Nursing Process 1 Test Questions

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: To determine clients response to therapy. Evaluating BUN, creatinine, and serum electrolyte levels in a client being treated for acute pyelonephritis helps the nurse assess the effectiveness of the therapy. Changes in these levels indicate how well the kidneys are functioning and how the client is responding to treatment. Monitoring these parameters allows for adjustments in therapy if needed. Incorrect choices: A: To determine the severity of the disorder - While these tests can provide information about the severity of kidney dysfunction, the primary focus is on monitoring the response to therapy. B: To identify signs of fluid retention - While BUN and creatinine levels can indirectly indicate fluid status, the main purpose of evaluating these tests is to assess therapy response. C: To determine the location of discomfort - These tests do not provide information about the location of discomfort but rather focus on kidney function and response to treatment.

Correct Answer: A

Rationale: The correct answer is A: New set of tracheostomy tubes and Oxygen tank. Rationale: 1. New set of tracheostomy tubes: Essential for reinserting the cannulas to secure the airway. 2. Oxygen tank: To ensure James has a stable oxygen supply while the tracheostomy tubes are being reinserted. Summary of incorrect choices: B: Theophylline and Epinephrine - These medications are not directly related to managing a dislodged tracheostomy. C: Obturator and Kelly clamp - While these are useful tools for tracheostomy care, they are not the immediate equipment needed in this emergency situation. D: Sterile saline dressing - This is not relevant for a dislodged tracheostomy; the priority is securing the airway.

Correct Answer: B

Rationale: The correct answer is B: Isolated systolic hypertension. This is because in isolated systolic hypertension, the systolic blood pressure is elevated while the diastolic blood pressure remains normal. This condition is common in older adults and is often related to aging and stiffening of the arteries. Primary hypertension (A) typically involves both elevated systolic and diastolic pressures. Secondary hypertension (C) is caused by an underlying condition. Hypertensive emergency (D) is characterized by severe elevations in both systolic and diastolic pressures with acute target organ damage.

Correct Answer: B

Rationale: The correct answer is B: Protein. Antibodies are a type of protein produced by the immune system to help identify and neutralize pathogens like bacteria and viruses. Proteins are composed of amino acids, which are the building blocks of proteins. Antibodies have a specific structure that allows them to bind to specific antigens. Fat (A), Sugar (C), and Carbohydrates (D) are not primary components of antibodies and do not play a significant role in their structure or function.