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1. Correct answer:
Herpes zoster develops in the following order:
1. F. Varicella-zoster virus is reactivated.
2. D. Residual antibodies from the initial infection mobilize but are ineffective.
3. A. Fever, malaise, and red nodules appear in a dermatome distribution.
4. B. The virus multiplies in the ganglia, causing deep pain, itching, and paresthesia or hyperesthesia.
5. E. Vesicles appear filled with either clear fluid or pus.
6. C. Vesicles crust and scab but no longer shed the virus.
Herpes zoster is an acute inflammation caused by infection with the herpes virus varicella-zoster (chickenpox virus).
2. Correct answer:
Identity versus role confusion is typical for teenagers in Erikson’s five stages of psychosocial development:
1. B. Trust versus mistrust (birth to age 1): The child develops trust as the primary caregiver meets his needs.
2. E. Autonomy verus shame and doubt (ages 1 to 3): The child gains control of body functions and becomes increasingly independent.
3. A. Initiative versus guilt (ages 3 to 6): The child develops a conscience and learns about the world through play.
4. C. Industry verus inferiority (ages 6 to 12): The child enjoys working on projects with others, follows rules, and forms social relationships.
5. D. Identity versus role confusion (Ages 12 to 19): The body changes and the child becomes preoccupied with how he looks, how others view him, meeting peer expectation, and establishing his own identity.
3. Correct answer: D
Rapid-cycling bipolar disorder is characterized by 4 changes of mood between depression and mania in a 12-month period. Bipolar I is a severe form with at least one episode of mania (usually preceded by depression), rapid cycling, and psychotic symptoms (paranoia, hallucinations). Bipolar II is characterized by cycles of depression and hypomania with depression predominating. Cyclothymia involves milder mood swings.
4. Correct answer: B
In syndrome of inappropriate antidiuretic hormone (SIADH), excess release of antidiuretic hormone increases the reabsorption of water and reduces the production of urine. Osmolality measures the degree of concentration. Because fluid is reabsorbed into systemic circulation, urine osmolality increases, serum sodium levels and serum osmolality decrease, and the blood urea nitrogen level remains normal.
5. Correct answer: A
The nurse should complete an assessment to identify symptoms of hyponatremia (level<135 mEq/L) and notify the physician of the lab results and assessment data. Symptoms range from irritability to lethargy and include alterations in consciousness, cerebral edema with seizures and coma, and respiratory distress ranging from dyspnea to respiratory failure. Normal value for sodium is 135 to 145 mEq/L. Hypernatremia (>145 mEq/L) is characterized by symptoms ranging from irritability to lethargy to confusion to coma, seizures, flushing, muscle weakness and spasms, and thirst.
Explanation: Dropping blood pressure and rising heart rate indicate that the
patient may be getting septic. Notification of the physician and ICU transfer is
Explanation: Although use of the varicella vaccine is now widespread, it is still
common. An annoyance in most patients, it can be life-threatening in
immunocompromised patients such as those on chemotherapy, radiation, or with
Explanation: The analysis of cerebral spinal fluid (CSF) is the diagnostic test of
choice for meningitis. This would provide diagnosis and also culture material for
appropriate antibiotic use. A head x-ray is of no benefit, and a CBC and pulse
oximetry would be done but are not procedures which need informed consent.
Explanation: She should avoid cleaning the cat box or any cat feces. Toxoplasma
gondii is a parasite that occurs in cat feces and, if infected, a pregnant woman can
transmit it to the fetus. Fetal infection can lead to chronic neurologic sequelae in
Explanation: Decreased pulses and capillary refill indicate a possible injury to the
posterior tibial artery during surgery. Immediate evaluation by the surgeon is
by Alanna Traylor
Last Updated: 01/30/2013
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