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Answers |100% Correct | Grade A - Nightingale
Benefits of daily exercise for pt with type two diabetes
improves blood circulation
reduces the need for insulin
lowers serum cholesterol and triglyceride levels
When assessing a client with an indwelling urinary catheter, which observation
requires the most immediate intervention by the nurse?
The drainage tubing is secured over the siderail.
The clamp on the urinary drainage bag is open.
There are no dependent loops in the drainage tubing.
The urinary drainage bag is attached to the bed frame.
The clamp on the urinary drainage bag is open
Rationale
Maintaining a closed urinary drainage system is important to prevent infection, so
the most immediate priority is to close the clamp (B) to reduce the risk for
ascending microorganisms. If the drainage tubing is secured over the siderail (A),
urine will not be able to flow out of the bladder, so the nurse should next
reposition the tubing. (C and D) indicate correct care of the urinary drainage
system, so documentation of an intact system is the last intervention needed.
The nurse encounters resistance when inserting the tubing into a client's rectum
for a tap water enema. What action should the nurse implement?
Withdraw the tube and apply additional lubricant to the tube.
Encourage the client to bear down and continue to insert the tube.
Remove the tube and check the client for a fecal impaction.
Ask the client to relax and run a small amount of fluid into the rectum.
Ask the client to relax and run a small amount of fluid into the rectum.
Rationale
If resistance is encountered during the initial insertion of an enema tube, the
client should be instructed to relax while a small amount of solution runs through
the tube into the rectum (D) to promote dilation. (A) is unlikely to resolve the
problem. (B) may cause injury. (C) should not be implemented until other, less
invasive actions, such as (D) have been taken.
Which statement is an example of a correctly written nursing diagnosis
statement?
Altered tissue perfusion related to congestive heart failure.
Altered urinary elimination related to urinary tract infection.
Risk for impaired tissue integrity related to client's refusal to turn.
,Ineffective coping related to response to positive biopsy test results.
Ineffective coping related to response to positive biopsy test results
Rationale
The first part of the nursing diagnosis statement is the "diagnostic label" and is
followed by "related to" the cause, which should direct the nurse to the
appropriate interventions. (D) best fits this criteria. (A and B) contain a medical
diagnosis. (C) includes an observable cause, but (D) focuses on the client's
"response," which the nurse can provide support, reflection, and dialogue.
Question 1 of 7
Which factor would be classified as a genetic or biologic determinant of health?
Culture
Risk for breast cancer
Low income level
Smoking cigarettes
Risk for breast cancer
Biologic and genetic determinants of health include factors that cannot be changed,
such as the inherited risk for breast cancer.
Question 2 of 7
A nurse is working with a nonprofit organization to improve understanding of the
etiology of congenital defects. This is an example of which category of health
determinants?
Biology and genetics
Health services
Social environments
Quality of housing
Biology and genetics
Congenital defects would be classified as examples of biologic and genetic
determinants of health.
Question 3 of 7
Match each genetics term with the appropriate example or definition.
Cystic fibrosis =Single-gene disorder
Epigenetics=Study of gene modification
Coronary heart disease =Multifactorial
Turner syndrome =Chromosomal
Question 4 of 7
Which factor is a key issue for a social determinant of health that increases a
patient's health risk?
Age
Sex
Poverty
Genetics
Poverty
Poverty is a key issue for a social determinant of health that increases a patient's health
risk.
Question 5 of 7
Match the key issue to its social determinant of health.
,Education=Language and literacy
Economic stability=Food security
Health and health care=Access to primary care
Neighborhood and built environment=Social cohesion
Question 6 of 7
Which topics are key issues in social and community context as a social
determinant of health?
Select all that apply.
Discrimination
Housing stability
Civic participation
Incarceration rates
Crime and violence
Discrimination
Civic participation
Incarceration rates
Question 7 of 7
Which factors negatively affect neighborhoods and built environments?
Select all that apply.
Education levels of community members
Radon exposure
Health education initiatives
Access to health care
Food deserts
Crowded conditions
Radon exposure
Food deserts
Crowded conditions
Question 1 of 7
Which actions apply to the concept of health promotion?
Select all that apply.
Establishing a vaccination program
Participating in a routine exercise program
Informing people of what they could do to stay healthy
Assessing community assets and strengths that influence health and well-being
Educating individuals on safe-sex practices to avoid acquiring a sexually
transmitted disease
Participating in a routine exercise program
Informing people of what they could do to stay healthy
Assessing community assets and strengths that influence health and well-being
Question 2 of 7
Which patient findings are risk factors for the development of diabetes?
Select all that apply.
Is overweight
Reports siblings have diabetes
Reports becoming a nonsmoker
, Has started walking in the evenings
Watches television 5 hours per night
Is overweight
Reports siblings have diabetes
Watches television 5 hours per night
Question 3 of 7
Which action would the nurse take to help a patient implement a risk-reduction
plan?
Suggest online health education resources that help to reduce the identified risk
factor.
Collaborate solely with a health care provider.
Administer a hepatitis vaccine.
Encourage assistive personnel to teach healthy strategies.
Suggest online health education resources that help to reduce the identified risk factor.
Multiple online educational materials for individuals, families, and communities enable
them to lead healthier lifestyles and make permanent changes in wellness habits.
Question 4 of 7
A nurse is screening children for scoliosis. Which type of prevention does this
illustrate?
Primary
Secondary
Tertiary
Quaternary
Secondary
Secondary prevention is performed to detect latent disease.
Question 5 of 7
Which nursing intervention is an example of tertiary prevention?
Encouraging the patient to use seatbelts
Helping the patient adjust to an incurable disease
Administering a purified protein derivative (PPD) skin test to a patient
Facilitating genetic screening for a patient and their significant other
Helping the patient adjust to an incurable disease
Adjusting to an incurable disease is tertiary prevention.
Question 6 of 7
Match the intervention to its level of prevention.
Primary=Teaching about safe-sex practice
Secondary=Screening for HIV
Tertiary=Administering medication to stop a disease process
Quaternary=Performing a chart audit to evaluate quality care
Question 7 of 7
A nurse is providing tertiary prevention for a patient with a stroke that resulted in
left-sided weakness. Which concept describes the focus of the nurse's
interventions?
Early diagnosis
Prompt detection