Which of the following statements should Nurse Cora consider as TRUE with anorexia nervosa?

Correct Answer: C

Rationale: Nurse Cora should consider statement C as TRUE with anorexia nervosa. Cultures that portray thinness as the ideal standard of beauty can increase the risk of developing anorexia nervosa. This is because individuals may internalize these societal norms and feel pressure to attain the thin ideal, leading to disordered eating behaviors.

Correct Answer: D

Rationale: If a nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field during surgery, it is crucial to inform the surgical team immediately and initiate a thorough search. Patient safety is of utmost importance, and any missing instruments could potentially pose a risk to the patient. By informing the team and conducting a thorough search, the missing instrument can be located promptly to ensure it is not inadvertently left inside the patient's body. Continuing with the procedure or ignoring the discrepancy without further investigation could lead to serious consequences for the patient's well-being. It is always better to address any discrepancies or concerns during surgery proactively to maintain a high standard of patient care and safety.

Correct Answer: D

Rationale: False imprisonment occurs when a client is physically restrained or confined without legal justification. In this scenario, the nurse restraining the confused and combative client without a physician's order constitutes false imprisonment. Restraints should only be used when necessary to ensure the safety of the client or others, and a physician's order is required to authorize their use. In this case, the nurse acted without proper authorization, making it a violation of the client's rights and false imprisonment. It is essential to follow proper protocols and obtain necessary orders before restraining a client.

Correct Answer: D

Rationale: Cooking foods in a variety that includes meat, dairy products, and beans demonstrates a positive coping index for the family in addressing the protein deficiency and malnutrition in their children. This behavior shows the family's understanding and effort to provide diverse sources of protein, which is essential for addressing protein deficiency. By including different protein-rich foods in their meals, the family is actively working towards improving the nutritional status of their children. This approach aligns with the goal of health education to change knowledge, attitudes, and practices to enhance individual, family, and community health.

Correct Answer: B

Rationale: Nurse Crissel likely informed the participants that HIV is not casually transmitted through activities like kissing. HIV transmission primarily occurs through activities that involve the exchange of bodily fluids, such as blood, semen, vaginal fluids, and breast milk. Accidental blood exposure, unprotected sex, and mother to child transmission are known routes of HIV transmission due to the direct exchange of bodily fluids containing the virus. However, the virus is not spread through saliva, including activities like kissing, which do not involve the exchange of significant amounts of bodily fluids.

Correct Answer: D

Rationale: The presentation described in the question – sudden-onset unilateral headache along with ipsilateral ptosis, miosis, and anhidrosis – is characteristic of Horner syndrome. Horner syndrome is caused by disruption of the sympathetic nerve pathway and can occur in trigeminal neuralgia. Trigeminal neuralgia is a painful condition affecting the trigeminal nerve commonly characterized by sudden and severe facial pain that can be triggered by various stimuli. The involvement of the sympathetic pathway in trigeminal neuralgia can lead to Horner syndrome symptoms such as ptosis (drooping eyelid), miosis (constricted pupil), and anhidrosis (lack of sweating) on the affected side of the face. Cluster headaches usually involve severe unilateral pain around the eye, but they do not typically present with Horner syndrome symptoms. Migraine and tension-type headaches also do not typically present with Horner syndrome symptoms.

Correct Answer: B

Rationale: Guava leaves are recommended by the Department of Health as a remedy for cough due to their natural expectorant properties. The leaves contain compounds that help to loosen mucus and make it easier to expel, providing relief from cough and congestion. Guava leaves are commonly used in traditional medicine for respiratory conditions such as cough, bronchitis, and asthma. They help soothe the throat, reduce inflammation, and promote overall respiratory health. It is important to note that while guava leaves can be a helpful remedy for cough, they should be used in conjunction with other treatments as advised by healthcare professionals for best results.

Correct Answer: A

Rationale: Ventilator-associated pneumonia (VAP) is a serious complication in patients receiving mechanical ventilation in the ICU. The priority intervention to manage respiratory infection in a patient with VAP is the administration of appropriate antibiotics to target and eliminate the causative pathogens. Broad-spectrum antibiotics are usually initiated empirically to cover a wide range of potential pathogens commonly associated with VAP, such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter species. Timely initiation of antibiotic therapy is crucial in improving outcomes and reducing morbidity and mortality associated with VAP. Other interventions like endotracheal suctioning, oral hygiene measures, and early mobilization are also important in preventing complications and promoting recovery, but the primary focus should be on treating the infection with antibiotics.

Correct Answer: B

Rationale: Loop diuretics such as furosemide are commonly prescribed for the management of heart failure to reduce fluid overload and lower blood pressure by increasing the excretion of sodium and water. These medications promote the loss of potassium through increased urinary output. Hypokalemia, or low potassium levels in the blood, is the most common electrolyte imbalance associated with loop diuretic therapy. Potassium is an essential electrolyte for proper functioning of the heart, muscles, and nerves. Low potassium levels can lead to symptoms such as muscle weakness, cramps, and potentially life-threatening cardiac arrhythmias. Patients on loop diuretics are often monitored for potassium levels, and sometimes potassium supplements may be prescribed to prevent or correct hypokalemia.