Nokea
A 2-year-old male child has an asymptomatic right flank mass discovered incidentally by the mother while bathing. Suspicion of Wilms tumor is raised. Of the following, the LEAST likely investigation to be performed in this child is
- A. plain abdominal radiography
- B. computerized tomography (CT) scan of the abdomen
- C. CT scan of the chest
- D. biopsy of the mass
Correct Answer: D
Rationale: Biopsy is generally avoided in suspected Wilms tumor to prevent upstaging the disease.
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A patient understands the common causes of urinary tract infection if he or she states the following, EXCEPT:
- A. "UTI can be caused by holding the urge to urinate."
- B. "Insertion of instruments and catheter to the urinary tract can introduce bacteria that can cause infection."
- C. "I usually drink lots of water at night and it might have caused my UTI."
- D. "UTI can be caused by unhygienic cleaning after defecation."
Correct Answer: C
Rationale: Drinking lots of water at night is actually a good practice for promoting urinary health and preventing urinary tract infections (UTIs). Adequate hydration helps to flush out bacteria from the urinary tract, reducing the risk of infections. Therefore, the statement that drinking lots of water at night might have caused a UTI is incorrect. The other choices describe common causes of UTIs such as holding the urge to urinate, introducing bacteria through instruments or catheters, and poor hygiene practices after defecation.
Two hours after arriving on the medical-surgical unit, the client develops dyspnea. SaO2 is 91%, and the client is exhibiting audible wheezing and use of accessory muscles. Which of the following medications should the nurse expect to administer?
- A. Antibiotic
- B. Beta-blocker
- C. Antiviral
- D. Beta2 agonist D.The nurse should expect to administer a beta2 agonist. Beta2 agonists are used for relief of acute symptoms. Neither an antibiotic, an antiviral, nor a beta blocker are indicated for this condition. of the following to guide interpretation of severity of findings?
Correct Answer: D
Rationale: In this situation, the client is experiencing dyspnea, audible wheezing, and decreased oxygen saturation, indicating the presence of respiratory distress, likely due to bronchoconstriction. These are classic symptoms of an acute asthma exacerbation or an obstructive respiratory condition. Beta2 agonists, such as albuterol, are bronchodilators that work by relaxing the muscles in the airways, relieving bronchoconstriction and improving airflow. Administering a beta2 agonist promptly is crucial to provide relief and improve the client's respiratory status. Antibiotics, antivirals, and beta-blockers are not appropriate treatments for acute bronchoconstriction or asthma exacerbation.
The nurse in the postoperative unit prepares to receive a client after a balloon angioplasty of the carotid artery. Which of the ff items of priority should the nurse keep at the bedside for such client?
- A. Blood pressure apparatus
- B. IV infusion stand
- C. Call bell
- D. Endotracheal intubation
Correct Answer: A
Rationale: Having a blood pressure apparatus at the bedside is a priority for a client following a balloon angioplasty of the carotid artery. Monitoring blood pressure closely is essential to assess for any signs of complications such as bleeding or thrombosis after the procedure. Rapid identification and management of any changes in blood pressure are crucial in the immediate postoperative period to ensure the client's safety and well-being. It allows the nurse to promptly intervene if there are any signs of complications, helping to prevent further harm to the client.
Poor prognostic factors in Hodgkin lymphoma include all the following EXCEPT
- A. age of more than 15 year at the time of diagnosis
- B. stage IV disease
- C. manifested by positron emission tomography (PET) scan positivity
- D. poor response to therapy
Correct Answer: A
Rationale: Older age is generally considered a poor prognostic factor, but not necessarily worse than other listed options.
A 90 y.o. nursing home resident with stage 2 Alzheimer's disease is found alone and crying in the dining room. She says she lost her mother and doesn't know what to do. Which response by the nurse will help calm the resident?
- A. "Remember your mother has been dead for 30 years. You forgot again, didn't you?"
- B. "I'm sorry you lost your mother; let's go and try to find her."
- C. "Are you feeling frightened? I'm here and I will help you."
- D. "You are 90 years old. It is impossible for your mother to still be living. I know if you try, you can figure out what to do."
Correct Answer: C
Rationale: Option C, "Are you feeling frightened? I'm here and I will help you," is the most appropriate response to help calm the resident. The resident is experiencing confusion and distress, likely due to her Alzheimer's disease. Invalidating her feelings by reminding her of the reality may lead to more confusion and distress. Instead, acknowledging the resident's emotions, offering support, and reassuring her of your presence can help calm her down and provide comfort in the moment. It is important to provide emotional support and reassurance to individuals with Alzheimer's disease, rather than focusing on correcting their statements or reminding them of reality.