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1. Which condition is associated with inadequate intake of vitamin C?
- A. rickets
- B. marasmus
- C. kwashiorkor
- D. scurvy
Correct answer: scurvy
Rationale: Scurvy is indeed associated with inadequate intake of vitamin C. Vitamin C deficiency leads to scurvy, which is characterized by weakness, anemia, gum disease, and skin hemorrhages. Choices A, B, and C are incorrect because rickets is caused by vitamin D deficiency, marasmus is due to severe malnutrition leading to wasting, and kwashiorkor is a form of severe protein-energy malnutrition.
2. A nurse is reviewing the medical record of an older client with presbycusis. Which finding would the nurse expect to note in the client’s record?
- A. Difficulty hearing whispered words in the voice test
- B. Improved hearing ability during conversational speech
- C. Unilateral conductive hearing loss
- D. Difficulty hearing low-pitched tones
Correct answer: Difficulty hearing whispered words in the voice test
Rationale: Presbycusis, a sensorineural hearing loss, is the most common form of hearing loss in older adults. Typically, the loss is bilateral, resulting in difficulty hearing high-pitched tones. The condition is revealed when the client has difficulty hearing whispered words in the voice test and consonants during conversational speech. Choice A is correct because it reflects the expected finding in presbycusis. Choices B, C, and D are incorrect because presbycusis does not result in improved hearing ability during conversational speech, unilateral conductive hearing loss, or difficulty hearing low-pitched tones.
3. The chemotherapeutic DNA alkylating agents such as nitrogen mustards are effective because they:
- A. cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA.
- B. have few, if any, side effects.
- C. are used to treat multiple types of cancer.
- D. are cell-cycle-specific agents.
Correct answer: cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA.
Rationale: Alkylating agents, such as nitrogen mustards, are effective chemotherapeutic agents because they cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA. This cross-linking interferes with DNA replication and transcription, leading to cell death. Choice B is incorrect because alkylating agents have numerous side effects, including alopecia, nausea, vomiting, and myelosuppression. Choice C is incorrect because while nitrogen mustards are used to treat multiple types of cancer like chronic lymphocytic leukemia, non-Hodgkin’s lymphoma, and breast and ovarian cancer, their effectiveness is primarily due to DNA cross-linkage. Choice D is incorrect because alkylating agents are non-cell-cycle-specific agents, meaning they can act on cells in any phase of the cell cycle, not just on cells that are actively dividing.
4. A nurse auscultating the fetal heart rate (FHR) of a pregnant client in the first trimester of pregnancy notes that the FHR is 160 beats/min. With this information, what should be the nurse’s next action?
- A. Notify the healthcare provider of the finding.
- B. Document the findings.
- C. Tell the client that the FHR is faster than normal but that it is nothing to be concerned about at this time.
- D. Wait 15 minutes and then recheck the FHR.
Correct answer: Document the findings.
Rationale: An FHR of 160 beats/min in the first trimester of pregnancy is within the normal range, which is generally 120 to 160 beats/min. The appropriate action for the nurse in this situation is to document the findings. There is no need to notify the healthcare provider as this is a normal finding. Informing the client that the FHR is faster than normal may cause unnecessary anxiety, as it falls within the expected range. Waiting to recheck the FHR is not necessary since the rate is already within the normal range.
5. Which statement reflects a primary belief of psychiatric mental health nursing?
- A. Most people have the potential to change and grow.
- B. Every person is worthy of dignity and respect.
- C. Human needs are individual to each person.
- D. Some behaviors have no meaning and cannot be understood.
Correct answer: Every person is worthy of dignity and respect.
Rationale: The correct answer reflects a primary belief of psychiatric mental health nursing, which is that every person is worthy of dignity and respect. This belief forms the foundation of providing holistic and compassionate care in mental health nursing. While it is true that most people have the potential to change and grow, this choice does not directly address a core belief of mental health nursing. Human needs being individual to each person is a general principle of nursing care but does not specifically capture a primary belief in psychiatric mental health nursing. The statement that some behaviors have no meaning and cannot be understood contradicts the fundamental principle that all behavior has meaning and can be understood from the client's perspective in psychiatric mental health nursing.
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