Nokea
A 12-year-old male adolescent, recently diagnosed with Hodgkin lymphoma, shows left cervical and supraclavicular lymph node involvement and drenching night sweats. Based on Ann Arbor Classification, the patient is classified as
- A. stage IA
- B. stage IB
- C. stage IIA
- D. stage IIB
Correct Answer: D
Rationale: Involvement of two lymph node regions above the diaphragm with systemic symptoms corresponds to stage IIB.
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A 57-year old patient had a right lower lobectomy. The nurse should initiate this action when the patient arrives from the Post Anesthesia Care Unit:
- A. immediately administer pain relief
- B. keep patient in semi-fowler's postion
- C. turn client every hour
- D. notify the family to report pateint's condition
Correct Answer: B
Rationale: After a right lower lobectomy, it is important to keep the patient in a semi-Fowler's position to promote lung expansion and oxygenation. This position helps to reduce pressure on the diaphragm and allows for better lung ventilation. By maintaining the patient in a semi-Fowler's position, it can help prevent complications such as atelectasis and pneumonia postoperatively. It is a crucial nursing intervention to ensure optimal respiratory function and promote recovery after lung surgery.
A newborn begins to cough, choke, and becomes cyanotic while feeding. What is the nurse's immediate action?
- A. Inform the physician.
- B. Have the mother stop feeding and observe.
- C. Remove the infant from the mother, place the infant in the crib for assessment, obtain oxygen saturation, and administer blow-by oxygen immediately.
- D. Continue feeding while monitoring.
Correct Answer: C
Rationale: Immediate removal from the feeding situation and rapid assessment with oxygen support is critical for airway safety.
Management of the foregoing patient should include:
- A. Regular diet with extra fruits and green vegetables
- B. Potassium-sparing diuretics
- C. Discontinuance of any oral magnesium salts
- D. All of the above measures
Correct Answer: C
Rationale: The patient's symptoms of muscle weakness and fatigue are likely due to hypermagnesemia, which is an excess of magnesium in the blood. Hence, the management should include discontinuing any oral magnesium salts that the patient may be taking. This will help in correcting the magnesium imbalance and improving the patient's symptoms. Regular diet modifications and potassium-sparing diuretics are not indicated for the treatment of hypermagnesemia and may not address the underlying cause in this case.
Neonates of mothers with diabetes are at risk for which complication following birth?
- A. Atelectasis
- B. Microcephaly
- C. Pneumothorax
- D. Macrosomia
Correct Answer: D
Rationale: Neonates of mothers with diabetes are at risk for macrosomia following birth. Macrosomia refers to a condition where the newborn baby is significantly larger than average, typically weighing more than 4,000 grams (8 pounds, 13 ounces) at birth. This risk is primarily due to maternal hyperglycemia, which can lead to excessive fetal growth. The elevated glucose levels in the maternal circulation can cross the placenta and stimulate fetal insulin production, resulting in increased growth and potentially leading to macrosomia. Neonates born with macrosomia are at increased risk for complications during delivery, such as shoulder dystocia, birth injuries, and the need for cesarean delivery.
Which of the following actions by the practitioner would be important in the prevention of rheumatic fever?
- A. Encourage routine hypertensive screenings.
- B. Conduct routine occult blood screenings.
- C. Refer children with sore throats for throat cultures.
- D. Recommend salicylates instead for minor discomforts.
Correct Answer: C
Rationale: The correct action to prevent rheumatic fever is to refer children with sore throats for throat cultures (Choice C). Rheumatic fever is caused by an abnormal immune response to a bacterial infection with group A Streptococcus. By promptly diagnosing and treating streptococcal infections with antibiotics, the risk of developing rheumatic fever can be minimized. Conducting throat cultures for children with sore throats helps identify streptococcal infections and allows for appropriate antibiotic treatment, thereby preventing the progression to rheumatic fever. Encouraging routine hypertensive screenings (Choice A) and conducting routine occult blood screenings (Choice B) are not directly related to the prevention of rheumatic fever. Recommending salicylates instead for minor discomforts (Choice D) is contraindicated in cases of suspected or confirmed streptococcal infections due to the risk of worsening symptoms and potentially triggering rheumatic fever.