Nokea
A 50 year old man has a BP of 160/100 mmHg despite being on 10 mg Lisinopril om. Which of the following is not a good choice?
- A. Diuretic
- B. Calcium channel blocker
- C. Bisoprolol
- D. Losartan
Correct Answer: D
Rationale: BP 160/100 diuretic, calcium, beta, upping lisinopril stack; losartan doubles ACE, risks crash. Nurses dodge this chronic overlap.
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The nurse is providing preoperative care for a 7-year-old patient with a brain tumor. Which of the following is the priority intervention?
- A. Assessing the child's level of consciousness
- B. Providing a tour of the intensive care unit for the child and parents
- C. Educating the child and parents about shunts
- D. Having the child talk to another child who has had this surgery
Correct Answer: A
Rationale: For a child with a brain tumor preoperatively, assessing level of consciousness (LOC) is the priority, as it monitors for increased intracranial pressure (ICP) from tumor mass effect vital signs like alertness or confusion shift rapidly and signal deterioration needing immediate action. No baseline data exists here, making LOC the first step in the nursing process to guide care. An ICU tour reduces anxiety but delays critical assessment. Shunt education applies post-diagnosis of hydrocephalus, not universally pre-op, and lacks urgency without LOC context. Peer support is psychosocial, not physiological, and secondary. LOC assessment aligns with ABCs (circulation includes cerebral perfusion), ensuring the nurse detects neurological decline early, a cornerstone of pediatric neuro-oncology care before surgery.
The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?
- A. The UAP flushes the toilet once after emptying the patient's bedpan.
- B. The UAP stands by the patient's bed for 30 minutes talking with the patient.
- C. The UAP places the patient's bedding in the laundry container in the hallway.
- D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.
Correct Answer: B
Rationale: Cervical implant's radioactive 30 minutes bedside overshoots exposure limits (under 30's safe); flushing , laundry , and mouthwash don't radiate. Nurses in oncology intervene UAP need time caps to dodge radiation, a safety must.
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled 'Cancer: The Risks and What You Can Do About Them.' Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?
- A. Disease prophylaxis
- B. Risk reduction
- C. Secondary prevention
- D. Tertiary prevention
Correct Answer: C
Rationale: Screening's the game here secondary prevention spots cancer early in symptom-free folks, like mammograms or colonoscopies, boosting survival odds. Prophylaxis (primary) stops it cold think vaccines or sunscreen. Risk reduction's broader, overlapping primary efforts (e.g., quit smoking). Tertiary's post-diagnosis care, minimizing damage. This program's focus on early catch aligns with secondary's core, a public health win in oncology to shift outcomes before symptoms scream.
The genetic profile determines the prevalence of diabetic nephropathy in a population group. Question: Which population group has the LOWEST risk to develop endstage renal disease as a consequence of diabetes?
- A. Afro-Americans
- B. Iberians (Spanish origin)
- C. Caucasians
- D. Native Americans
Correct Answer: C
Rationale: Caucasians dodge worst kidney doom Afro-Americans, Native Americans soar high, Iberians mid-tier. Genes and diabetes hit lighter here, a chronic renal risk low nurses screen this gradient.
Following chemotherapy, a patient is being closely monitored for tumor lysis syndrome. Which laboratory value requires particular attention?
- A. Platelet count
- B. Electrolytes
- C. Hemoglobin
- D. Hematocrit
Correct Answer: B
Rationale: Tumor lysis syndrome, a post-chemotherapy emergency, floods blood with cell breakdown products potassium, phosphate, uric acid disrupting electrolytes, risking renal failure or cardiac arrest. Monitoring electrolytes is critical to catch hyperkalemia or hyperphosphatemia, guiding urgent correction like dialysis. Platelets drop with chemotherapy but aren't TLS-specific. Hemoglobin and hematocrit track anemia, not lysis effects. Electrolytes' volatility in TLS demands focus abnormalities signal escalating danger, a nurse's lifeline to intervene, ensuring rapid response to this metabolic storm in cancer treatment's wake.