Nokea
A client is admitted with suspected Hodgkin's lymphoma. The diagnosis is confirmed by the:
- A. Overproliferation of immature white cells
- B. Presence of Reed-Sternberg cells
- C. Increased incidence of microcytosis
- D. Reduction in the number of platelets
Correct Answer: B
Rationale: Hodgkin's lymphoma is diagnosed by the presence of Reed-Sternberg cells, large abnormal cells found in lymph node biopsies.
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Which of the following findings is associated with right-sided heart failure?
- A. Shortness of breath
- B. Nocturnal polyuria
- C. Daytime oliguria
- D. Crackles in the lungs
Correct Answer: B
Rationale: Nocturnal polyuria is a classic sign of right-sided heart failure due to fluid redistribution when lying down.
A client has orders for placing a small-bore nasoenteric tube. Which finding in the health history would prompt the nurse to notify the prescriber before placing tube?
- A. small-bowel lesion
- B. basilar skull fracture
- C. acute coronary syndrome
- D. use of diabetic insulin pump
Correct Answer: B
Rationale: A basilar skull fracture is a contraindication for nasoenteric tube placement due to the risk of intracranial insertion. Other conditions are not absolute contraindications.
The client is admitted to the emergency room with shortness of breath, anxiety, and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. The doctor orders quinidine sulfate. While he is receiving quinidine, the nurse should monitor his ECG for:
- A. Peaked P wave
- B. Elevated ST segment
- C. Inverted T wave
- D. Prolonged QT interval
Correct Answer: D
Rationale: Quinidine can prolong the QT interval, increasing the risk of torsades de pointes.
Which action is contraindicated in the client with epiglottis?
- A. Ambulation
- B. Oral airway assessment using a tongue blade
- C. Placing a blood pressure cuff on the arm
- D. Checking the deep tendon reflexes.
Correct Answer: B
Rationale: Using a tongue blade can trigger airway obstruction in epiglottitis, making it contraindicated.
The nurse is preparing to administer streptomycin 0.25 g. The directions say to reconstitute with 9 mL of sterile water for a concentration of 400 mg/2 mL. How many mLs will the nurse give? Fill in the blank.
Correct Answer: 1.25 mL
Rationale: Dose: 0.25 g = 250 mg. Concentration: 400 mg/2 mL = 200 mg/mL. Volume = 250 mg ÷ 200 mg/mL = 1.25 mL.