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1. A nurse is caring for an 8-month-old infant who screams when the parent leaves the room. The parent begins to cry and says, 'I don't understand why my child is so upset. I've never seen my child act this way around others before.' Which of the following statements should the nurse make?
- A. This is a normal, expected reaction for a child of this age.
- B. This is a response to an overstimulating environment.
- C. This is a common reaction to an overexposure to caregivers.
- D. This is a typical reaction for a child who is sick.
Correct answer: A
Rationale: The correct answer is 'This is a normal, expected reaction for a child of this age.' Separation anxiety typically peaks around 8-10 months of age, leading to distress when separated from caregivers. Choice B is incorrect because the infant's behavior is more likely due to separation anxiety rather than overstimulation. Choice C is incorrect as the infant's behavior is not related to overexposure to caregivers but rather a natural developmental stage. Choice D is incorrect as the infant's behavior is not indicative of illness but rather a normal emotional response.
2. Without enough calcium, both males and females are at risk of osteoporosis.
- A. TRUE
- B. FALSE
- C.
- D.
Correct answer: A
Rationale: The statement is true. Both males and females are at risk of developing osteoporosis if they do not consume enough calcium. Calcium is essential for maintaining strong bones, and inadequate intake can lead to bone density loss and increase the risk of osteoporosis. Therefore, it is crucial for individuals of all genders to ensure they have an adequate calcium intake to support bone health. Choice B is incorrect because osteoporosis is a condition that can affect both males and females.
3. Which of the following is reflected in an ECG due to hypokalemia?
- A. Tall T waves and Pathologic Q wave
- B. Widening QRS Complex and U wave
- C. None of the above
- D. Both A and B
Correct answer: B
Rationale: Hypokalemia, a condition characterized by low levels of potassium in the blood, is reflected in an ECG by a widening QRS Complex and a U wave. This is because potassium plays a key role in the electrical activity of the heart, and its deficiency can lead to abnormalities in the heart's rhythm as represented by these specific changes on the ECG. Choice A is incorrect as tall T waves and pathologic Q waves are more commonly associated with hyperkalemia or myocardial infarction, respectively, rather than hypokalemia. Choices C and D are also incorrect as they do not accurately reflect the ECG changes caused by hypokalemia.
4. Which type of bath would you recommend for a patient experiencing pruritus?
- A. Saline
- B. Colloidal (oatmeal)
- C. Water
- D. Sodium bicarbonate
Correct answer: B
Rationale: The best choice for a pruritus (itching) patient is a colloidal (oatmeal) bath, as it is known for its soothing effect on itchy, irritated skin. Saline, water, and sodium bicarbonate baths may not provide the same level of relief for pruritus. The nursing care should involve comprehensive assessments and appropriate interventions to optimize patient outcomes. In this case, a colloidal bath is the most suitable intervention for a patient experiencing pruritus.
5. When assessing older adult clients for malnutrition at an adult day care center, which risk factors should the nurse consider?
- A. Dental problems
- B. Depression
- C. Both A and B
- D. Ability to prepare meals
Correct answer: C
Rationale: The correct answer is C: Both A and B. Dental problems and depression are both significant risk factors for malnutrition in older adults. Dental problems can lead to difficulty in chewing and swallowing, resulting in reduced food intake. On the other hand, depression can cause changes in appetite and decreased interest in eating, which can also contribute to malnutrition. Although the ability to prepare meals is important, it is not specifically identified as a risk factor for malnutrition within the context of this question. Therefore, choices A and B are the most appropriate answers.
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