Nursing Process 1 Test Questions

Correct Answer: A

Rationale: The correct answer is A: Liver. Cancer cells commonly metastasize to the liver due to its rich blood supply, making it an ideal environment for tumor growth. Liver metastasis can occur from various primary cancer sites. The liver filters blood and is susceptible to receiving cancer cells circulating in the bloodstream. Metastasis to the colon (B) is less common as it is typically the primary site for colon cancer. Metastasis to the reproductive tract (C) can occur but is not as common as liver metastasis. White blood cells (D) are a part of the immune system and do not serve as a common site for cancer metastasis.

Correct Answer: B

Rationale: The correct answer is B: 7th cranial nerve. Bell's palsy is caused by inflammation of the facial nerve (7th cranial nerve), leading to facial muscle weakness or paralysis. The 3rd cranial nerve (choice A) controls eye movement, the 5th cranial nerve (choice C) is responsible for facial sensation and chewing, and the 8th cranial nerve (choice D) is related to hearing and balance. Bell's palsy specifically affects the facial muscles, making choice B the correct answer.

Correct Answer: D

Rationale: The correct answer is D because monitoring for signs of infection, air embolus, and leakage/puncture are crucial in caring for a patient with a central venous line to prevent serious complications. Infections can lead to sepsis, air embolus can cause respiratory distress, and leakage/puncture can result in hemorrhage or damage to surrounding tissues. A: While a complete blood count and electrolytes may be important for monitoring the patient's overall health, they are not specific to the central venous line care. B: Regular chest x-rays are not necessary unless there are specific indications of line malposition or complications. C: Continuous infusion at a keep-vein-open rate is a standard practice but does not address the critical aspects of central line care mentioned in option D. Therefore, monitoring for signs of infection, air embolus, and leakage/puncture is the most essential component of the plan of care for a patient with a central venous line.

Correct Answer: D

Rationale: The correct answer is D, assess vital signs, as it is crucial to monitor the client's hemodynamic stability and response to treatment during the critical initial 24 hours of Addisonian crisis. Vital signs such as blood pressure, heart rate, and respiratory rate provide valuable information about the client's condition and response to therapy. Weighing the client (choice A) and testing urine for ketones (choice C) may be important but not as immediately critical as monitoring vital signs. Administering oral hydrocortisone (choice B) is essential for treatment but does not require frequent administration within the first 24 hours.

Correct Answer: A

Rationale: The correct answer is A because educating young adults about the rise in heterosexual transmission of HIV is crucial to prevent the spread of AIDS. This information helps them understand the importance of safe sex practices and awareness of risks. Choice B is incorrect as HIV transmission in children is not primarily due to sexual abuse. Choice C is also incorrect as herpes zoster is not a form of the HIV virus. Choice D is incorrect as transmission by IV drug users is not prominent with sterile equipment use. Focusing on the rise in heterosexual transmission is key in teaching young adults about AIDS prevention.