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　　今天是【点名时间】与你第29次见面。

　　如果条件允许的话，小编建议，正在看这个试题的你，为自己泡杯咖啡或者倒杯果汁，然后再进入题中。

　　因为一天的劳累工作，值得对自己好点。做题也不要把自己逼得太紧，才能达到最满意的境界。

　　141. Which statement best exemplifies spiritual distress in relation to adult survivors of childhood sexual abuse?

　　A Life is not fair”

　　B. "It was my fault that this happened.”

　　C. "I don't go to church every week.”

　　D.“I'm going to pray for the person who did this to me.”

　　142. Which of the following neuromuscular assessments would the nurse expect to find in a healthy term infant?

　　A. Absent stepping reflex

　　B. Asymmetrical Moro reflex

　　C. Positive Babinski reflex

　　D. Unilateral grasp reflex

　　143. A nurse suspects that a psychiatric patient is not taking her oral medication. Which of the following actions should the nurse take?

　　A. Obtain an order to change the patient's medication to intramuscular form

　　B. Observe the patient for signs of swallowing the medication

　　C. Engage the patient in conversation for at least five minutes after she takes the medication

　　D. Inspect the patient's mouth after each dose of medication

　　144. Which of the following behaviors by a 36-month-old child supports a nursing diagnosis of growth and development, altered?

　　A. Does not link syllables together

　　B. Uses pointing to communicate

　　C. Stutters when speaking

　　D. Often repeats and hesitates

　　145. During the flushing of a peripherally inserted central catheter (P1CC)，the nurse realizes the line will not flush. The nurse's next step would be to

　　A. contact the primary practitioner on call.

　　B. continue to flush the catheter using a smaller-size syringe.

　　C. examine the line for kinks.

　　D. hold the medication until the next dose is due.

　　昨天答案解析

　　136. Key: A

　　Client Needs Psychosocial Adaptation

　　A. The patient with anorexia nervosa experiences the complications of a decrease in heart rate, a decrease in cardiac output and Increased hair loss. These physical changes occur due to inadequate nutritional intake that leads to fluid and electrolyte imbalances.

　　B. A decrease in body temperature and body mass are physical changes that occur in a patient with anorexia nervosa. These changes result from the inadequate intake of food and the fluid and electrolyte imbalances that develop.

　　C. Blood pressure decreases in anorexia nervosa due to the decreased cardiac output. Hypokalemia results from fluid and electrolyte imbalances.

　　D. Although serum cholesterol levels are decreased due to decreased fat absorption and digestion, there is a decrease in red blood cells. not white blood cells, in response to an inadequate intake of iron.The immune system is affected in the anorexic patient. increasing the patient's susceptibility to infection and causing an increase in white blood cells.

　　137. Key: B

　　Client Need: Growth and Development

　　B. By one year of age, an infant's birth weight has tripled to an average weight of 21 lbs (9.75 kg).

　　A. The first half of infancy is characterized by very rapid growth. Birth weight has doubled by approximately age four to seven months.

　　C. At the end of the first year. in infant’s weight has tripled. not quadrupled. compared with the birth weight.

　　D. Although the infant's birth weight triples at approximately one year of age. this answer is not very specific. To say the weight has multiplied" does not provide the specific information about the amount of weight gain.

　　138. Key: D

　　Client Need, Growth and Development

　　D. Because growth is a continuous but uneven process, the most reliable evaluation lies in comparing growth measurements over a prolonged period of time. The National Center of Health Statistics has available growth charts to assess height. weight. head circumference and height for weight for ages birth to 36 months and ages two to 20 years.

　　A. As physical growth is an uneven process. assessing the pattern of growth over time is more valuable than comparing a current weight with birth weight. Also. weight alone is not sufficient, as length is required, as well, to assess body surface area (BSA). body mass index (BMI). and determinants of normal weight for height.

　　B. The West Nomogram. used for the determination of BSA, is the most reliable method for determining children's medication dosages. Unlike growth charts, the nomogram results are not associated with norms for various ages.

　　C. The Denver Developmental Screening Test II is a screening test identifying what tasks most children can normally perform at a specified age. The four categories of the test are personal-social fine motor adaptive. language and gross motor. This test does not address physical growth.

　　139. Key: B

　　Client Need, Basic Care and Comfort

　　B. The burn patient is in a hypermetabolic and highly catabolic state. It is necessary for this patient to have a high-protein, high-carbohydrate to meet the high caloric needs created by his metabolic state. Since baked custard is high in milk and eggs (high-protein foods), this would be the best choice for a snack.

　　A. Applesauce is a carbohydrate with no measurable protein.

　　C. Gelatin with fruit is also a carbohydrate food without any protein value.

　　D. Although bread has a few grams of protein per slice, it would not be the best choice for a highprotein snack. Butter is considered a fat.

　　140. Key: D

　　Client Need, Psychosocial Adaptation

　　D. A predisposing factor for a dissociative reaction is a set of traumatic experiences that overwhelm the patient's capacity to cope. These experiences usually take the form of severe physical. sexual or psychological abuse by a parent or significant other in the child's life.

　　A. A history of sexual abuse is not identified as a predisposing factor for attention deficit hyperactivity.Genetic links, biochemical theories and prenatal influences. such as maternal smoking and alcohol use, are identified as possible causes for attention deficit hyperactivity disorder.

　　B. Munchausen syndrome is considered a form of child abuse. The caregiver, usually the mother, reports that her child has symptoms of an illness. causing the child to have unnecessary medical tests.A history of sexual abuse is not identified as a predisposing factor for this illness.

　　C. Factors that predispose an individual to bipolar disorder include genetic links. biochemical influences and possible disruption of ego development during childhood. A history of sexual abuse is not identified as a predisposing factor for this illness.

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