Nokea
A charge nurse is teaching a newly licensed nurse about risk factors for chronic myelogenous leukemia (CML). Which of the following information should the nurse include?
- A. Exposure to radiation
- B. Family history
- C. Another type of cancer
- D. Genetic mutation
Correct Answer: A
Rationale: Exposure to high levels of radiation is a known risk factor for CML, as seen in historical data from atomic bomb survivors. Family history and other cancers are not significant risk factors, and the Philadelphia chromosome mutation is an acquired, not inherited, genetic factor.
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A nurse is caring for a client who has developed pulmonary embolism (PE). Which of the following diagnostic tests should the nurse anticipate the provider to prescribe to confirm the client's condition?(Select All that Apply.)
- A. D-dimer blood test
- B. Complete blood count (CBC)
- C. CT scan
- D. Chest x-ray
- E. Lung ventilation and perfusion scan (VQ scan)
Correct Answer: A,C,E
Rationale: A D-dimer test measures clot breakdown products in the blood, with elevated levels suggesting the presence of an abnormal blood clot like in PE. A CT pulmonary angiography is the gold standard for diagnosing PE, providing detailed images of the lung's blood vessels. A VQ scan is another diagnostic tool for PE, especially for clients who cannot tolerate contrast dye, as it identifies ventilation-perfusion mismatches suggestive of PE. A CBC is not typically used to diagnose PE, and a chest x-ray is performed to rule out other causes but does not confirm PE.
A nurse is developing a plan of care for a client who is rehabilitating from major burns. Which of the following interventions should the nurse include to provide emotional support?
- A. Keep family members aware of his condition.
- B. Talk with the client during wound care.
- C. Rotate nursing staff so he can have varied interactions.
- D. Assign assistive personnel to keep his room neat and clean.
Correct Answer: B
Rationale: Talking with the client during wound care builds trust, provides emotional support, and helps cope with pain and stress. Other options are less directly supportive emotionally.
A nurse is teaching a group of clients about causes for developing hearing loss, which of the following risk factors should the nurse include in the teaching?
- A. Alcohol use disorder
- B. Prolonged exposure to loud noises
- C. Exposure to environmental toxins
- D. Contact with excessive heat
Correct Answer: B
Rationale: Prolonged exposure to loud noises causes noise-induced hearing loss. Environmental toxins can also contribute, but noise exposure is the most direct and common risk factor.
A nurse is caring for a client who has a prescription for one unit of packed RBCs. The nurse should plan to remain in the room with the client at which of the following times during the infusion to observe for a transfusion reaction?
- A. The first 2 min
- B. The final 2 min
- C. The final 15 min
- D. The first 15 min
Correct Answer: D
Rationale: Transfusion reactions typically occur within the first 15 minutes of starting the blood transfusion. The nurse should remain with the patient during this critical period to monitor for signs of a reaction, such as fever, chills, rash, or difficulty breathing.
After radiation treatment, a client reports dryness, redness, and scaling of his skin occurring within the designated radiation treatment markings. The nurse should instruct the client to take which of the following actions?
- A. Wash with plain soap and water.
- B. sit in the sun for 10 min per day.
- C. Apply moist heat.
- D. Apply hydrating lotions.
Correct Answer: D
Rationale: Hydrating lotions soothe and moisturize skin, alleviating dryness and scaling from radiation. Other options risk further irritation or damage.