Nokea
A 9-year-old boy develops acute myelogenous leukemia (AML) one year after completion of therapy for soft tissue sarcoma at his right thigh. Which of the following chemotherapeutic agents is MOST likely the cause of secondary acute myelogenous leukemia AML in this boy?
- A. cyclophosphamide
- B. vincristine
- C. etoposide
- D. doxorubicin
Correct Answer: C
Rationale: Etoposide is known to be associated with secondary AML due to its potential to induce chromosomal abnormalities.
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The difficulty in putting words together, limited vocabulary, or inability to use language in a socially appropriate way is defined as a disorder of
- A. fluency
- B. reception
- C. expression
- D. resonance
Correct Answer: C
Rationale: Expression disorders involve difficulties in putting words together or using language appropriately.
A 1-year-old child develops right eye ptosis, miosis, and loss of sweating; you suspect neuroblastoma. The MOST valuable investigation to confirm the diagnosis is
- A. CT scan of the neck and chest
- B. CT scan of the abdomen
- C. CT scan of the brain
- D. magnetic resonance imaging (MRI) of the brain
Correct Answer: A
Rationale: CT scan of the neck and chest can help identify a primary neuroblastoma mass in the adrenal gland or sympathetic chain.
The nurse knows which of the following statements about TPN and peripheral parenteral nutrition is true?
- A. TPN is usually indicated for clients needing short term (less than 3 weeks) nutritional support, whereas PPN is for long term maintenance
- B. A client needing more than 3000 calories would receive PPN, whereas TPN is given to those requiring less than 3000 calories
- C. TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake
- D. TPN is given to those who need to augment oral feeding, whereas PPN is used for those who are nothing by mouth
Correct Answer: C
Rationale: The statement that is true about TPN and peripheral parenteral nutrition (PPN) is that TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake. This is because TPN is a hypertonic solution that can cause fluid overload if given in large volumes, so it's typically reserved for patients who have fluid restrictions. On the other hand, PPN is a less concentrated solution that can be safely administered to patients without fluid restrictions.
The nurse is assigned to a client with acquired immunodeficiency syndrome (AIDS). When handling the client's blood and body fluids, the nurse uses standard precautions, which include:
- A. Wearing gloves to empty a bedpan
- B. Wearing gown, gloves, and protective eyewear when obtaining a urine specimen via catheterization
- C. Disposing of needles uncapped
- D. Wearing gloves when applying eyedrops
Correct Answer: A
Rationale: Standard precautions are infection control practices designed to prevent transmission of diseases like AIDS. When handling a client's blood and body fluids, it is important to use standard precautions. Wearing gloves to empty a bedpan is an appropriate practice to prevent direct contact with blood and body fluids. This helps protect the nurse from exposure to infectious agents. Other options like wearing a gown, gloves, and protective eyewear for obtaining a urine specimen via catheterization or disposing of needles uncapped do not align with standard precautions for handling blood and body fluids in a client with AIDS. Similarly, wearing gloves when applying eyedrops is not necessary for preventing transmission of bloodborne pathogens in this context.
An adult has been diagnosed with some type of anemia. The results of his blood tests showed: decreased WBC, normal RBC, decreased HCT, decreased Hgb. Based on these data, which of the following nursing diagnosis should the nurse prioritize as the most important?
- A. Potential for infection
- B. Self care deficit
- C. Alteration in infection
- D. Fluid volume excess
Correct Answer: A
Rationale: The decreased white blood cell count (WBC) in the blood tests indicates a potential for infection. White blood cells are crucial for fighting off infections in the body. A decrease in WBC count can result in an impaired immune response, making the individual more susceptible to infections. Therefore, the nurse should prioritize the nursing diagnosis of "Potential for infection" to address the heightened risk of infection in the adult with anemia. It is important to monitor for signs and symptoms of infection, provide appropriate hygiene measures, and implement interventions to prevent infections in this individual.