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A client has been scheduled for a Schilling test. What instruction will the nurse give the client?
- A. Take nothing mouth fro 12 hours prior to the test
- B. Collect his urine for 12 hours
- C. Administer a fleet enema the evening before the test
- D. Empty his bladder immediately before the test
Correct Answer: B
Rationale: The correct instruction the nurse will give to the client scheduled for a Schilling test is to collect his urine for 12 hours. The Schilling test is a diagnostic test used to assess the body's ability to absorb vitamin B12. The test involves collecting urine samples over a period of 24 hours after the client ingests a small amount of radioactive vitamin B12. By collecting urine for 12 hours, the healthcare provider will be able to analyze the excretion of the vitamin and determine the client's ability to absorb vitamin B12. Instructions such as fasting, enema administration, or emptying the bladder before the test are not typically associated with the Schilling test procedure.
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A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribes mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How mitomycin does exert its cytotoxic effects?
- A. It inhibits deoxyribonucleic acid (DNA) synthesis
- B. It's cell cycle-phase specific
- C. It inhibits ribonucleic acid (RNA) synthesis
- D. It inhibits protein synthesis
Correct Answer: A
Rationale: Mitomycin exerts its cytotoxic effects by forming cross-links between adjacent guanine residues in DNA, leading to inhibition of DNA synthesis. This mechanism disrupts the replication of cancer cells, ultimately inducing cell death. Mitomycin is an alkylating agent that primarily targets DNA, making it an effective treatment for certain types of cancers, such as adenocarcinoma of the stomach.
Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her, "We are sick of Mom always sitting with you in the hospital and playing with you. It isn't fair that you get everything and we have to stay with the neighbors." Which is the nurse's best assessment of this situation?
- A. The siblings are immature and probably spoiled.
- B. Jealousy and resentment are common reactions to the illness or hospitalization of a sibling.
- C. Family has ineffective coping mechanisms to deal with chronic illness.
- D. The siblings need to better understand their sister's illness and needs.
Correct Answer: B
Rationale: Jealousy and resentment are common reactions among siblings when one child requires more attention due to illness or hospitalization. It is natural for siblings to feel left out, overlooked, or envious of the extra attention the sick child is receiving. These feelings do not necessarily indicate immaturity or being spoiled but rather a normal emotional response to a challenging family situation. It is important for healthcare providers to recognize and address these feelings to support the entire family in coping with the chronic illness of one of their members.
Which of the ff are the symptoms of basilar skull fracture? Choose all that apply
- A. Raccoon eyes
- B. Amnesia
- C. Halo sign
- D. Paresthesia
Correct Answer: A
Rationale: Raccoon eyes and Battle's sign are classic signs of basilar skull fracture. Raccoon eyes refer to the presence of bruising or discoloration around the eyes, resembling the appearance of a raccoon. This occurs due to blood collecting in the soft tissues around the eyes. Battle's sign is bruising behind the ear, which can also indicate a basilar skull fracture.
A male client, age 45, undergoes a lumbar puncture in which CSF was extracted for a particular neurologic diagnostic procedure. After the procedure, he complains of dizziness and a slight headache. Which of the ff steps must the nurse take to provide comfort to the client? Choose all that apply
- A. Position the client flat for at least 3 hrs or as directed by the physician
- B. Encourage a liberal fluid intake
- C. Keep the room well lit and play some soothing music in the ground
- D. Help the client ambulate and perform a few light leg exercises#
Correct Answer: B
Rationale: - **Encourage a liberal fluid intake (B):** It is essential to maintain hydration after a lumbar puncture to help prevent or alleviate a headache, which may occur due to a decrease in cerebrospinal fluid (CSF) pressure. Adequate hydration can help reduce the chances of a post-lumbar puncture headache.
For a client diagnosed with idiopathic thrombocytopenic purpura (ITP), which nursing intervention is appropriate?
- A. Teaching coughing and deep-breathing techniques to help prevent infection
- B. Administering platelets, as ordered to maintain an adequate platelet count
- C. Giving aspirin, as prescribed to control body temperature
- D. Administering stool softeners, as ordered, to prevent straining during infection
Correct Answer: B
Rationale: The appropriate nursing intervention for a client diagnosed with idiopathic thrombocytopenic purpura (ITP) is administering platelets, as ordered, to maintain an adequate platelet count. ITP is a condition characterized by a decrease in platelet count, which can lead to thrombocytopenia and an increased risk of bleeding. Administering platelets can help prevent excessive bleeding and maintain hemostasis in these patients. Platelet transfusions may be required in severe cases to raise the platelet count to a safe level and prevent bleeding complications. It is crucial for nurses to monitor the platelet count regularly and administer platelets as prescribed to manage ITP effectively.