Nokea
A 52-year old female tells the nurse that she has found a painless lump in her right breast during her monthly self- examination. Which assessment finding would strongly suggest that this client's lump is cancerous?
- A. Eversion of the right nipple and mobile mass
- B. Mobile mass that is soft and easily
- C. Non-mobile mass with irregular edges delineated
- D. Non palpable right axillary lymph nodes
Correct Answer: C
Rationale: The assessment finding that strongly suggests that the client's lump is cancerous is a non-mobile mass with irregular edges delineated. Generally, cancerous breast lumps tend to have irregular shapes/edges and lack mobility. This finding is concerning for malignancy because it indicates that the lump is fixed in place and possibly invading nearby tissues, which are characteristics often associated with cancerous tumors. It's essential for the client to undergo further diagnostic tests, such as a biopsy, to confirm the presence of cancer and establish a proper treatment plan.
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What does the surgical closure of the ductus arteriosus do?
- A. Stop the loss of unoxygenated blood to the systemic circulation
- B. Decrease the edema in legs and feet
- C. Increase the oxygenation of blood
- D. Prevent the return of oxygenated blood to the lungs
Correct Answer: A
Rationale: The ductus arteriosus is a fetal blood vessel that allows blood to bypass the lungs while in utero. After birth, the ductus arteriosus should close to redirect blood flow through the lungs for oxygenation. Surgical closure of the ductus arteriosus is performed to prevent the shunting of unoxygenated blood from the pulmonary artery to the aorta, therefore stopping the loss of unoxygenated blood to the systemic circulation. This helps to ensure that oxygenated blood is properly circulated to the body tissues and organs.
Laboratory confirmation of the diagnosis in Question 1 can best be obtained by measuring the toxic compound's concentration in which of the following?
- A. Urine
- B. Blood
- C. Hair
- D. Saliva
Correct Answer: A
Rationale: Mercury levels are most accurately measured in urine, especially in cases of chronic exposure.
A 10 years old girl presented with fever and bruises for last 2 weeks. On examination she is pale; however there is no evidence of lymphadenopathy or hepatosplenomegaly. Her Hb is 6g/dl, TLC is 2700 and platelets are 90000. The most appropriate investigation to clinch the diagnosis is:
- A. Bone marrow aspiration
- B. Retics count
- C. Bleeding time
- D. PT and APTT
Correct Answer: A
Rationale: Bone marrow aspiration is essential to rule out conditions like aplastic anemia or leukemia, which could explain the symptoms and lab findings.
The following. items are transported in blood plasma, EXCEPT:
- A. Oxygen
- B. Carbon dioxide
- C. Nutrients
- D. Hormones
Correct Answer: A
Rationale: Oxygen is not transported in blood plasma. Instead, it is transported bound to hemoglobin within red blood cells. Carbon dioxide, nutrients, and hormones are examples of substances that are transported in blood plasma. Oxygen binds to hemoglobin in the red blood cells as they pass through the lungs, while carbon dioxide is carried back to the lungs and expelled from the body through the respiratory system. Nutrients like glucose and amino acids are carried in the blood plasma to be delivered to various tissues for energy production and cellular processes. Hormones are chemical messengers that are released into the bloodstream by endocrine glands to regulate numerous physiological functions throughout the body.
During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?
- A. Recommending that the client discontinue chemotherapy
- B. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
- C. monitoring the client's platelet and leukocyte counts
- D. Checking regularly for signs and symptoms of stomatitis
Correct Answer: B
Rationale: Providing a solution of hydrogen peroxide and water for use as a mouth rinse is most likely to decrease the pain of stomatitis. Stomatitis is inflammation of the oral mucous membranes and can be quite painful for oncology clients undergoing chemotherapy. Using a solution of hydrogen peroxide and water as a mouth rinse can help reduce the risk of infection and promote healing of the mucous membranes, thereby decreasing the pain associated with stomatitis. This intervention helps to maintain oral hygiene and prevent further complications, making it an effective way to manage the client's symptoms while undergoing chemotherapy. It is important to note that discontinuing chemotherapy would not be a recommended intervention as it is the primary treatment for the client's cancer. Monitoring platelet and leukocyte counts and checking for signs and symptoms of stomatitis are important aspects of care, but providing a mouth rinse would directly address the pain and discomfort experienced by the client.