Nokea
The nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for:
- A. Chronic liver failure.
- B. Pathologic bone fractures.
- C. Acute heart failure.
- D. Hypoxemia.
Correct Answer: B
Rationale: Clients with multiple myeloma are at increased risk for pathologic bone fractures due to the disease's effects on bone tissue. Multiple myeloma is a cancer of plasma cells, a type of white blood cell found in the bone marrow. The growth of abnormal plasma cells weakens the bone structure, leading to bone lesions and an increased risk of fractures. The bone lesions can cause pain, bone deformities, and complications such as hypercalcemia. Therefore, nurses caring for clients with multiple myeloma should prioritize interventions to prevent pathologic bone fractures and manage bone health.
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A 2-month-old is diagnosed with hip dysplasia. The parent asks you how long will the child be in the hip Spica Cast. How should you respond?
- A. Not longer than 4 months.
- B. The child will be placed in a Pavlik Harness for 3 to 5 months.
- C. Following the osteotomy, the child remains in a cast for 5 months.
- D. Between 2 and 4 months.
Correct Answer: B
Rationale: Hip dysplasia in infants is often managed initially with a Pavlik Harness, which helps maintain the hips in the correct position for optimum development. The Pavlik Harness is typically worn for a period of 3 to 5 months, depending on the severity of the hip dysplasia and the response to treatment. If the dysplasia is more severe or does not respond well to the Pavlik Harness, further interventions such as hip spica casting or surgery may be required, but the initial treatment is usually with the Pavlik Harness.
Which of the following types of hearing loss does the nurse understand is most improved with the use of a hearing aid?
- A. Conductive
- B. Mixed
- C. Sensorineural
- D. Central
Correct Answer: C
Rationale: Sensorineural hearing loss occurs when there is damage to the inner ear (cochlea) or the auditory nerve. This type of hearing loss is most commonly associated with aging or prolonged exposure to loud noises. Sensorineural hearing loss is typically permanent and cannot be medically or surgically corrected; however, it can be effectively managed with hearing aids. A hearing aid can amplify sound and help individuals with sensorineural hearing loss improve their ability to hear and communicate effectively. Conductive and mixed hearing losses may benefit from other interventions such as surgical procedures, while central hearing loss is related to the processing of sound in the brain and is not effectively managed by hearing aids.
Which type of neuron transmits impulses from the central nervous system to the muscles and glands?
- A. Afferent
- B. Efferent
- C. Affective
- D. Effective
Correct Answer: B
Rationale: Efferent neurons, also known as motor neurons, transmit impulses from the central nervous system (brain and spinal cord) to the muscles and glands in the body. These neurons are responsible for inducing muscle contraction or glandular secretion in response to signals from the brain or spinal cord. In contrast, afferent neurons transmit impulses from sensory receptors to the central nervous system to convey sensory information. Thus, the correct answer is efferent neurons.
When evaluating a severely depressed adolescent, the nurse knows that one indicator of a high risk for suicide is:
- A. Depression
- B. Excessive sleepiness
- C. A history of cocaine use
- D. A preoccupation with death
Correct Answer: D
Rationale: A key indicator of high risk for suicide in a severely depressed adolescent is a preoccupation with death. This preoccupation may manifest as talking about death frequently, expressing a desire to die, or showing an interest in activities or media related to death. It is important for healthcare providers to take any mention of suicidal thoughts or intentions seriously and to assess for other risk factors. While depression, excessive sleepiness, and a history of cocaine use may also be concerning in an adolescent's mental health assessment, a preoccupation with death is a more direct indicator of suicidal risk. It is crucial for healthcare providers to address suicidal ideation promptly and to ensure the adolescent receives appropriate mental health support and interventions.
Other signs of hypovolemia includes all of the following except:
- A. Dry mucous membranes and soft eyeballs
- B. Increased hematocrit and hemoglobin
- C. Decreased pulse rate and widened pulse pressure
- D. Increased lethargy and confusion
Correct Answer: A
Rationale: When assessing for signs of hypovolemia, dry mucous membranes and soft eyeballs are actually indicative of dehydration, not specifically hypovolemia. In hypovolemia, the body loses both fluid and electrolytes, leading to decreased circulating blood volume. Other signs of hypovolemia include increased hematocrit and hemoglobin levels due to hemoconcentration, decreased pulse rate and widened pulse pressure as compensatory mechanisms to maintain perfusion to vital organs, and increased lethargy and confusion due to impaired perfusion to the brain.