A nurse is caring for a patient with diabetes who is experiencing hypoglycemia. The nurse should prioritize which of the following interventions?

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health assessment exam 2 test bank Questions

Question 1 of 9

A nurse is caring for a patient with diabetes who is experiencing hypoglycemia. The nurse should prioritize which of the following interventions?

Correct Answer: B

Rationale: The correct answer is B: Providing a source of fast-acting carbohydrate. In hypoglycemia, the priority is to quickly raise the patient's blood sugar levels to prevent potential complications like seizures or loss of consciousness. Fast-acting carbohydrates, such as glucose tablets or juice, can rapidly increase blood sugar levels. Administering insulin (A) would further lower blood sugar levels, worsening the situation. Administering an oral hypoglycemic agent (C) is not appropriate in an acute hypoglycemic episode. Monitoring blood pressure (D) is important but not the priority in this situation.

Question 2 of 9

In obtaining a review of systems on a "healthy" 7-year-old girl, the health care provider knows that it would be important to include the:

Correct Answer: D

Rationale: The correct answer is D because obtaining information on the limitations related to the girl's involvement in sports activities is crucial for assessing her overall physical health and well-being. This information helps in understanding any potential risks or issues that may arise from her participation in sports. Choices A, B, and C are incorrect as they are not relevant to a review of systems for a healthy 7-year-old girl. Glaucoma examination, breast self-examination frequency, and electrocardiogram date are not typically part of a routine review of systems for a child of her age and health status.

Question 3 of 9

When a nurse is assessing a patient's pain level, which of the following questions would be most appropriate?

Correct Answer: A

Rationale: Step 1: Asking the patient to rate pain on a scale of 0 to 10 is a standard pain assessment tool, allowing for quantification and tracking of pain intensity. Step 2: This question helps in understanding the severity of pain objectively. Step 3: It provides a baseline for further pain management interventions. Step 4: Other choices are incorrect as they do not directly address assessing pain intensity or severity. Summary: Option A is the most appropriate as it focuses on quantifying pain, which is crucial for effective pain management. Choices B, C, and D are not as relevant for assessing pain intensity.

Question 4 of 9

A nurse is teaching a patient about managing chronic obstructive pulmonary disease (COPD). Which of the following statements by the patient indicates the need for further education?

Correct Answer: C

Rationale: The correct answer is C because stopping the inhaler once feeling better is incorrect. Inhalers are used to manage COPD symptoms long-term, not just when feeling unwell. Step 1: Explain that inhalers are essential for managing COPD and should be used consistently. Step 2: Emphasize that stopping inhaler use prematurely can lead to exacerbation of symptoms and worsening of the condition. Step 3: Reinforce the importance of following the prescribed treatment plan for optimal COPD management. Other choices are incorrect: A: True, avoiding second-hand smoke is crucial for COPD management. B: True, taking medications as prescribed is essential. D: True, breathing exercises can help improve lung function.

Question 5 of 9

The nurse is performing a health assessment on a 16-year-old girl, who has been brought to the clinic by her parents. Which of the following instructions would be appropriate for the parents before the interview begins?

Correct Answer: D

Rationale: The correct answer is D because it respects the girl's privacy and allows her to speak freely without parental influence. By asking the parents to step out, the nurse creates a safe space for the girl to discuss any sensitive issues. Choice A may inhibit the girl's honest communication. Choice B risks the parents dominating the conversation. Choice C may make the girl uncomfortable discussing personal matters in front of her parents.

Question 6 of 9

A nurse is caring for a patient with a history of hypertension. The nurse should educate the patient to avoid which of the following?

Correct Answer: D

Rationale: The correct answer is D: Increasing caffeine consumption. Caffeine can potentially raise blood pressure in individuals with hypertension. The rationale is that caffeine is a stimulant that can lead to temporary spikes in blood pressure. This can be harmful for patients with a history of hypertension as it can exacerbate their condition. A: Increasing potassium intake is generally recommended for individuals with hypertension as it can help lower blood pressure. B: Consuming more fruits and vegetables is also beneficial for hypertension due to their high fiber and nutrient content. C: Limiting sodium intake is crucial for managing hypertension as high sodium levels can lead to increased blood pressure. In summary, increasing caffeine consumption is the correct answer to avoid for patients with hypertension, as it can potentially worsen their condition by raising blood pressure.

Question 7 of 9

A nurse is caring for a patient with a history of chronic obstructive pulmonary disease (COPD). The nurse should monitor for which of the following signs of exacerbation?

Correct Answer: A

Rationale: The correct answer is A because increased sputum production and shortness of breath are classic signs of exacerbation in COPD. This indicates worsening airflow limitation and potential respiratory distress. Monitoring these signs helps in early intervention and preventing further complications. B: Improved oxygen saturation is not a sign of exacerbation in COPD. It would actually suggest improvement in the patient's condition. C: Increased energy levels are not typical signs of exacerbation in COPD. Patients usually experience fatigue and weakness during exacerbations. D: Decreased respiratory rate is not indicative of exacerbation in COPD. It could be a sign of respiratory depression or sedation, but not exacerbation.

Question 8 of 9

During an interview, a woman says, "I just know labour will be so painful that I won't be able to stand it. I know it sounds awful, but I really dread going into labour." The nurse responds by stating, "Oh, don't worry about labour so much. I have been through it myself, and yes, it is painful, but there are many good medications to decrease the pain." Which of the following statements about this response is true?

Correct Answer: B

Rationale: The correct answer is B: It was a nontherapeutic response. The nurse responded in a way that downplayed the patient's concerns and shut down the conversation. Rationale: 1. The nurse's response of dismissing the woman's fear and immediately shifting the focus to medication options invalidates the woman's feelings. 2. By sharing her own experience without acknowledging the woman's emotions, the nurse fails to provide genuine support. 3. The response lacks empathy and fails to address the woman's emotional needs, thus hindering effective communication. 4. This type of response may discourage the woman from expressing her concerns openly in the future, leading to potential emotional distress. Summary of other choices: A: Incorrect. Sharing personal experience alone does not make it therapeutic. In this context, it did not address the woman's emotional concerns effectively. C: Incorrect. Providing information about medications, although helpful, does not address the woman's emotional distress and fears. D: Incorrect. While the response did minimize the patient

Question 9 of 9

Expecting that all Chinese persons believe in the hot"“cold theory of health and illness is an example of:

Correct Answer: B

Rationale: The correct answer is B: culturalism. This is because culturalism refers to the belief that all members of a culture share the same beliefs or practices. Expecting all Chinese persons to believe in the hot-cold theory is an example of culturalism as it assumes a homogenous perspective within the Chinese culture. A: A critical cultural perspective would involve questioning and analyzing cultural beliefs and practices rather than assuming they are universal. C: Ethnic practice refers to specific customs or traditions within a particular ethnic group, not a general belief system like the hot-cold theory. D: Ethnicity refers to one's cultural background or heritage, but it does not address the assumption of shared beliefs within a culture.

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