A chemotherapeutic agent that is classified as a vesicant is capable of what effect if deposited into subcutaneous tissue?
- A. Tissue necrosis, damage to tendons, nerves and blood vessels
- B. Mild discomfort
- C. Bruising and paraesthesia
- D. No side effects
Correct Answer: A
Rationale: Vesicants like doxorubicin chew tissue necrosis, nerve-tendon wreck if leaked, not mild or nil. Nurses dread this, a chronic chemo spill.
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Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.
Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy?
- A. Using lemon glycerin swabs for oral hygiene.
- B. Keeping the child NPO until all sores are healed.
- C. Having the child swish and swallow viscous lidocaine.
- D. Giving the child pudding for breakfast.
Correct Answer: D
Rationale: Mucositis, a painful chemotherapy side effect, involves inflamed, ulcerated mucous membranes, often in the mouth, complicating eating and hygiene. Offering pudding a soft, bland, cool food is the best intervention, as it minimizes irritation and pain, encouraging nutrition without exacerbating sores. Lemon glycerin swabs are harsh, with citric acid and chemicals worsening discomfort and delaying healing. Keeping the child NPO (nothing by mouth) for weeks until sores heal is impractical and risks malnutrition, as mucositis can persist throughout chemotherapy. Viscous lidocaine might numb pain but is a last resort if the child refuses all intake, not a first-line comfort measure. Pudding supports hydration and calorie intake safely, aligning with nursing's goal to maintain nutrition and comfort in pediatric oncology, reducing mucositis-related distress effectively.
The definition of Chronic Heart Failure is:
- A. Failure of the heart to adequately pump blood to the body
- B. Long-term inability of the heart to meet metabolic demands required to maintain homeostasis
- C. Prolonged enlargement of the left ventricle impacting on the contractility of the muscle
- D. Long term fluid build-up, causing increase in blood volume and reducing the ability of the heart to maintain blood flow
Correct Answer: B
Rationale: Chronic heart failure's essence long-term pump lag can't match body's metabolic needs, a homeostasis bust. Simple pump fail's vague; LV growth or fluid traps are bits, not the whole. Nurses grasp this, a chronic ticker's root.
A 44 year old man with type 2 DM and hyperlipidemia is currently taking daily simvastatin 40 mg. His lipid profile repeated 12 weeks after treatment shows the following results: Total cholesterol 4.2 mmol/L, HDL-cholesterol 0.9 mmol/L, LDL-cholesterol 2.2 mmol/L, Triglyceride 2.4 mmol/L. Which lipid regulating drug should be MOST appropriately added?
- A. Colestyramine
- B. Omega 3 fatty acid
- C. Fenofibrate
- D. Nicotinic acid
Correct Answer: C
Rationale: Simvastatin's cut LDL to 2.2, but triglycerides linger at 2.4 above 1.7's ideal and HDL's low at 0.9. Fenofibrate slashes triglycerides, lifts HDL, a perfect next step for this type 2 mix. Colestyramine binds bile, not triglycerides; omega-3 helps less here; nicotinic acid's harsh; ezetimibe's LDL focus misses. Nurses see this combo statin plus fibrate as a chronic lipid tune-up, dodging heart risks tied to diabetes.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Stopping all oral hypoglycaemic agents
- C. Recognition and self-management of hypoglycaemia
- D. Sick day management
Correct Answer: B
Rationale: Insulin therapy education for diabetes patients covers injection technique, hypoglycemia recognition and management, sick day rules, and safe driving, per diabetes care standards. However, stopping all oral hypoglycemic agents isn't universally essential many patients continue agents like metformin or SGLT-2 inhibitors alongside insulin for synergistic effects, depending on glycemic control needs. Assuming cessation oversimplifies treatment plans, potentially reducing efficacy. Education must tailor to individual regimens, not mandate stopping orals, making this the exception. Physicians ensure comprehensive teaching to enhance adherence and safety, critical in chronic disease management.