EXPLANATION
Correct: Risk for stroke during procedure if not previously addressed. The patient will be at higher risk for stroke during the procedure if there is an unknown high-grade stenosis of the carotid artery. Left carotid stenosis- A bruit heard over the left carotid is concerning for a left carotid bruit.

Incorrect: No concern; it was probably the cause of his strokes.
As a nurse, you should never assume an abnormal exam finding has been addressed until verified with the patient or his provider. Right carotid stenosis- A left carotid bruit would be concerning for left carotid stenosis.

LEARNING OBJECTIVE
Nurses require not only good assessment skills but critical thinking as well. After detecting an abnormality, one must act to prevent harm.

For correct answer choice:

"Avoid crossing your legs to improve circulation." is correct. This statement is crucial for patients with PVD, as crossing the legs can impede blood flow and worsen symptoms.

For incorrect answer choices:

"You can soak your feet in hot water to keep them warm." is incorrect. Hot water can cause burns or injuries in patients with decreased sensation due to PVD.

"It's fine to wear tight-fitting shoes occasionally." is incorrect. Tight shoes can restrict blood flow and cause further complications.

"Use a warm compress on your legs whenever they feel cold." is incorrect. While warmth can be beneficial, the method of application needs to be safe and cautious to prevent burns, making this less appropriate than option A.

For correct answer choice:

18 pounds is correct. It reflects the expected tripling of the birth weight (6 pounds) by the infant's first birthday, resulting in a weight of 18 pounds.

For incorrect answer choices:

12 pounds is incorrect. While this represents a doubling of birth weight, it is below the expected weight for a 1-year-old, as infants typically triple their birth weight by that age.

15 pounds is incorrect. This reflects a 2.5-fold increase from birth weight, which is still less than the expected tripling of birth weight by one year.

24 pounds is incorrect. This weight represents a quadrupling of the birth weight and is excessive, as it exceeds the typical growth pattern for an infant within the first year of life.

EXPLANATION
Correct: Decreased capillary refill and shiny skin on the feet are signs of peripheral vascular disease. Meanwhile, decreased sensation in the feet can signify all three.
Incorrect: Bounding dorsalis pedis and posterior tibialis: Patients with peripheral vascular disease are likelier to have decreased or absent pulses than bounding pulses.

LEARNING OBJECTIVE
With an understanding of pathophysiology, nurses know what abnormal assessment findings they might expect when caring for patients. Focused assessments can be vital in the ER when time is critical.

For correct answer choice:

“You will need to use another form of contraception until sperm is no longer detected.” is correct. This emphasizes the importance of using alternate contraception until a semen analysis shows no sperm, which is critical for effective patient education.

For incorrect answer choices:

“You can expect to return to your regular activities immediately after the procedure.” is incorrect. This is misleading, as patients are often advised to rest for a period and avoid strenuous activities for a few days.

“You may experience significant pain, and we recommend over-the-counter pain relievers only.” is incorrect. While pain management is important, the statement may downplay the potential need for prescription pain medications in some cases.

“It is advisable to avoid sexual activity for only one day after the procedure.” is incorrect. This is insufficient information, as healthcare providers typically recommend refraining from sexual activity for a longer period, generally around one to two weeks.

For correct answer choice:

A diet high in potassium-rich foods is correct. Patients with Addison’s disease often struggle to regulate potassium levels due to adrenal insufficiency, which can lead to hyperkalemia. So, a diet high in potassium-rich foods should be avoided.

For incorrect answer choices:

Increased intake of sodium is incorrect. Patients with Addison’s disease experience salt cravings due to low aldosterone levels and subsequent loss of sodium. Increasing sodium intake is essential, particularly during periods of stress, to prevent hyponatremia.

High protein intake is incorrect. A high protein intake is beneficial for maintaining muscle mass and supporting overall health. This makes it a recommended component of the diet for patients with Addison’s disease.

Adequate caloric intake to maintain energy levels is incorrect. Fatigue and weakness are commonly associated with Addison’s disease so, ensuring adequate caloric intake to meet energy demands is important and should be encouraged.

For correct answer choice:

22.5 pack-years is correct. To determine pack years, divide the number of cigarettes smoked per day by 20 (the number of cigarettes in a pack) and multiply by the number of years smoked. Thus, (15 cigarettes/day ÷ 20) × 30 years = 22.5 pack-years.

For incorrect answer choices:

15 pack-years is incorrect. This option does not account for the number of cigarettes smoked per day relative to a pack and underestimates the client’s smoking history.

7.5 pack-years is incorrect. This calculation is incorrect as it misrepresents both the daily cigarette use and the years smoked.

10 pack-years is incorrect. This option significantly underrepresents the client’s smoking history and does not reflect an accurate calculation.

EXPLANATION
Correct: Secondary prevention aims to detect disease early. HTN is detected through blood pressure testing at office visits or screenings. Through early detection treatment and control, other secondary conditions, such as stroke and heart disease, can be prevented.

Incorrect:

Primary prevention is preventing a disease before it occurs, such as by vaccination.

Tertiary prevention aims to reduce the sequela of an event or disease. An example is providing rehabilitation to improve strength after a car accident with a head injury, weakness, and speech changes.

Quaternary prevention aims to protect individuals with diseases from medical interventions that cause more harm than good.

LEARNING OBJECTIVE
Health promotion and maintenance is an essential part of being a nurse. Ownership of one’s health is crucial to a patient’s well-being. Nurses can accomplish this through education.

For correct answer choice:

"I will stop all physical activity to prevent triggering my pain." is correct. This reflects a misunderstanding. Completely avoiding physical activity can worsen fibromyalgia symptoms. Gradual, low-impact exercises are recommended so, additional teaching is required.

For incorrect answer choices:

"I will take warm baths to help relax my muscles." is incorrect. This is a correct statement and demonstrates an effective strategy for managing chronic pain.

"I will engage in low-impact activities like walking to improve my stamina." is incorrect. Low-impact exercises are encouraged to maintain flexibility and strength in patients with fibromyalgia.

"I will keep a journal to track my pain and identify triggers." is incorrect. Keeping a pain journal is a useful tool for managing chronic pain by recognizing patterns and potential triggers.

For correct answer choice:

"I need to limit my fluid intake to avoid worsening my condition." is correct. This statement shows the patient understands the importance of managing fluid intake to help control symptoms and prevent fluid overload in CHF.

For incorrect answer choices:

"I can continue my regular diet without any restrictions." is incorrect. Patients with CHF often need to limit sodium and, in some cases, fluid intake as part of dietary modifications.

"It's okay to skip my medications if I feel fine." is incorrect. This reflects a misunderstanding, as adherence to medication is crucial in managing CHF even when symptoms seem manageable.

"I should only be concerned about my symptoms if they get worse." is incorrect. This option suggests a lack of understanding that any new or worsening symptoms should prompt immediate attention, not just a wait-and-see approach.

EXPLANATION
Correct: The trigeminal nerve is responsible for facial sensation and jaw strength.
Incorrect: The oculomotor nerve is responsible for most eye movements and pupillary response. The hypoglossal nerve controls the movement of your tongue. The facial nerve is responsible for the movement of your face and taste on part of your tongue.

LEARNING OBJECTIVE
On admission, patients undergo a comprehensive health assessment. Nurses frequently perform one of these assessments. Not only must they know normal examinations, but they must also understand the pathophysiology of abnormal. Patients may arrive with one issue, yet another is discovered. Recognition of changes in the patient’s clinical status and abnormal physical findings is crucial to treating their conditions. Nurses must be ready to react to abnormal findings.

For correct answer choice:

Decreased amniotic fluid levels is correct. This is a common complication associated with post-term pregnancies. Reduced amniotic fluid can lead to umbilical cord compression and fetal distress.

For incorrect answer choices:

Increased likelihood of preterm labor is incorrect. Post-term pregnancies are characterized by delayed labor rather than preterm labor.

Maternal anemia is incorrect. While this can occur in pregnancy, it is not directly associated with postmaturity.

Enhanced fetal growth restriction is incorrect. This is more commonly associated with intrauterine growth restriction (IUGR) but is not typically a characteristic of post-term pregnancies where fetal weight is generally higher.

For correct answer choice:

"We need to ensure feedback is frequent and based on clear performance criteria." is correct. This statement emphasizes the necessity for regular feedback that is specific and criteria-based, which is vital for effective performance management.

For incorrect answer choices:

"Feedback should only focus on weaknesses to highlight areas for improvement." is incorrect. This is incorrect as it overlooks the importance of recognizing strengths alongside weaknesses for a balanced approach to feedback.

"The same feedback format should be used for every staff member, regardless of their role." is incorrect. This option fails to consider the individual roles and contexts that require tailored feedback for effectiveness.

"Constructive feedback can be given only after a long period of observation." is incorrect. This is misleading, as timely feedback is more beneficial than waiting an extended period, which may allow issues to persist unaddressed.

EXPLANATION
Correct: Listeria monocytogenes causes the foodborne illness Listeorsis.
Incorrect:. All of these organisms do cause foodborne illnesses. However, this food grouping best matches Listeria monocytogenes.
E. coli can be found in pasteurized milk and juice, raw vegetables and fruits, undercooked beef(especially hamburgers), and contaminated water. It can also be found in food or water contaminated by human feces.
Salmonella can be found in unpasteurized milk or juice, raw vegetables, fruits, cheese, eggs, poultry, and meat.
Norovirus can be found in contaminated drinking water, shellfish from contaminated waters, raw produce or uncooked foods, and cooked foods that are not reheated after contact with an infected food handler.

LEARNING OBJECTIVE
Listeorsis can cause stillbirth, miscarriage, premature birth, or death in the newborn without timely treatment. Knowledge of symptoms in pregnancy is critical to obtain timely treatment. They include fever along with other flu-like symptoms, including muscle aches and fatigue.
Preventing the illness can prevent death in the newborn and unborn.
Education on food avoidance is crucial.

EXPLANATION
Correct: Instructions should be printed in Spanish. Instructions should be given in Spanish by someone fluent. The patient speaks Spanish and should receive verbal and written instructions in Spanish.

Incorrect: Sign receipt of discharge instructions. Although, most hospital policies require a signature for discharge instructions. It is not critical in this situation. Speak slowly and clearly so the patient can understand. The patient may understand some English, but the information clearly states that he speaks Spanish. Therefore, the instructions must be provided in Spanish.

LEARNING OBJECTIVE
Nurses need to not only educate patients but also minimize communication barriers. To do so, education must be communicated in the patient's native language. The nurse's understanding of the patient’s healthcare literacy is vital to navigating the healthcare system and making decisions. Their literacy can be affected by education level, language barrier, and the stress of their health issue, to name a few. Both verbal and written instructions are critical to aid in the patient's well-being.

For correct answer choice:

“Taking the pill every day will protect me from getting ovarian cancer.” is correct. While long-term use of oral contraceptives has been associated with a reduced risk of ovarian cancer, the primary purpose of the pill is contraception. This statement indicates a misunderstanding of the primary function of the medication by the client, which suggests that further teaching is necessary here.

For incorrect answer choices:

“I might feel nauseous for the first few weeks of taking the pill.” is incorrect. This statement is accurate, as nausea is a common side effect when starting oral contraceptives. It indicates that the client understands the information provided.

“I’ve heard that some women gain weight on the pill, but it’s usually not much.” is incorrect. This statement reflects an understanding of a potential side effect, as some women do experience weight gain while on the pill, albeit typically minimal.

“It’s important to report if I develop severe headaches while on the pill.” is incorrect. This statement is correct, as severe headaches can be a sign of serious side effects, such as an increased risk of stroke or other cardiovascular complications. Reporting such symptoms is essential for the client's safety.

For correct answer choice:

Encouraging adequate fluid intake is correct. Hydration is critical for patients with sickle cell anemia, especially during pregnancy, to prevent dehydration and reduce the risk of a vaso-occlusive crisis. Adequate fluid intake helps maintain blood volume and prevent sickling of red blood cells.

For incorrect answer choices:

Recommending bed rest throughout the pregnancy is incorrect. Bed rest is not necessary unless complications arise. Maintaining normal activity with adequate hydration and regular prenatal care is generally recommended.

Administering prophylactic blood transfusions is incorrect. Prophylactic blood transfusions are not standard for all pregnant clients with sickle cell anemia and are only considered in high-risk cases.

Applying cold therapy to prevent crisis is incorrect. Cold therapy can actually worsen sickle cell crises due to vasoconstriction. Warm environments and avoiding cold temperatures are better recommendations for these patients.

For correct answer choice:

Gravida 3, Para 2, Abortions 1 is correct. This documentation is correct as it reflects that she is pregnant (Gravida 3, including the ectopic pregnancy), has had 2 live births (Para 2), and has experienced one abortion (the ectopic pregnancy counts as a loss).

For incorrect answer choices:

Gravida 2, Para 2, Abortions 1 is incorrect. It does not include the ectopic pregnancy in the gravida count.

Gravida 3, Para 1, Abortions 0 is incorrect. This option misrepresents her live births and does not account for the two children she has.

Gravida 2, Para 1, Abortions 1 is incorrect. It undercounts her pregnancies and live births.