Nokea
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Stopping all oral hypoglycaemic agents
- C. Recognition and self-management of hypoglycaemia
- D. Sick day management
Correct Answer: B
Rationale: Insulin therapy education for diabetes patients covers injection technique, hypoglycemia recognition and management, sick day rules, and safe driving, per diabetes care standards. However, stopping all oral hypoglycemic agents isn't universally essential many patients continue agents like metformin or SGLT-2 inhibitors alongside insulin for synergistic effects, depending on glycemic control needs. Assuming cessation oversimplifies treatment plans, potentially reducing efficacy. Education must tailor to individual regimens, not mandate stopping orals, making this the exception. Physicians ensure comprehensive teaching to enhance adherence and safety, critical in chronic disease management.
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A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first?
- A. Give the patient the prescribed PRN opioid.
- B. Assess for sensation and strength in the legs.
- C. Notify the health care provider about the symptoms.
- D. Teach the patient how to use relaxation to reduce pain.
Correct Answer: B
Rationale: Stage IV lung cancer plus back pain flags spinal cord compression leg checks for numbness or weakness come first; paralysis kills fast. Opioids , calls , or relaxation follow. Nurses in oncology prioritize this neuro's the lifeline, catching mets' chaos early.
It is the start of your second successive night shift on the labour ward. You have only managed to sleep for 4 h in the previous day. Your usual sleep requirement is 8 h per night. Appropriate statements regarding this situation include:
- A. Your total cumulative sleep deficit is 8 h.
- B. Your alertness will increase between 3 a.m. and 7 a.m. due to natural fluctuation in your circadian rhythm.
- C. Unintentional dural puncture during epidural insertion is more likely to occur during a night shift than during normal working hours.
- D. Sleeping for an extra 4 h will eliminate the sleep deficit.
Correct Answer: C
Rationale: Night shifts disrupt sleep and performance. After one night with 4 hours sleep (8-hour need), the deficit is 4 hours; a second night compounds it variably, but total' implies current state 8 hours overstates it without further context. Alertness dips 3-7 a.m. (circadian nadir), not increases, heightening fatigue. Night-shift studies (e.g., anaesthesia journals) show increased errors like dural puncture due to fatigue, reduced dexterity, and decision-making capacity, especially with sleep deprivation. Four extra hours reduce, not eliminate, a deficit if it's 4-12 hours cumulatively. Modafinil promotes wakefulness, not daytime sleep. The night-shift risk of dural puncture reflects fatigue's real-world impact on technical skills.
A client is receiving treatment for the diagnosis of hemophilia A. Which of the following is the most appropriate to include in the assessment of this client?
- A. Cranial nerves
- B. Appetite
- C. Joint pain and bruising
- D. Urine output
Correct Answer: C
Rationale: Hemophilia A, a factor VIII deficiency, impairs clotting joint pain and bruising from hemarthrosis and bleeds are hallmark signs, demanding assessment to gauge bleeding severity and guide factor replacement. Cranial nerves check neurologic status, irrelevant unless bleeds hit the brain. Appetite or urine output offers general insight, not hemophilia-specific. Nurses zero in on joints and skin, tracking this genetic disorder's impact, critical for managing acute episodes and preventing long-term damage in this bleeding-prone client.
A chemotherapeutic agent that is classified as a vesicant is capable of what effect if deposited into subcutaneous tissue?
- A. Tissue necrosis, damage to tendons, nerves and blood vessels
- B. Mild discomfort
- C. Bruising and paraesthesia
- D. No side effects
Correct Answer: A
Rationale: Vesicants like doxorubicin chew tissue necrosis, nerve-tendon wreck if leaked, not mild or nil. Nurses dread this, a chronic chemo spill.
The nurse is teaching the parents of a 15-year-old who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which of the following symptoms should the parents seek medical care immediately?
- A. Earache, stiff neck or sore throat
- B. Blisters, ulcers or a rash appear
- C. A temperature of 101.5 degrees Fahrenheit
- D. Difficulty or pain when swallowing
Correct Answer: C
Rationale: Chemotherapy for acute myelogenous leukemia suppresses the immune system by reducing white blood cell production, leaving the child highly susceptible to infections. A fever of 101.5°F is a critical sign in this context, as it may indicate an infection that, without a functioning immune response, could rapidly progress to sepsis a life-threatening condition. Parents must seek immediate medical care to evaluate and treat the underlying cause, often requiring emergency department intervention. While earache, stiff neck, or sore throat could suggest infection, they are less urgent without fever and may not necessitate immediate action unless severe. Blisters, ulcers, or rashes might reflect chemotherapy side effects like mucositis or drug reactions, manageable with outpatient care unless infected. Difficulty swallowing could stem from mucositis or infection, but fever trumps it in urgency due to its systemic implications. Educating parents to prioritize fever ensures timely intervention, aligning with oncology nursing's focus on preventing complications in immunocompromised pediatric patients.