During assessment of a patient with dementia, the nurse determines that the condition is potentially reversible when finding out what about the patient?

Correct Answer: C

Rationale: The correct answer is C) Recently developed symptoms of hypothyroidism. In a patient with dementia, if the condition is potentially reversible, it suggests that an underlying and treatable cause may be contributing to the cognitive impairment. Hypothyroidism can present with symptoms that mimic dementia, such as memory problems, confusion, and difficulty concentrating. Once hypothyroidism is identified and treated with thyroid hormone replacement therapy, cognitive function can improve significantly, leading to a reversal of dementia-like symptoms. Option A) Has long-standing abuse of alcohol is incorrect because while chronic alcohol abuse can lead to cognitive impairment and conditions like Wernicke-Korsakoff syndrome, it is not typically reversible to the extent that the dementia-like symptoms would completely resolve. Option B) Has a history of Parkinson's disease is incorrect because Parkinson's disease is a progressive neurodegenerative disorder that can lead to cognitive decline over time. While some symptoms of Parkinson's disease can be managed with treatment, the dementia associated with it is not considered reversible. Option D) Was infected with human immunodeficiency virus (HIV) 10 years ago is incorrect because although HIV can lead to neurocognitive disorders, once the virus has caused damage to the brain, the resulting cognitive impairment is usually not reversible even with antiretroviral therapy. Educationally, this question highlights the importance of thorough assessment in patients presenting with dementia-like symptoms. It emphasizes the need to consider and investigate potentially reversible causes of cognitive impairment to provide appropriate and timely treatment to improve patient outcomes. It also reinforces the significance of understanding the pathophysiology of different conditions that can manifest with similar clinical presentations in order to make accurate diagnostic and treatment decisions.

Correct Answer: C

Rationale: In this question, the correct answer is C) Petechiae around the neck and upper chest. This symptom is indicative of a fat embolism rather than a pulmonary embolism from a venous thrombosis. Petechiae are tiny red or purple spots that appear on the skin when small blood vessels break. They are a result of fat globules entering the circulation and lodging in small blood vessels in the lungs. This situation is commonly seen in patients with long bone fractures, where fat from the bone marrow can enter the bloodstream. Option A) Tachycardia and dyspnea are non-specific symptoms that can be present in both fat embolism and pulmonary embolism, making it a less specific choice. Option B) A sudden onset of chest pain is more commonly associated with a pulmonary embolism rather than a fat embolism. Option D) Electrocardiographic changes and decreased PaO2 are also non-specific and can be seen in various conditions affecting the respiratory and cardiovascular systems. Educational context: Understanding the specific signs and symptoms of fat embolism is crucial for nurses caring for patients with fractures. Recognizing petechiae can aid in early identification and prompt intervention, ultimately improving patient outcomes. It highlights the importance of thorough assessment and critical thinking in clinical practice.

Correct Answer: D

Rationale: In the case of a patient who has undergone a total hip arthroplasty with a cemented prosthesis, the correct activity the nurse anticipates for the patient on the first or second postoperative day is D) Ambulation and weight bearing on the right leg with a walker. The rationale behind this is that early mobilization and weight-bearing on the affected limb help prevent complications such as blood clots, muscle weakness, and joint stiffness. Walking with assistance like a walker promotes circulation, strengthens muscles, and aids in the recovery process. Option A is incorrect because transferring from bed to chair twice a day may not provide sufficient mobilization for the patient's recovery. Option B, turning from back to unaffected side every 2 hours, is important for preventing pressure ulcers but does not address the need for weight-bearing activity. Option C, crutch walking with non-weight bearing on the operative leg, is not appropriate for a patient with a cemented prosthesis as weight-bearing is usually encouraged with this type of surgery. Educationally, it is essential for nurses to understand the rationale behind postoperative activities to provide optimal care for their patients. In the context of the NCLEX exam, understanding the importance of early mobilization and weight-bearing after orthopedic procedures is crucial for selecting the most appropriate nursing interventions.

Correct Answer: A

Rationale: The correct answer is option A) Perform daily exercise as a lifelong routine. This option is the most appropriate because regular exercise plays a crucial role in preventing and managing low back pain. Strengthening exercises help support the spine and improve flexibility, reducing the risk of future episodes of low back pain. Additionally, exercise promotes overall health and well-being, which can positively impact recovery and prevent recurrence of pain. Option B) Sit in a chair with the hips higher than the knees is incorrect because while maintaining proper posture is important for back health, this specific position may not be practical or feasible in all situations. It is essential to promote good posture and body mechanics, but this alone is not sufficient for recovery from acute low back pain. Option C) Avoid occupations in which the use of the body is required is incorrect because it is unrealistic and impractical advice. Most occupations require some level of physical activity, and avoiding them altogether is not a viable solution for managing or recovering from low back pain. Option D) Sleep on the abdomen or on the back with the legs extended is incorrect because there is no one-size-fits-all sleeping position for individuals with low back pain. The best sleeping position varies from person to person based on their specific condition and comfort level. In an educational context, it is crucial for nurses to provide evidence-based education to patients recovering from low back pain. Teaching patients about the benefits of exercise, proper posture, body mechanics, and individualized self-care strategies empowers them to take an active role in their recovery and overall health. Encouraging patients to adopt healthy lifestyle habits, including regular exercise, can lead to better outcomes and improved quality of life.

Correct Answer: C

Rationale: In the physical assessment of a patient with early to moderate rheumatoid arthritis (RA), the nurse should expect to find spindle-shaped fingers (Option C) as a characteristic manifestation. This is due to synovitis causing inflammation in the joints, leading to a characteristic deformity of the fingers. A) Hepatomegaly (Option A) is not typically associated with RA. It is more commonly seen in conditions like liver disease or heart failure. B) Heberden's nodes (Option B) are bony swellings that occur at the distal interphalangeal joints and are commonly seen in osteoarthritis, not RA. D) Crepitus on joint movement (Option D) is a sensation of grating or grinding within the joint and is more commonly associated with osteoarthritis due to the wearing down of cartilage, not typically seen in early to moderate RA. Educationally, understanding the characteristic signs and symptoms of RA is crucial for nurses to provide effective care and support to patients with this condition. Recognizing spindle-shaped fingers can help in early identification and management of RA, leading to improved outcomes for patients. Nurses need to be able to differentiate between various joint conditions to provide appropriate care and support to patients with rheumatoid arthritis.