Nokea
A client has malignant lymphoma. As part of her chemotherapy, the physician prescribes chlorambucil (Leukeran), 10mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to chlorambucil, such as alopecia. How soon after the first administration of chorambucil might this reaction occur?
- A. Immediately
- B. 2 to 3 weeks
- C. 1 week
- D. 1 month
Correct Answer: B
Rationale: Alopecia (hair loss) is a common adverse reaction to chlorambucil, which typically occurs within 2 to 3 weeks of starting treatment. This is because chemotherapy drugs like chlorambucil target rapidly dividing cells, which also includes hair follicles leading to hair loss. Patients should be informed about this potential side effect so that they can be prepared for it and explore options like wearing wigs or scarves if they wish.
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For a 14-month-old whose cleft palate was repaired 12 hours ago, which should be included in the plan of care?
- A. Allow familiar comfort items (e.g., favorite stuffed animal) and a 'sippy' cup (avoid suction items).
- B. Once liquids are tolerated, encourage a bland diet (e.g., soup, Jell-O, saltine crackers).
- C. Administer scheduled pain medication rather than PRN only.
- D. Use a Yankauer suction catheter to decrease aspiration risk.
Correct Answer: A
Rationale: Providing comfort items and avoiding suction items helps reduce distress and supports healing.
A client with newly diagnosed type 2 diabetes mellitus is admitted to the metabolic unit. The primary goal for this admission is education. Which of the following goals should the nurse incorporate into her teaching plan?
- A. Maintenance of blood glucose levels between 180 and 200mg/dl
- B. Smoking reduction but not complete cessation
- C. An eye examination every 2 years until age 50
- D. Exercise and a weight reduction diet
Correct Answer: D
Rationale: For a client with newly diagnosed type 2 diabetes mellitus, the primary focus should be on lifestyle modifications to help manage the condition. A key component of managing type 2 diabetes is maintaining a healthy weight through a balanced diet and regular exercise. Regular physical activity can help improve insulin sensitivity and can assist in weight management. A weight reduction diet can help control blood sugar levels and reduce the risk of complications associated with diabetes. Therefore, incorporating education on exercise and a weight reduction diet is essential in optimizing the client's health outcomes and quality of life.
The basic principle of healthy sleep hygiene which is NOT included is
- A. set routine
- B. avoid stimulating activities as playing computer games
- C. makes sure child spends time outside every day
- D. gives a heavy meal within an hour of bedtime
Correct Answer: D
Rationale: Heavy meals close to bedtime disrupt sleep.
How are young people with anorexia nervosa often described?
- A. Independent
- B. Disruptive
- C. Conforming
- D. Low achieving
Correct Answer: A
Rationale: Young people with anorexia nervosa are often described as independent. This is because individuals with anorexia nervosa tend to exhibit strong willpower and control over their behavior, often making independent decisions related to their eating habits and body image. They may resist help or intervention, preferring to maintain control over their food intake and weight loss. This independence can make it challenging to address and treat anorexia nervosa effectively, as individuals may be resistant to seeking or accepting help.
A client takes prednisone (Deltasone), as prescribed, for rheumatoid arthritis. During follow-up visits, the nurse should assess the client for common adverse reactions to this drug, such as:
- A. Tetany and tremors
- B. Fluid retention and weight gain
- C. Anorexia and weight loss
- D. None of the above
Correct Answer: B
Rationale: Prednisone, or Deltasone, is a corticosteroid medication commonly prescribed for conditions like rheumatoid arthritis. One of the common adverse reactions to corticosteroids like prednisone is fluid retention and weight gain. This can occur due to the drug's effect on sodium and water retention in the body, leading to edema and increased body weight. Monitoring for signs of fluid retention, such as swelling in the extremities, and weight changes is important during follow-up visits to ensure the client's well-being and to address any concerns promptly. Tetany and tremors (choice A) are not typically associated with prednisone use, and anorexia and weight loss (choice C) are not common adverse reactions but rather less common side effects of prednisone.