Nokea
A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribes mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How mitomycin does exert its cytotoxic effects?
- A. It inhibits deoxyribonucleic acid (DNA) synthesis
- B. It's cell cycle-phase specific
- C. It inhibits ribonucleic acid (RNA) synthesis
- D. It inhibits protein synthesis
Correct Answer: A
Rationale: Mitomycin exerts its cytotoxic effects by forming cross-links between adjacent guanine residues in DNA, leading to inhibition of DNA synthesis. This mechanism disrupts the replication of cancer cells, ultimately inducing cell death. Mitomycin is an alkylating agent that primarily targets DNA, making it an effective treatment for certain types of cancers, such as adenocarcinoma of the stomach.
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The nurse is testing an infant's visual acuity. By what age should the infant be able to fix on and follow a target?
- A. 1 month
- B. 1 to 2 months
- C. 3 to 4 months
- D. 6 months
Correct Answer: D
Rationale: By 6 months of age, infants should be able to fix on and follow a target with their eyes. This behavior is indicative of normal visual development in infants. It typically signifies that the infant's visual acuity is developing as expected. Therefore, by the age of 6 months, most infants should demonstrate the ability to focus on and track objects within their field of vision.
What should the nurse suggest to the parents of an infant who has a prolonged need for middle-of-the-night feedings?
- A. Decrease daytime feedings.
- B. Allow child to go to sleep with a bottle.
- C. Offer last feeding as late as possible at night.
- D. Put infant to bed after asleep from rocking.
Correct Answer: C
Rationale: The nurse should suggest to the parents to offer the last feeding as late as possible at night for an infant who has a prolonged need for middle-of-the-night feedings. By ensuring that the infant gets a full feeding closer to bedtime, it can potentially help the baby stay fuller for a longer period during the night, reducing the need for frequent nighttime feedings. This approach can help the parents establish a bedtime routine that supports longer stretches of sleep for both the infant and themselves. It is important to note that decreasing daytime feedings, allowing the child to go to sleep with a bottle, and putting the infant to bed after they are already asleep from rocking are not recommended strategies for addressing prolonged middle-of-the-night feedings.
Just as the nurse was entering the room, the patient who was sitting on his chair begins to have a seizure. Which of the following must the nurse do first?
- A. Ease the patient to the floor
- B. Insert a padded tongue depressor between his jaws
- C. Lift the patient and put him on the bed
- D. Restraint patient's body movement
Correct Answer: A
Rationale: When a patient is having a seizure, the primary goal is to keep the patient safe and prevent injury. By easing the patient to the floor, the nurse can prevent potential injury from falling. It is important to ensure there are no objects nearby that can harm the patient during the seizure. Placing something between the patient's jaws or restraining their body movements are not recommended as they can potentially harm the patient or exacerbate the seizure. Once the patient is safely on the floor, the nurse can protect the patient's head, remove any harmful objects, and monitor the seizure until it subsides.
Aling Nena, 68 years old, had a MVA and underwent surgery for hip fracture. Two days post-surgery, she suddenly complained of chest heaviness despite the absence of cardiac history. What is the nursing priority?
- A. document the onset, duration, severity, and precipitating factors
- B. may offer analgesics for chest pain
- C. administer oxygen via face mask
- D. inform the physician about the heaviness
Correct Answer: C
Rationale: In a post-operative patient, sudden chest heaviness can be a sign of various complications, such as a pulmonary embolism or cardiac issue. One of the immediate nursing interventions for a patient complaining of chest heaviness is to ensure adequate oxygenation. Administering oxygen via a face mask can help improve oxygenation and provide relief while further assessments are being done to determine the cause of the symptom. This intervention takes priority over documenting the symptom, offering analgesics, or informing the physician, as addressing the patient's oxygen needs is crucial in this situation.
Which is a function of brown adipose tissue (BAT) in the newborn?
- A. Provides ready source of calories in the newborn period
- B. Insulates the body against lowered environmental temperature
- C. Protects the newborn from injury during the birth process
- D. Generates heat for distribution to other parts of body
Correct Answer: D
Rationale: Brown adipose tissue (BAT) is specialized adipose tissue found in newborns and hibernating mammals, whose primary function is to generate heat through non-shivering thermogenesis. This heat generation is essential for maintaining body temperature in newborns, especially as they have a larger surface area-to-volume ratio, which results in greater heat loss compared to adults. BAT produces heat by metabolizing stored lipids and disrupting the normal process of cellular respiration, leading to the production of heat instead of ATP. The heat generated by BAT is then distributed throughout the body to help maintain a stable core body temperature in newborns, who are not yet able to regulate their body temperature as effectively as adults.