Nokea
A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to:
- A. Prevent metabolic breakdown of xanthine to uric acid
- B. Prevent uric acid from precipitating in the ureters
- C. Enhance the production of uric acid to ensure adequate excretion of urine
- D. Ensure that the chemotherapy doesn’t adversely affect the bone marrow
Correct Answer: A
Rationale: Allopurinol prevents the breakdown of xanthine to uric acid, reducing the risk of uric acid nephropathy during chemotherapy-induced tumor lysis.
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Sequelae of a complete posterior cord section between C3 and T1 include:
- A. Muscle fasciculation
- B. Loss of sensation below the lesion
- C. Loss of deep tendon reflexes
- D. Athetoid movements
Correct Answer: B
Rationale: A complete posterior cord section results in loss of sensation below the lesion due to damage to the sensory pathways. Motor functions may remain intact as the anterior cord is unaffected.
In scabies:
- A. Itching is due to sensitisation by the mite
- B. Vesicles may be seen in children
- C. The organism is easily demonstrated
- D. Spread can occur through clothes and bedding
Correct Answer: A
Rationale: Itching in scabies is due to an allergic reaction to the mites and their products, leading to sensitization.
Croup:
- A. Is a disease
- B. Is commonly caused by parainfluenza viruses
- C. Most cases are managed with nebulised adrenaline
- D. Inhaled steroids are reported to be of benefit
Correct Answer: B
Rationale: Croup is most commonly caused by parainfluenza viruses, which lead to inflammation of the larynx and trachea.
Aspirin has been ordered for the child with rheumatic fever (RF) in order to:
- A. Keep the patent ductus arteriosus (PDA) open
- B. Reduce joint inflammation
- C. Decrease swelling of strawberry tongue
- D. Treat ventricular hypertrophy of endocarditis
Correct Answer: B
Rationale: Aspirin helps alleviate the joint inflammation and pain experienced in RF.
A client with cancer is receiving chemotherapy with a known vesicant. The client's IV has been in place for 72 hours. The nurse determines that a new IV site cannot be obtained, and leaves the present IV in place. What is the greatest clinical risk related to this situation?
- A. Impaired skin integrity
- B. Fluid volume excess
- C. Acute pain and anxiety
- D. Peripheral neurovascular dysfunction
Correct Answer: A
Rationale: Vesicants can cause severe tissue damage if they extravasate, leading to impaired skin integrity.