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 dont understand why my chi
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Nursing Elites

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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?

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. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

3. While evaluating the meal choices of a client with major depressive disorder and a prescription of Phenelzine, which of the following selections should the nurse identify as appropriate?

Correct answer: C

Rationale: The correct answer is C, 'Strawberry yogurt.' This choice is appropriate because it does not contain high levels of tyramine, which can lead to a dangerous interaction with Phenelzine, a monoamine oxidase inhibitor. Tyramine-rich foods, like aged cheeses (such as cheddar cheese) and cured meats (like smoked salmon and pepperoni), should be avoided by individuals taking Phenelzine to prevent hypertensive crisis. Strawberry yogurt is a safer option for the client in this scenario.

4. Which dietary supplement is often recommended for patients taking statins to lower cholesterol?

Correct answer: B

Rationale: Coenzyme Q10 is often recommended for patients on statins because it may help reduce muscle pain, a common side effect of these medications. Iron (Choice A) is not typically recommended for patients taking statins to lower cholesterol. Calcium (Choice C) and Magnesium (Choice D) are not specifically indicated for addressing muscle pain associated with statin use, making them less suitable choices in this scenario.

5. The major determinant of a person's total cholesterol levels is the amount of cholesterol in their diet.

Correct answer: B

Rationale: It is false that the major determinant of a person's total cholesterol levels is the amount of cholesterol in their diet. While dietary cholesterol can have some impact on total cholesterol levels, it is not the major determinant. The amount and types of fats consumed, particularly saturated and trans fats, have a more significant impact on blood cholesterol levels. Therefore, a diet high in these types of fats can lead to high cholesterol, irrespective of the amount of dietary cholesterol consumed. This is why it is essential to maintain a balanced diet with a limited intake of saturated and trans fats.

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