The nurse is teaching the parent of a child newly diagnosed with JRA. The nurse would evaluate the teaching as successful when the parent is able to say that the disorder is caused by:

Correct Answer: D

Rationale: The correct answer is D. Juvenile rheumatoid arthritis (JRA) is caused by the immune-stimulated inflammatory response in the joints. In JRA, the body's immune system attacks its own healthy joint tissues, leading to inflammation, pain, and damage to the joints. This chronic inflammation can cause joint stiffness, swelling, and in severe cases, joint deformities. It is not caused by the breakdown of osteoclasts in the joint space (A), the loss of cartilage in the joints (B), or the buildup of calcium crystals in joint spaces (C).

Correct Answer: C

Rationale: Option C, which is to toilet the patient according to his pre-illness schedule, whether or not he feels the urge, is the best intervention by the nurse to help reduce episodes of bowel incontinence in this patient with subarachnoid hemorrhage. This strategy can help establish a routine and promote regular bowel movements, which may reduce the likelihood of bowel incontinence episodes. Asking the patient frequently if he has to have a bowel movement (Option A) may not be effective, as the patient may not always be able to accurately communicate their needs due to the underlying condition. Placing incontinence pads on the patient's bed and chair (Option B) may manage the consequences of incontinence but does not address the root cause. While taking care not to embarrass the patient when incontinent episodes occur (Option D) is important for maintaining the patient's dignity, it does not directly address the issue of reducing bowel incontinence episodes.

Correct Answer: A

Rationale: Alzheimer's disease is a neurodegenerative disease that primarily affects the brain, not connective tissue or bones. It is characterized by the accumulation of abnormal protein aggregates in the brain, leading to loss of cognitive function and memory. The nurse would be aware that Alzheimer's disease does not involve bones or purine metabolism, making connective tissue the correct answer in this context.

Correct Answer: D

Rationale: A patient experiencing an exacerbation of COPD, especially due to an infection, requires a diet that is high in calories and protein. This is because during exacerbations, the body's energy requirements increase due to increased work of breathing and inflammation. High-calorie intake helps provide the necessary energy for breathing and healing. Additionally, a high-protein diet is important for maintaining respiratory and skeletal muscle strength, which can be affected during exacerbations of COPD. Therefore, a high-calorie high-protein diet would be most appropriate for Aling Maria to support her recovery and overall health during this period.

Correct Answer: B

Rationale: The best way to assess a patient's fatigue is to have her rate her fatigue on a scale of 0 to 10. Fatigue is primarily a subjective symptom, and patients are the best source of information regarding their own levels of fatigue. Using a standardized scale allows for a more quantitative assessment of the severity of the fatigue experienced by the patient. This can also help in monitoring changes in fatigue over time and evaluating the effectiveness of interventions aimed at managing fatigue. While observing the patient's activity level (choice A) can provide some information, it may not always accurately reflect the subjective experience of fatigue. Monitoring for changes in vital signs (choice C) and assessing hemoglobin and hematocrit values (choice D) can be important in evaluating overall health status and potential causes of fatigue, but they do not directly assess the patient's subjective experience of fatigue.