Nokea
A 50-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic?
- A. Smoking is the reason you are here
- B. The doctor left orders for you not to smoke
- C. You are anxious about the surgery. Do you see smoking as helping?
- D. Smoking is OK right now, but after your surgery it is contraindicated
Correct Answer: C
Rationale: Anxiety's screaming here naming it and asking if smoking helps opens a door to his feelings, not a lecture. Blaming smoking shames him, spiking stress. Citing orders shuts down dialogue. Greenlighting it's reckless nicotine constricts vessels, risking surgical healing, especially post-lung resection. Therapeutic nursing in oncology digs into emotions, guiding patients through fear without judgment, key for pre-op calm.
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The BMI that does NOT INCREASE the risk of renal disease and CKD is X. What is X?
- A. 25 or more
- B. 30 or more
- C. 35 or more
- D. 40 or more
Correct Answer: A
Rationale: Body Mass Index (BMI) correlates with chronic kidney disease (CKD) risk, with higher values linked to increased incidence due to obesity-related glomerular hypertension and inflammation. A BMI of 25 or more defines overweight and obesity, elevating CKD risk, though 18.5-24.9 is the range typically not increasing risk. The question's phrasing implies the threshold where risk begins, making 25 or more the level where renal disease risk rises, per studies like the Framingham Heart Study. Higher BMIs (30+, 35+, 40+) progressively worsen risk, with 30 marking obesity. Thus, 25 or more is the correct cutoff, guiding family physicians in counseling patients on weight management to prevent CKD onset.
A nurse is assessing a female client who is taking progestins. What assessment finding requires the nurse to notify the provider immediately?
- A. Irregular menses
- B. Edema in the lower extremities
- C. Ongoing breast tenderness
- D. Red, warm, swollen calf
Correct Answer: D
Rationale: Progestins, used in some cancer treatments (e.g., endometrial cancer), increase thromboembolism risk due to their hormonal effects on clotting factors. A red, warm, swollen calf suggests deep vein thrombosis (DVT), a medical emergency requiring immediate provider notification to prevent pulmonary embolism. Irregular menses, edema, and breast tenderness are common side effects of progestins, manageable with monitoring or symptomatic relief, and don't pose the same urgency. DVT's potential to escalate rapidly into a life-threatening condition prioritizes it over other findings. The nurse's prompt reporting ensures timely imaging (e.g., ultrasound) and anticoagulation therapy, aligning with oncology nursing's focus on vigilant complication detection in hormonally treated clients.
The nurse is caring for a 6-year-old child with leukemia who is having an oncological emergency. Which of the following signs and symptoms would indicate hyperleukocytosis?
- A. Bradycardia and distinct S1 and S2 sounds
- B. Wheezing and diminished breath sounds
- C. Respiratory distress and poor tissue perfusion
- D. Intermittent fever and frequent vomiting
Correct Answer: C
Rationale: Hyperleukocytosis, a leukemia emergency with white blood cell counts over 100,000/mm³, causes blood hyperviscosity, leading to venous stasis and microvessel occlusion by blast cells. This results in respiratory distress (from lung infarction or hypoxemia) and poor tissue perfusion (from impaired circulation), critical signs requiring urgent intervention like leukapheresis or hydration. Bradycardia and clear heart sounds don't fit tachycardia might occur from hypoxia, not bradycardia. Wheezing and diminished breath sounds suggest asthma or infection, not hyperleukocytosis's systemic impact. Fever and vomiting are non-specific and less acute here. Nurses recognizing these symptoms prioritize airway and circulation support, aligning with oncology's focus on rapid response to life-threatening complications in pediatric leukemia care.
Erysipelas
- A. responds to erythromycin
- B. is caused strep pneumoniae
- C. results from microorganism exotoxin production
- D. typically occurs on the neck
Correct Answer: A
Rationale: Erysipelas erythro clears strep pyogenes, not pneumo, toxins, neck-only, or TEN's peel. Nurses dose this chronic red edge.
Which of the following is the most common assessment finding related to autoimmune thrombocytopenic purpura?
- A. A reddish-purple fine petechial rash
- B. Confusion in the elderly
- C. Fever greater than 102.0 degrees F
- D. Extreme fatigue
Correct Answer: A
Rationale: Autoimmune thrombocytopenic purpura (ITP) trashes platelets via antibodies petechiae, tiny reddish-purple spots, bloom from capillary bleeds, the most frequent sign. Confusion, fever, or fatigue might tag along in severe cases or infection, but petechiae's visibility and link to low platelets (below 100,000) make it dominant. Nurses spot this rash, tying it to ITP's core, guiding steroids or IVIG to halt this autoimmune bleed risk.