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A 10-mo-old boy has a left suprarenal mass. Surgery is accomplished with complete removal of the mass as well as the non-adherent lymph nodes; surgical biopsies are taken during surgery. The histology reveals poorly differentiated neuroblastoma with microscopic ipsilateral lymph nodes involvement. The contralateral lymph nodes are negative. Of the following, the BEST therapeutic approach for this infant is
- A. chemotherapy
- B. radiotherapy
- C. concomitant chemo-radiotherapy
- D. chemotherapy followed by radiotherapy
Correct Answer: A
Rationale: Complete resection with microscopic residual disease typically warrants adjuvant chemotherapy.
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Which of the ff. is a symptom that the nurse would expect to find during assessment of a patient experiencing acute angle-closure glaucoma?
- A. Flashing lights
- B. Lens opacity
- C. Halos around lights A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET N
Correct Answer: C
Rationale: Halos around lights are a common symptom observed in patients experiencing acute angle-closure glaucoma. This occurs due to the increased intraocular pressure causing corneal edema, which leads to light scattering and the appearance of halos. Other symptoms may include severe eye pain, redness in the eye, decreased vision, and headache. It is important for the nurse to recognize these symptoms promptly as acute angle-closure glaucoma is a medical emergency that requires immediate treatment to prevent permanent vision loss.
An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.
- A. 60
- B. 70
- C. 90
- D. 100
Correct Answer: A
Rationale: In pediatric patients receiving digoxin, the nurse should notify the practitioner and withhold the medication if the apical pulse is less than 60 beats/min in an 8-year-old child. Digoxin can cause bradycardia as a side effect, and a low heart rate (bradycardia) can indicate toxicity. Monitoring the apical pulse rate before administering digoxin is essential to ensure the child's safety and prevent complications related to digoxin toxicity.
Antivenins should be considered in the treatment of all of the following EXCEPT
- A. rattlesnake envenomations
- B. scorpion envenomations
- C. black widow envenomations
- D. stonefish envenomations
Correct Answer: E
Rationale: Hymenoptera envenomations (e.g., bee stings) typically do not require antivenin, as they are managed with supportive care.
The staff nurse in a regional hospital is aware that a dose of parenteral ampicillin must be administered within how many hours after it has been mixed?
- A. 1 hour
- B. 4 hours
- C. 2 hours
- D. 8 hours
Correct Answer: B
Rationale: The correct administration time frame for a dose of parenteral ampicillin after it has been mixed is within 4 hours. This is based on the stability and compatibility of ampicillin when it is mixed and prepared for injection. Beyond 4 hours, the effectiveness and safety of the medication may be compromised due to potential degradation or contamination. It is crucial for healthcare providers to adhere to the recommended administration time frame to ensure the patient receives the full therapeutic benefits of the medication and to prevent any negative outcomes associated with the degradation of the drug.
The nurse is caring for a client with diabetes insipidus. The nurse should anticipate the administration of:
- A. insulin.
- B. poatassium chloride.
- C. furosemide (Lasix)
- D. vasopressin (Pitressin).
Correct Answer: D
Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to conserve water, leading to excessive urination and extreme thirst. The main treatment for diabetes insipidus is the administration of vasopressin (also known as antidiuretic hormone or ADH). Vasopressin helps the kidneys retain water, reduce urine output, and stabilize the body's fluid balance. Therefore, in caring for a client with diabetes insipidus, the nurse should anticipate the administration of vasopressin to help manage the symptoms of excessive urination and dehydration.