NURSING 554 Answers_with_rationals.

Answers With Rationales 1. A) Obtain a complete and thorough history Before prescribing medications, a thor- ough history must be obtained to determine possible causes of hives. The patient denied difficulty with swallowing and breathing, so there was no medical emergency that would require calling 911. 2. B) Edema of the face and the upper extremities Common signs and symptoms of pregnancy-induced hypertension include edema of the face and the upper extremities, weight gain, blurred vision, elevated blood pressure, proteinuria, and headaches. 3. D) Tingling and numbness of both feet Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms of B12 deficiency anemia may include tingling or numbness in fingers and toes, difficulty walking, mood changes or depression, memory loss, disorientation, and dementia. 4. A) Order an ultrasound Abnormally low levels of alpha fetoprotein and estriol and high levels of human chorionic gonadotropin are abnormal during pregnancy. An ultra- sound should be ordered to further evaluate the fetus for characteristics of Down syn- drome and/or fetal demise. 5. C) Most diverticula in the colon are infected with gram-negative bacteria Diverticula in the colon can be infected with both gram-negative and gram-positive bacteria. 6. B) Chlamydia trachomatis When diagnosed with gonorrhea, the patient should also be treated for Chlamydia trachomatis. 7. C) Osteoporosis Kyphosis is a curvature of the spine that causes a rounding of the back, which leads to a slouching posture. Severe thinning of the bones (osteoporosis) contributes to this curvature in the spine. Symptoms that may occur with severe cases of kyphosis include difficulty breathing, fatigue, and back pain. 8. B) Higher than normal Alpha fetoprotein (AFP) is produced in the fetal and maternal liver. Higher levels of AFP are commonly seen in multiple gestations due to the growing liver in each fetus, which cumulatively lead to higher AFP levels. 9. D) Thiazide diuretics Thiazide diuretics have a favorable effect in patients with osteo- penia and osteoporosis by slowing down the kidney’s excretion of calcium and increas- ing distal tubule calcium reabsorption. This results in decreased bone demineralization. Leik, M. T. C. M. A. (2017). Family nurse practitioner certification intensive review, third edition : Fast facts and practice questions. ProQuest Ebook 633 Thiazide diuretics are a good choice of therapy for this population because they treat hypertension and slow bone loss. 10. A) Instability of the knee The Lachman maneuver is a test performed to assess for knee instability (i.e., damage to the motion of anterior translation [laxity] of the anterior cruciate ligament [ACL]) or tear of the ACL. The maneuver should be tested on both knees, comparing the injured and the opposite knee, the uninjured knee is used as the “control.” The test is positive if the injured knee slips back further (laxity). Perform the test by bending the knee 30 degrees. Stabilize the femur with one hand. Place the other hand under the proximal tibia at the level of the joint line and then pull forward. The laxity is graded on a 0 (normal)-to-3 scale (1.0–1.5 cm of translation). ..................................continued,..........................................