Nokea
A client admitted for sickle cell crisis is distraught after learning her child also has the disease. What response by the nurse is best?
- A. Both you and the father are equally responsible for passing it on
- B. There are many good treatments for sickle cell disease these days
- C. It's not your fault; there is no way to know who will have this disease
- D. It's understandable that you are upset about this news. Would you like to talk about what you're feeling?
Correct Answer: D
Rationale: Sickle cell's genetic blow autosomal recessive hits emotionally. Acknowledging distress and offering to talk validates feelings, fostering coping over blame or facts alone. Blaming genetics risks guilt, while touting treatments sidesteps her pain. Denying fault misleads carriers are predictable via screening but misses empathy. Nurses prioritize therapeutic communication, opening dialogue to process this crisis, a compassionate bridge to support mother and child through sickle cell's lifelong challenges.
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You are monitoring your client who is at risk for spinal cord compression related to tumor growth. Which client statement is most likely to suggest early manifestation?
- A. Last night my back really hurt, and I had trouble sleeping
- B. My leg has been giving out when I try to stand
- C. My bowels are just not moving like they usually do
- D. When I try to pass my urine, I have difficulty starting the stream
Correct Answer: A
Rationale: Spinal cord compression from tumors strikes early with back pain reported in 95% of cases as vertebral pressure or nerve irritation flares, a red flag needing urgent imaging to prevent paralysis. Leg weakness signals motor loss, a later sign as compression worsens. Bowel or bladder issues like constipation or hesitancy mark advanced nerve involvement, not initial hints. Nurses prioritize this pain statement, recognizing its prevalence and timing, prompting swift action like steroids or surgery to halt progression, critical in cancer clients where spinal integrity dictates mobility and survival.
A 79 year old woman is told by his GP that she has postural hypertension. Which of the following BP is she likely to be having?
- A. A drop of 15 mmHg/10 mmHg within 3 minutes of standing
- B. A drop of 17 mmHg/10 mmHg within 3 minutes of standing
- C. A drop of 21 mmHg/10 mmHg within 3 minutes of standing
- D. A rise of 5 mmHg/10 mmHg within 3 minutes of standing
Correct Answer: C
Rationale: Postural hypotension 21/10 drop flags, not rises or mild dips. Nurses catch this chronic stand slip (assuming typo meant hypotension).
Cardiac catheterisation (angiography) is performed to assess blood flow through the coronary arteries through use of a contrast agent and radiographic imaging. The nursing responsibilities in caring for the patient post angiography do not include:
- A. Applying pressure and observing the insertion site for bleeding or haematoma formation
- B. Informing the patient of the findings of the angiogram to allay fear and provide reassurance
- C. Monitor for arrhythmias by both cardiac monitoring and assessing apical or peripheral pulses
- D. Encourage fluids to increase urinary output and flush out the dye
Correct Answer: B
Rationale: Post-angio, nurses press sites, watch rhythms, flush dye hands-on musts. Telling results? Docs' turf nurses soothe, don't spill, a chronic care line.
Appropriate statements concerning radiology and trauma interventional radiology include:
- A. To rule out injury of the cervical spine in the unconscious patient, application of a protocol involving a computed tomography (CT) scan to the neck is recommended.
- B. A FAST (Focused Assessment with Sonography for Trauma) scan is a specific investigation for assessment of intraperitoneal bleeding.
- C. In a patient who is persistently hypotensive in the emergency department despite adequate fluid resuscitation, radiological interventions to treat bleeding caused by a pelvic fracture are not recommended.
- D. Interventional radiology has a role in the management of injuries to the liver, kidney and spleen.
Correct Answer: A
Rationale: Trauma radiology optimizes diagnosis and intervention. CT is the gold standard for cervical spine assessment in unconscious patients, per NICE guidelines, offering high sensitivity for fractures/ligamentous injury versus plain films. FAST scans detect free fluid (e.g., blood) intraperitoneally but lack specificity positive findings need confirmation (e.g., CT). Persistent hypotension with pelvic fracture warrants interventional radiology (e.g., embolization), not dismissal contrary to the statement. Interventional radiology manages solid organ injuries (liver, kidney, spleen) via embolization, reducing surgical need. Staffing in radiology matches theatre for critical cases. CT's diagnostic precision in cervical spine trauma ensures timely, accurate management, critical in unconscious patients where clinical exam is unreliable.
The nurse is caring for a patient who has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patient's care needs are unable to be met in a home environment. What might you suggest as an alternative?
- A. Discuss a referral for rehabilitation hospital
- B. Panel the patient for a personal care home
- C. Discuss a referral for acute care
- D. Discuss a referral for hospice care
Correct Answer: D
Rationale: Extensive small-cell lung cancer with a 6-month clock screams end-stage hospice fits, offering comfort-focused care in settings like home (with support), hospitals, or community sites. It matches his wish to avoid aggressive fixes, unlike rehab (for recovery) or acute care (for crises). Personal care homes lack the palliative punch needed here. Hospice blends patient and family needs, easing symptoms like pain or dyspnea, a cornerstone in oncology for terminal cases where quality trumps quantity.