The nurse working on a pediatric unit bends to pick up an 8-month-old infant. The infant begins to cry, and rolls away from the nurse. The nurse interprets the infant's behavior as:
1. An indication of possible abuse requiring further assessment.
2. A common response of babies requiring frequent hospitalization.
3. Normal behavior for an infant of this age.
4. Failure of the infant to develop a sense of trust.
3
Rationale: An 8-month-old infant is beginning to have stranger anxiety, and turns away from strangers. This behavior is not indicative of abuse, frequent hospitalization, or lack of trust.
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During a home visit, the nurse notices that an older adult woman is caring for her bedridden husband. The woman states that this is her duty, she does the best she can, and her children come to help when they are in town
Her husband is unable to care for himself, and she appears thin, weak, and exhausted. The nurse notices that several of his prescription medication bottles are empty. This situation is best described by the term: a. Physical abuse. b. Financial neglect. c. Psychological abuse. d. Unintentional physical neglect.
An 80-year-old patient has decreased renal cortexes, atherosclerosis of the renal arteries, and hypo-osmolality of urine. What should the nurse consider first as an explanation for this patient's renal status?
1. These are typical changes associated with aging. 2. These are signs of chronic renal failure. 3. These are signs of acute renal failure. 4. These are signs of a genetic renal disorder.
The nurse assesses a child and finds the child to have hypotonic muscles, decreased respirations, and to be irritable. Looking at the lab work, the nurse will likely find:
a. hypernatremia and hypochloremia c. hypocalcemia and hypernatremia b. hypercalcemia and hyperchloremia d. hyponatremia and hypochloremia
A patient who has just been prescribed estrogen-based hormone replacement therapy (HRT) also has all of the following health problems. For which problem does the nurse check with the pre-scriber to determine whether the patient should take HRT?
a. Asthma b. Hypertension c. Osteoporosis d. Diabetes mellitus