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A client is receiving chemotherapy to treat breath cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
- A. A Urine output of 400 ml in 8 hours
- B. B. Serum potassium level of 3.6 mEq/L
- C. C. Blood pressure of 120/64 to 130/72 mm Hg
- D. D. Dry oral mucous membranes and cracked lips
Correct Answer: A
Rationale: Chemotherapy can cause fluid and electrolyte imbalances in the body, leading to potential kidney damage and altered urinary output. A low urine output of 400 ml in 8 hours could indicate dehydration or impaired renal function, both of which can be induced by chemotherapy. Monitoring urine output is crucial in assessing the patient's fluid balance and kidney function during chemotherapy. It is essential to identify and address such imbalances promptly to prevent complications.
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What is the pathophysiologic mechanism of cystic fibrosis leading to obstructive lung disease?
- A. Fibrosis of mucous glands and destruction of bronchial walls
- B. Destruction of lung parenchyma from inflammation and scarring
- C. Production of secretions low in sodium chloride and therefore thickened mucus
- D. Increased serum levels of pancreatic enzymes that are deposited in the bronchial mucosa
Correct Answer: C
Rationale: Cystic fibrosis (CF) is caused by mutations in the CFTR gene, leading to altered transport of sodium and chloride ions in and out of epithelial cells. This results in the production of secretions that are low in sodium chloride, leading to thickened mucus. The abnormally thick, abundant secretions from mucous glands in the respiratory tract can obstruct the airways, leading to chronic, diffuse obstructive pulmonary disease in almost all patients with CF. This process impairs mucociliary clearance, predisposing individuals to recurrent lung infections, inflammation, and ultimately bronchiectasis. This mechanism is a key factor in the pathophysiology of cystic fibrosis-associated obstructive lung disease.
Antivenins should be considered in the treatment of all of the following EXCEPT
- A. rattlesnake envenomations
- B. scorpion envenomations
- C. black widow envenomations
- D. stonefish envenomations
Correct Answer: E
Rationale: Hymenoptera envenomations (e.g., bee stings) typically do not require antivenin, as they are managed with supportive care.
A 45-year-old patient has a long- standing history of allergies to pollen. Which of the following actions indicates that the patient does not understand how to control this disease?
- A. Staying indoors on dry, windy days.
- B. Refusing to walk outside in the spring.
- C. Driving in the care with the windows open.
- D. Working in the garden on sunny days.
Correct Answer: C
Rationale: Driving in the car with the windows open is not a recommended action for someone with allergies to pollen. Keeping the windows closed while driving can help minimize exposure to pollen particles in the air. By driving with the windows open, the individual is increasing their exposure to pollen and not effectively controlling their allergy symptoms. Staying indoors on dry, windy days (Choice A), refusing to walk outside in the spring (Choice B), and working in the garden on sunny days (Choice D) are all actions that demonstrate understanding of how to control allergies to pollen by avoiding potential triggers.
A 10-mo-old boy has a left suprarenal mass. Surgery is accomplished with complete removal of the mass as well as the non-adherent lymph nodes; surgical biopsies are taken during surgery. The histology reveals poorly differentiated neuroblastoma with microscopic ipsilateral lymph nodes involvement. The contralateral lymph nodes are negative. Of the following, the BEST therapeutic approach for this infant is
- A. chemotherapy
- B. radiotherapy
- C. concomitant chemo-radiotherapy
- D. chemotherapy followed by radiotherapy
Correct Answer: A
Rationale: Complete resection with microscopic residual disease typically warrants adjuvant chemotherapy.
A patient is admitted for a splenectomy. Why is an injection of Vit. K ordered before surgery?
- A. To correct clotting problems
- B. To prevent postoperative infection
- C. To promote healing
- D. To dry secretions
Correct Answer: A
Rationale: Vitamin K plays a crucial role in the production of clotting factors in the liver. Patients undergoing a splenectomy may be at an increased risk of bleeding during and after surgery due to the decreased availability of these clotting factors. Administering Vitamin K before the surgery helps to correct any potential clotting problems, ensuring proper hemostasis and reducing the risk of excessive bleeding during the procedure. This preoperative intervention can help optimize the patient's coagulation status and improve their outcomes postoperatively.