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A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?
- A. The patient requests that her family bring her makeup and wig
- B. The patient begins to discuss the future with her family
- C. The patient reports less disruption from pain and discomfort
- D. The patient cries openly when discussing her disease
Correct Answer: A
Rationale: Alopecia guts self-image, especially at 16 requesting makeup and a wig shows she's fighting back, reclaiming her look and confidence. It's active, not passive, unlike future talks (hopeful but vague), less pain (physical, not emotional), or crying (raw but not progress). Nurses in oncology cheer this, knowing it signals resilience against chemo's brutal psychosocial hit, a win for body image goals.
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A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.
Which of the following is FALSE regarding patient education for insulin therapy?
- A. It improves the patients experience and adherence to insulin therapy
- B. It requires time and preparation
- C. It can only be done by diabetes nurse educators
- D. Different topics and focus can be covered at different stages of insulin therapy
Correct Answer: C
Rationale: Insulin education boosts adherence and takes prep varied topics hit stages, and checking understanding's key. But pinning it to diabetes nurse educators alone flops; GPs, pharmacists, even peers can teach, widening reach. Team effort trumps solo specialty, ensuring chronic care's flexible, not bottlenecked, a practical truth in diabetes' long haul.
In a patient with COPD, the risk of postoperative pulmonary complications increases with:
- A. Wheezing on preoperative examination.
- B. A history of preoperative cough.
- C. Low body mass index (BMI).
- D. A serum albumin concentration less than 35 mg litreâ»Â¹.
Correct Answer: A
Rationale: Postoperative pulmonary complications in COPD patients are influenced by disease severity and patient condition. Wheezing indicates active airway obstruction and inflammation, directly increasing the risk of complications like atelectasis or pneumonia due to impaired ventilation and secretion clearance. A preoperative cough may suggest irritation or infection but is less specific than wheezing as a risk predictor. Low BMI reflects malnutrition, a known risk factor, but its impact is less immediate than active respiratory symptoms. Low serum albumin (<35 g/L, not mg/L as stated) also indicates poor nutritional status and healing capacity, elevating risk, but wheezing is more directly tied to airway dynamics. Regional anesthesia may reduce complications compared to general anesthesia, but the question focuses on risk factors. Wheezing's presence signals acute respiratory compromise, making it the strongest preoperative indicator of postoperative issues.
Tetanus:
- A. typically has an incubation period of 23 days
- B. immunization status is particularly poor in elderly women
- C. toxoid is more effective by S.C. injection
- D. IgG will provide passive protection for about a week
Correct Answer: B
Rationale: Tetanus 7-10 days incubate, elderly women lag shots, IM toxoid, Ig lasts longer, pregnancy's fine. Nurses tag this chronic gap.
Which of the following factors has a major impact on the development of chronic illness?
- A. Poverty
- B. Social stability
- C. Urban dwelling
- D. High school diploma
Correct Answer: A
Rationale: Poverty slams chronic illness cash shortages spike stress, skimp care, and fuel risks like poor diet, a root driver nurses see in diabetes or heart woes. Stability's a buffer, urban life's neutral, education helps but lacks poverty's punch. Socioeconomic holes breed disease, a chronic trap clinicians fight.