Which sociocultural finding in the history of a patient will alert the nurse to a possible developmental problem?
Childhood obesity.
Prolonged poverty.
Family relocation.
Loss of stamina.
The Correct Answer is B
A. Childhood obesity may indicate dietary and lifestyle issues but does not directly reflect sociocultural factors affecting developmental problems.
B. Prolonged poverty can significantly impact a child's development by limiting access to resources such as nutrition, education, and healthcare, thus signaling a potential developmental issue.
C. Family relocation can cause stress and adjustment challenges but is not as directly associated with long-term developmental problems as prolonged poverty.
D. Loss of stamina may be a physical issue but does not necessarily correlate with sociocultural factors that would indicate developmental concerns.
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Correct Answer is C
Explanation
A. Certification relates to additional qualifications and does not directly involve independent nursing actions in patient care.
B. Licensure is the legal permission to practice nursing but does not describe decision-making and action in patient care.
C. Autonomy is demonstrated when the nurse independently assesses the patient’s fluid status and takes action to promote health by encouraging fluid intake. This reflects the nurse’s ability to make decisions and act based on professional judgment.
D. Accountability refers to being responsible for one's actions but does not specifically cover the independent decision-making shown here.
Correct Answer is A
Explanation
A. Hyperkalemia can lead to dangerous cardiac arrhythmias and other heart-related complications due to its effect on the electrical conduction system of the heart, making cardiac assessment the priority.
B. While neurological assessment is important in various conditions, it is secondary to assessing cardiac status in hyperkalemia.
C. Gastrointestinal symptoms can occur with hyperkalemia, but they do not pose an immediate life-threatening risk like cardiac issues do.
D. Respiratory assessment is essential in many contexts, but the immediate threat of hyperkalemia lies in its impact on heart function, making cardiac assessment the most critical.