfusion of fresh frozen plasma may be indicated if there is evidence of coagulopathy, but addressing the bleeding source should be the initial priority to

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The correct answer is C: Skin. The skin is known as the 'Jack of all trades' because it performs multiple functions such as protection, regulation of body temperature, sensation, and synthesis of Vitamin D. It acts as a barrier against pathogens and harmful substances, regulates body temperature through sweat production, contains sensory receptors for touch, pressure, and pain, and plays a role in the synthesis of Vitamin D when exposed to sunlight. Rationale for other choices: A: Kidney - While the kidney plays a crucial role in filtering waste and maintaining electrolyte balance, it doesn't perform as wide a range of functions as the skin. B: Brain - The brain is the control center of the body, responsible for processing information, coordinating movements, and regulating bodily functions. However, it doesn't have the same versatility in functions as the skin. D: All of the above - This choice is incorrect because not all organs mentioned (kidney, brain) are known as the 'Jack of all