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A multidisciplinary health care team operates a program aimed at the prevention,
identification, and treatment of diabetes on a large Indian reservation. Which of the
following aspects of the program would be most likely to be classified as secondary
prevention?
A) Regularly scheduled wound dressing changes for clients who have foot ulcers
secondary to peripheral neuropathy and impaired wound healing
B) Teaching school children how a nutritious, traditional diet can lessen their
chances of developing adult-onset diabetes
C) Staffing a booth where community residents who are attending a baseball
tournament can have their blood glucose levels checked
D) Administering oral antihyperglycemic medications to clients who have a
diagnosis of diabetes - ANSWER C) Staffing a booth where community
residents who are attending a baseball tournament can have their blood glucose
levels checked
An occupational therapist conducts a group therapy program called MindWorks with
older adults who have diagnoses of dementia and Alzheimer disease. The goal of the
group is to slow the cognitive decline of clients by engaging them in regular, organized
mental activity such as reading maps and solving puzzles. How would the program most
likely be characterized? A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Prognosis enhancement - ANSWER C) Tertiary prevention
The clinical educator of a hospital medical unit has the mandate of establishing
evidence-based practice guidelines for the nursing care on the unit. Which of the
following statements most accurately captures a guiding principle of the nurse's task?
A) Evidence-based practice guidelines will be rooted in research rather than nurses'
subjective practice preferences and experiences.
B) Guidelines are synonymous with systematic research reviews.
C) The need for continuity and standardization of guidelines will mean that they will
be fixed rather than changeable.
D) The guidelines will combine individual expertise with external systematic
evidence. - ANSWER D) The guidelines will combine individual expertise with
external systematic evidence.
The neuroscience nursing unit has developed a set of step-by-step directions of what
should occur if a nursing assessment reveals that the patient may be exhibiting
clinical manifestations of a cerebrovascular accident (CVA). Which of the following
statements about clinical practice guidelines are accurate? Select all that apply.
,A) Step-by-step guidelines are usually developed and based primarily on "how it
has always been done before."
B) The development of evidence-based practice guidelines requires a research
review from different studies to develop the most accurate diagnostic method to
implement. C) Once developed, practice guidelines only need to be reviewed if a
national committee sends out an update on new research.
D) When developing a CVA set of step-by-step directions, the nursing unit should
ask for assistance from experts in the neuroscience field. The potential users of the
guidelines should pilot test it for further feedback.
E) A meta-analysis could be utilized to combine evidence from different studies to
produce a more accurate diagnostic method. - ANSWER B, D, E
During a period of extreme excess fluid volume, a renal dialysis patient may be
administered which type of IV solution to shrink the swollen cells by pulling water out
of the cell?
A) 0.9% sodium chloride
B) 5% dextrose and water
C) 3% sodium chloride
D) Lactated Ringer solution - ANSWER C) 3% sodium chloride
A 34-year-old male client has diagnoses of liver failure, ascites, and hepatic
encephalopathy secondary to alcohol abuse. The client's family is questioning the
care team as to why his abdomen is so large even though he is undernourished and
emaciated. Which of the following statements most accurately underlies the
explanation that a member of the care team would provide the family?
A) An inordinate amount of interstitial fluid is accumulating his abdomen.
B) The transcellular component of the intracellular fluid compartment contains far
more fluid than normal.
C) Normally small transcellular fluid compartment, or third space, is becoming
enlarged. D) Gravity-dependent plasma is accumulating in his peritoneal cavity. -
ANSWER C) Normally small transcellular fluid compartment, or third space, is
becoming enlarged.
Which of the following individuals would be considered to be at risk for the
development of edema? Select all that apply.
A) An 81-year-old man with right-sided heart failure and hypothyroidism B)
A 60-year-old obese female with a diagnosis of poorly controlled diabetes
mellitus
C) A 34-year-old industrial worker who has suffered extensive burns in a job-related
accident
D) A 77-year-old woman who has an active gastrointestinal bleed and consequent
anemia
E) A 22-year-old female with hypoalbuminemia secondary to malnutrition and
, anorexia nervosa - ANSWER A, C, E
Recognizing the prevalence and incidence of dehydration among older adults, a care
aide at a long-term care facility is in the habit of encouraging residents to drink even
though they may not feel thirsty at the time. Which of the following facts underlies the
care aide's advice?
A) Older adults often experience a decrease in the sensation of thirst, even when
serum sodium levels are high.
B) The metabolic needs for both fluid and sodium in older adults differ from those of
younger individuals.
C) Regulation and maintenance of effective circulating volume by the kidneys is
less effective in the elderly.
D) The renin-angiotensin-aldosterone system (RAAS) is less able to facilitate
sodium clearance in older adults. - ANSWER A) Older adults often experience a
decrease in the sensation of thirst, even when serum sodium levels are high.
The nurse is providing teaching to a student nurse about how antidiuretic hormone
(ADH) plays a central role in the reabsorption of water by the kidneys. The nursing
student is correct to place the following components of the homeostatic action of ADH
in the correct sequence. Use all the options.
A) Stored ADH is released into circulation.
B) ADH is transported along a neural pathway to the posterior pituitary gland.
C) Aquaporins are inserted into tubular cell membranes.
D) ADH is synthesized by cells in the supraoptic and paraventricular nuclei of the
hypothalamus.
E) Serum osmolality increases. - ANSWER D, B, E, A, C
A patient arrives in the ED very hypovolemic related to excretion of "at least 3 gallon
jugs of urine in the past 24 hours." He describes the urine as being clear-like water.
The physician suspects diabetes insipidus. The nurse should be prepared to
administer which of the following medications?
A) Desmopressin acetate (DDAVP)
B) Benadryl, an anticholinergic
C) Calcium gluconate
D) Prednisone - ANSWER A) Desmopressin acetate (DDAVP)
A patient has been diagnosed with a brain tumor that cannot be removed surgically.
During each office visit, the nurse will be assessing the patient for syndrome of
inappropriate antidiuretic hormone (SIADH). Which of the following assessments
would alert the clinic nurse that the patient may be developing this complication?
A) Complaints that his urine output is decreased, no edema noted in ankles, and
increasing headache