Nokea
A child is diagnosed with acquired aplastic anemia. The nurse knows that this child has the best prognosis with which treatment regimen?
- A. blood transfusion
- B. chemotherapy
- C. bone marrow transplantation
- D. immunosuppressive therapy
Correct Answer: C
Rationale: In the case of acquired aplastic anemia, bone marrow transplantation offers the best chance of cure as it replaces the abnormal stem cells with healthy ones. Blood transfusion may provide temporary relief by replacing blood cells, but it does not address the root cause of the condition. Chemotherapy may be used in some cases, but it is not the preferred treatment for acquired aplastic anemia. While immunosuppressive therapy can be effective, especially in patients who are not candidates for a bone marrow transplant, it is not the first-line treatment and does not offer the same potential for a cure as bone marrow transplantation.
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A client who has a body mass index (BMI) of 30 is requesting information on the initial approach to a weight loss plan. Which action should the nurse recommend first?
- A. Plan low-carbohydrate and high-protein meals
- B. Engage in moderate physical activity for an hour daily
- C. Keep a record of food and drinks consumed daily
- D. Participate in a group exercise class 3 times a week
Correct Answer: C
Rationale: A BMI of 30 indicates the patient is obese. The first step in a weight loss plan should be to keep a food journal to track calorie intake, which can help in meal planning and creating a workout routine. Choice (A) suggests a dietary approach, which is important but not the first step. Choice (B) recommends strenuous activity, which may not be suitable for everyone and is not the initial step. Choice (D) involves group exercise, which can be beneficial but is not the primary action to take at the beginning of a weight loss plan.
The nurse observes an unlicensed assistive personnel (UAP) who is providing a total bed bath for a confused and lethargic client. The UAP is soaking the client's foot in a basin of warm water placed on the bed. What action should the nurse take?
- A. Remove the basin of water from the client's bed immediately
- B. Remind the UAP to dry between the client's toes completely
- C. Advise the UAP that this procedure is damaging to the skin
- D. Add skin cream to the basin of water while the foot is soaking
Correct Answer: B
Rationale: Choice (B) is the correct action for the nurse to take in this situation. Ensuring that the UAP dries between the client's toes completely is crucial to prevent skin breakdown due to excessive moisture. While keeping the client's feet clean is important, maintaining dryness is paramount for skin integrity. Choices (A), (C), and (D) are incorrect: (A) removing the basin of water immediately may disrupt the care process without addressing the root issue, (C) advising the UAP that the procedure is damaging to the skin is not as immediate or specific to the observed problem, and (D) adding skin cream to the water may not address the need for drying the client's toes thoroughly.
Which task can the registered nurse (RN) caring for a critically ill patient with multiple IV lines delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
- A. Administer IV antibiotics through the implantable port.
- B. Monitor the IV sites for redness, swelling, or tenderness.
- C. Remove the patient's nontunneled subclavian central venous catheter.
- D. Adjust the flow rate of the 0.9% normal saline in the peripheral IV line.
Correct Answer: B
Rationale: An experienced LPN/LVN can monitor IV sites for signs of infection because it falls within their education, experience, and scope of practice. Administering IV antibiotics through an implantable port, adjusting infusion rates, and removing central catheters are tasks that require RN level education and scope of practice. These activities involve a higher level of assessment, critical thinking, and potential complications that are typically within the RN's domain.
A nurse in the outpatient clinic is caring for a patient who has a magnesium level of 1.3 mg/dL. Which assessment would be most important for the nurse to make?
- A. Daily alcohol intake
- B. Intake of dietary protein
- C. Multivitamin/mineral use
- D. Use of over-the-counter (OTC) laxatives
Correct Answer: A
Rationale: The correct answer is A: Daily alcohol intake. Hypomagnesemia is often associated with alcoholism, making it crucial for the nurse to assess the patient's alcohol consumption. Protein intake is not directly related to magnesium levels. The use of over-the-counter laxatives and multivitamin/mineral supplements would typically increase magnesium levels, which are not the focus when dealing with hypomagnesemia.
The nurse requests a meal tray for a client who follows Mormon beliefs and who is on a clear liquid diet following abdominal surgery. Which menu items should the nurse request for this client? (Select all that apply)
- A. apple juice
- B. black coffee
- C. orange juice
- D. hot chocolate
Correct Answer: A
Rationale: The correct answer is A: apple juice. Clear liquids like apple juice and orange juice are suitable for a client following a clear liquid diet and Mormon beliefs. Options B and D, black coffee and hot chocolate, contain caffeine, which may not align with the client's religious dietary restrictions. Therefore, these options should be avoided for this client.