Nokea
A client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?
- A. Stand as far away from the implant as possible and call for help.
- B. Pick up the implant with long-handled forceps and place it in a lead-lined container.
- C. Leave the room and notify the radiation therapy department immediately.
- D. Put the implant back in place, using forceps and a shield for self-protection, and call for help.
Correct Answer: B
Rationale: The nurse should first pick up the internal radioactive implant with long-handled forceps and place it in a lead-lined container. This action ensures the safety of the nurse and prevents further exposure to radiation. Handling the implant with forceps helps minimize direct contact, and placing it in a lead-lined container containing the radiation will effectively shield any further exposure. Once the implant is secured, proper authorities should be notified to take further action and ensure the client's safety.
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Assume you are going to estimate the prevalence of amoebic dysentery in a small country which harbors a total number of population of 530,000; you find that 57,000 of the population are infected by the disease. The prevalence of this disease is closest to
- A. 5.33%
- B. 7.45%
- C. 10.75%
- D. 20.22%
Correct Answer: C
Rationale: Prevalence = (Number of infected / Total population) * 100 = (57,000 / 530,000) * 100 ≈ 10.75%.
To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?
- A. The client is maintained on strict bed rest
- B. The head of the bed is at 30-degree angle
- C. The client receives a complete bed bath each morning
- D. The nurse checks the applicator's position every 4 hours
Correct Answer: B
Rationale: Keeping the head of the bed at a 30-degree angle can dislodge the applicator of radioactive material placed in the vagina. When caring for a client with a radioactive applicator, it is important to ensure that the position of the applicator is maintained to prevent radiation exposure to staff and other clients. This can be achieved by keeping the head of the bed flat without elevation. The other options are appropriate measures in caring for a client with a radioactive applicator.
In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is
- A. long bone
- B. bone marrow
- C. lung
- D. skin
Correct Answer: D
Rationale: Skin metastases are rare in neuroblastoma compared to bone, bone marrow, and lung involvement.
A client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should the nurse provide?
- A. "Administer desmopressin while the suspension is cold."
- B. "Your condition isn't chronic, so you won't need to wear a medical identification bracelet."
- C. "You may not be able to use desmopressin nasally if you have nasal discharge or blockage."
- D. "You won't need to monitor your fluid intake and output after you start taking desmopressin."
Correct Answer: C
Rationale: It is important for the nurse to instruct the client that they may not be able to use desmopressin nasally if they have nasal discharge or blockage. This is because nasal absorption is critical for the effectiveness of desmopressin, and any nasal issues may hinder proper absorption. If the client experiences nasal discharge or blockage, an alternative route for administering desmopressin may need to be considered, such as oral or injectable forms. This instruction is essential to ensure the client receives the medication effectively and manages their condition appropriately.
Which of the following settings is most therapeutic for an agitated head-injured patient?
- A. A day room with family visitors and variety of caregivers
- B. A semiprivate room with one or two consistent caregivers
- C. A ward with other head-injured patients and volunteers to assist with needs
- D. A hallway near the nurse's station with adequate sensory stimulation
Correct Answer: B
Rationale: For an agitated head-injured patient, the most therapeutic setting would be a semiprivate room with one or two consistent caregivers. Consistency and familiarity can help reduce agitation and promote a sense of security for the patient. A quieter environment with fewer stimuli can also help in managing agitation and promoting a sense of calmness. By having consistent caregivers, the patient can build trust and feel more comfortable, which can contribute to their overall well-being and recovery. It is essential to minimize external factors that could contribute to further agitation, making a semiprivate room with consistent caregivers the most optimal setting for an agitated head-injured patient.