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1. A nurse is caring for an 8-month-old infant who screams when the parent leaves the room. The parent begins to cry and says, 'I don't understand why my child is so upset. I've never seen my child act this way around others before.' Which of the following statements should the nurse make?
- A. This is a normal, expected reaction for a child of this age.
- B. This is a response to an overstimulating environment.
- C. This is a common reaction to an overexposure to caregivers.
- D. This is a typical reaction for a child who is sick.
Correct answer: A
Rationale: The correct answer is 'This is a normal, expected reaction for a child of this age.' Separation anxiety typically peaks around 8-10 months of age, leading to distress when separated from caregivers. Choice B is incorrect because the infant's behavior is more likely due to separation anxiety rather than overstimulation. Choice C is incorrect as the infant's behavior is not related to overexposure to caregivers but rather a natural developmental stage. Choice D is incorrect as the infant's behavior is not indicative of illness but rather a normal emotional response.
2. A patient tells the nurse “I am depressed to talk to you, leave me alone†Which of the following response by the nurse is most therapeutic?
- A. I’ll be back in an hour
- B. Why are you so depressed?
- C. I’ll seat with you for a moment
- D. Call me when you feel like talking to me
Correct answer: C
Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.
3. A client newly diagnosed with hypertension is receiving teaching about the Mediterranean diet from a nurse. Which of the following statements by the client indicates a need for further teaching?
- A. I will limit my intake of red meat to twice weekly.
- B. I can have dairy in moderate portions daily.
- C. I can have fish two times a week.
- D. I can drink wine in moderation.
Correct answer: D
Rationale: The correct answer is D. Patients with hypertension should be advised to limit alcohol consumption, including wine, to help manage their blood pressure. Choices A, B, and C are all consistent with the Mediterranean diet and are appropriate for a client with hypertension. Reducing red meat intake, consuming dairy in moderate portions, and having fish regularly align with the principles of this heart-healthy eating pattern.
4. Is the loss of teeth or supporting periodontium often associated with poor food selection and limited chewing ability, and do the patients' masticatory efficiency and biting force decline with each tooth lost?
- A. Both statements are true
- B. Both statements are false
- C. The first statement is true; the second is false
- D. The first statement is false; the second is true
Correct answer: A
Rationale: Both statements are indeed true. The loss of teeth or supporting periodontium frequently leads to poor food selection and limited chewing ability, as these conditions can make certain foods difficult to consume. Additionally, a patient's masticatory efficiency and biting force do decline with each tooth lost, as there are fewer teeth to distribute the force of the bite. Choices B, C, and D are incorrect because they suggest that one or both of these statements are false, which is not the case.
5. What is the primary food safety concern for a patient undergoing chemotherapy?
- A. Possible food allergy reactions
- B. Possible food-drug interactions
- C. Possible pesticide residue
- D. Potential risk of foodborne illness
Correct answer: D
Rationale: The correct answer is D: Potential risk of foodborne illness. Patients undergoing chemotherapy have compromised immune systems, making them more susceptible to foodborne illnesses. Chemotherapy can reduce the count of white blood cells, which impairs the body's ability to fight off infections from bacteria or other pathogens that might be present in food. Therefore, the prevention of foodborne illnesses is a critical concern for these patients. Choices A, B, and C, while they represent valid concerns for food safety in general, are not the primary concern for patients undergoing chemotherapy. These patients are at a heightened risk of experiencing severe complications from foodborne illnesses, making it a more significant concern than potential food allergies, food-drug interactions, or pesticide residues.
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