Nokea
A client is admitted with superior vena cava syndrome. What action by the nurse is most appropriate?
- A. Administer a dose of allopurinol (Aloprim).
- B. Assess the client's serum potassium level.
- C. Gently inquire about advance directives.
- D. Prepare the client for emergency surgery.
Correct Answer: C
Rationale: Superior vena cava syndrome (SVCS) occurs when cancer (often lung or lymphoma) obstructs the superior vena cava, impairing venous return from the head and upper body. It's often a late-stage manifestation with a poor prognosis, though treatable with radiation or stenting. After stabilizing the client (e.g., with oxygen, positioning), gently inquiring about advance directives is most appropriate, as it opens a compassionate discussion about goals of care amid a potentially terminal condition. Allopurinol and potassium levels relate to tumor lysis syndrome, not SVCS. Surgery is rare for SVCS, with non-invasive options preferred. This action respects the client's autonomy and prepares for realistic outcomes, aligning with oncology nursing's holistic approach to end-of-life care in advanced disease.
You may also like to solve these questions
A 44 year old man with type 2 DM and hyperlipidemia is currently taking daily simvastatin 40 mg. His lipid profile repeated 12 weeks after treatment shows the following results: Total cholesterol 4.2 mmol/L, HDL-cholesterol 0.9 mmol/L, LDL-cholesterol 2.2 mmol/L, Triglyceride 2.4 mmol/L. Which lipid regulating drug should be MOST appropriately added?
- A. Colestyramine
- B. Omega 3 fatty acid
- C. Fenofibrate
- D. Nicotinic acid
Correct Answer: C
Rationale: Simvastatin's cut LDL to 2.2, but triglycerides linger at 2.4 above 1.7's ideal and HDL's low at 0.9. Fenofibrate slashes triglycerides, lifts HDL, a perfect next step for this type 2 mix. Colestyramine binds bile, not triglycerides; omega-3 helps less here; nicotinic acid's harsh; ezetimibe's LDL focus misses. Nurses see this combo statin plus fibrate as a chronic lipid tune-up, dodging heart risks tied to diabetes.
The hospice nurse is caring for a patient with cancer in her home. The nurse has explained to the patient and the family that the patient is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this patient and family to do to reduce the patient's risk of hypercalcemia?
- A. Stool softeners are contraindicated
- B. Laxatives should be taken daily
- C. Consume 2 to 4 L of fluid daily
- D. Restrict calcium intake
Correct Answer: C
Rationale: Hypercalcemia cancer's bone breakdown gift needs hydration (2-4 L/day) to flush calcium through kidneys, unless heart or renal issues say no. Stool softeners and laxatives fight constipation (a symptom), not the cause, and aren't contraindicated. Cutting calcium's pointless tumors, not diet, spike it. Nurses in hospice drill this, balancing fluid push with symptom watch (confusion, thirst), keeping comfort king in late-stage oncology care.
Which of the following should be not be routinely performed for patients with suspected non-alcoholic fatty liver disease?
- A. Liver biopsy
- B. Imaging studies like US scan
- C. Fasting lipids
- D. Fasting glucose
Correct Answer: A
Rationale: Liver biopsy, while diagnostic for NAFLD/NASH, isn't routine due to invasiveness and risks, reserved for unclear cases or staging needs, per AASLD. Ultrasound (fatty liver detection), fasting lipids, glucose, and liver function tests are non-invasive, routine screens for metabolic risk and diagnosis confirmation. This approach optimizes chronic disease evaluation safely.
Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy?
- A. Using lemon glycerin swabs for oral hygiene.
- B. Keeping the child NPO until all sores are healed.
- C. Having the child swish and swallow viscous lidocaine.
- D. Giving the child pudding for breakfast.
Correct Answer: D
Rationale: Mucositis, a painful chemotherapy side effect, involves inflamed, ulcerated mucous membranes, often in the mouth, complicating eating and hygiene. Offering pudding a soft, bland, cool food is the best intervention, as it minimizes irritation and pain, encouraging nutrition without exacerbating sores. Lemon glycerin swabs are harsh, with citric acid and chemicals worsening discomfort and delaying healing. Keeping the child NPO (nothing by mouth) for weeks until sores heal is impractical and risks malnutrition, as mucositis can persist throughout chemotherapy. Viscous lidocaine might numb pain but is a last resort if the child refuses all intake, not a first-line comfort measure. Pudding supports hydration and calorie intake safely, aligning with nursing's goal to maintain nutrition and comfort in pediatric oncology, reducing mucositis-related distress effectively.
Regarding HIV/AIDS
- A. Shingles, seborrhoeic dermatitis and recurrent HSV infections are typical of early infection
- B. A CD4 count of 1.0 x 10^9/L is associated with late stage AIDS
- C. Pre and post test counselling for HIV serology is now no longer mandatory
- D. Pneumococcus is a more likely pathogen than TB in AIDS patients with pneumonia
Correct Answer: D
Rationale: HIV early skin woes, CD4's units flop, counseling holds, TB trumps pneumococcus, toxo hits brain. Nurses chase this chronic lung truth.