Nokea
A client hospitalized for chemotherapy has a hemoglobin of $6.1 mg/dL. What medication should the nurse prepare to administer?
- A. Epoetin alfa (Epogen)
- B. Filgrastim (Neupogen)
- C. Mesna (Mesnex)
- D. Oprelvekin (Neumega)
Correct Answer: A
Rationale: A hemoglobin of 6.1 mg/dL (normal 12-16 g/dL for women, 13-18 g/dL for men) indicates severe anemia, often from chemotherapy suppressing bone marrow red cell production. The nurse should prepare epoetin alfa (Epogen), a synthetic erythropoietin that stimulates red blood cell production, addressing anemia directly. Filgrastim (Neupogen) boosts white cells for neutropenia, not hemoglobin. Mesna (Mesnex) protects the bladder from chemotherapy toxicity, irrelevant here. Oprelvekin (Neumega) increases platelets, not red cells. Administering epoetin alfa corrects the anemia, improving oxygen delivery and reducing symptoms like fatigue and dyspnea, a critical intervention in oncology to support the client's recovery and quality of life during treatment.
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The Barker hypothesis describes the relationship between birth weight and the development of diseases. Question: Which relationship is correct?
- A. High birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
- B. High birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
- C. Low birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
- D. Low birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
Correct Answer: D
Rationale: Barker's call low birth weight scars metabolism, upping later obesity, diabetes, heart woes. High weight leans risky too, but low's the proven chronic link nurses track this fetal echo.
In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.
A nurse is caring for four clients with leukemia. After hand-off report, which client should the nurse see first?
- A. Client who had two bloody diarrhea stools this morning
- B. Client who has been premedicated for nausea prior to chemotherapy
- C. Client who is crying and feeling lonely
- D. Client with an unchanged lesion to the lower right lateral malleolus
Correct Answer: A
Rationale: Leukemia's marrow suppression risks bleeding two bloody stools signal GI hemorrhage, a potential emergency needing urgent assessment for stability, trumping others per ABCs. Premedicated nausea's managed, loneliness needs support but waits, and an unchanged lesion's stable. Nurses prioritize bleeding, anticipating labs or fluids, a life-saving call in this fragile hematologic lineup.
The nurse is caring for a client with mitral regurgitation. Which of the following would the nurse anticipate the client to develop if left untreated?
- A. Left-sided heart failure
- B. Right-sided heart failure
- C. Renal failure
- D. Myocardial ischemia
Correct Answer: A
Rationale: Mitral regurgitation backflows blood into the left atrium, hiking pressure and volume untreated, it overburdens the left ventricle, leading to left-sided heart failure. Pulmonary congestion follows, with dyspnea and edema, a direct consequence of this valve flaw. Right-sided failure stems from downstream effects or separate causes, not primary here. Renal failure or ischemia might complicate advanced disease, but left-sided failure's progression is the immediate risk, rooted in mitral dysfunction's mechanics. Nurses anticipate this, monitoring for early signs like crackles, ensuring timely intervention to halt this predictable cardiac cascade.
Which of the following statements regarding weight regulation is FALSE?
- A. The reward system of weight regulation cannot override the signals from the homeostatic weight regulation circuitry
- B. Weight regain after weight loss is physiological and not necessarily due to a failure of conscious efforts to lose weight
- C. Liking and wanting of food are subconscious processes
- D. In human studies, functional MRI (fMRI) studies have shown overactivation of reward-encoding brain regions and/or deficiency in cortical inhibitory networks in obese people
Correct Answer: A
Rationale: Reward can trump homeostatic signals dopamine's pull often beats leptin's brake, a false claim busted by obesity's hedonic drive. Regain's wired, liking/wanting's deep, fMRI shows reward overdrive, and corticolimbic rules non-homeostatic. Clinicians tackle this override, a chronic quirk in weight's tug-of-war.