Nokea
A child with leukemia bruises easily. This is most likely due to which of the following?
- A. Decreased fibrinogen levels
- B. Excessive clotting elsewhere in the body
- C. Decreased platelets
- D. Decreased erythrocytes
Correct Answer: C
Rationale: Leukemia causes bone marrow failure, leading to decreased platelets, which results in easy bruising.
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The nurse is preparing to administer the chemotherapeutic agent cisplatin IV to the client with ovarian cancer. The dose is 100 mg/m2 in 2 liters of DSW to be infused over 8 hours. What is the rate in milliliters (mL) per hour that the nurse should set the infusion pump to deliver the medication? __________ mL/hour (Record your answer as a whole number.)
Correct Answer: 250
Rationale: first convert liters to milliliters: 1000 mL/1L= XmL/2L. 1000mL* 2L= 1L * x mL;
2000 mL = X. Next ,CALCULATE the mL per hour 2000 mL /8 Hours =250mL/hour
The young adult, diagnosed with hemophilia A, is receiving a monthly scheduled dose of factor VIII cryoprecipitate. The client begins to cry during administration. Which response by the nurse is most appropriate?
- A. “Why are you crying? You seem afraid when I am administering the drug.”
- B. “Is it painful while I’m giving this IV push? If so, I can give it by infusion.”
- C. “I know this is uncomfortable for you; this only takes a few minutes to give.”
- D. “If you want to talk to me about what you are feeling, I am here to listen.”
Correct Answer: D
Rationale: A. Asking a “why” question challenges the client’s feelings. B. This response seeks information but is not most appropriate. It is unlikely that the initial response from an adult would not be crying if the administration of IV factor VIII cryoprecipitate by IV push were painful. C. This response ignores the client’s feelings and presumes that the nurse knows what initiated the client’s crying. D. The nurse is offering self, which is a therapeutic communication technique.
The HCP has ordered one (1) unit of packed RBCs for the client who is right-handed. Which area would be the best place to insert the intravenous catheter?
- A. A
- B. B
- C. C
- D. D
Correct Answer: C
Rationale: For a right-handed client, the non-dominant (left) arm is preferred for IV access (C) to maintain function. Specific sites (A, B, D) depend on image, but C is typically left forearm/antecubital.
Which sign/symptom should the nurse expect to assess in the client diagnosed with hemophilia A?
- A. Epistaxis.
- B. Petechiae.
- C. Subcutaneous emphysema.
- D. Intermittent claudication.
Correct Answer: A
Rationale: Hemophilia A causes bleeding; epistaxis (A) is common. Petechiae (B) indicate thrombocytopenia, emphysema (C) is unrelated, and claudication (D) is vascular.
The nurse explains “watchful waiting” (ongoing visits to a physician for observation of signs and symptoms without treatment) to the client with prostate cancer. Which client is a candidate for “watchful waiting”?
- A. 50-year-old with prostate cancer that has metastasized to the bone
- B. 75-year-old expected to live 5 years and has low-grade disease
- C. 45-year-old who has extension of the tumor outside of the prostate
- D. 59-year-old who is asymptomatic with an elevated prostate-specific antigen
Correct Answer: B
Rationale: A. The client with prostate cancer that has metastasized to the bone generally requires aggressive therapy. B. The client is a candidate for “watchful waiting” when older than age 70 with a life expectancy of less than 10 years and with low-grade disease. C. The client with extension of the tumor outside of the prostate generally requires aggressive therapy. D. The client who is asymptomatic with an elevated prostate-specific antigen generally requires aggressive therapy.