Nokea
A client is receiving treatment for the diagnosis of hemophilia A. Which of the following is the most appropriate to include in the assessment of this client?
- A. Cranial nerves
- B. Appetite
- C. Joint pain and bruising
- D. Urine output
Correct Answer: C
Rationale: Hemophilia A, a factor VIII deficiency, impairs clotting joint pain and bruising from hemarthrosis and bleeds are hallmark signs, demanding assessment to gauge bleeding severity and guide factor replacement. Cranial nerves check neurologic status, irrelevant unless bleeds hit the brain. Appetite or urine output offers general insight, not hemophilia-specific. Nurses zero in on joints and skin, tracking this genetic disorder's impact, critical for managing acute episodes and preventing long-term damage in this bleeding-prone client.
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The best way to prevent chronic complications of Diabetes is to:
- A. Take medications as prescribed and remove sugar from the diet completely
- B. Check feet daily for cuts, long toe nails and infections between the toes
- C. Maintain a BGL that is as close to normal as possible
- D. Undertake daily exercise to burn up the excess glucose in the system
Correct Answer: C
Rationale: Diabetes' chronic woes tight BGL control trumps meds-no-sugar, foot checks, or exercise alone, cutting nerve, eye, kidney hits. Nurses push this, a sugar-steered win.
The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?
- A. Salvage surgery
- B. Palliative surgery
- C. Prophylactic surgery
- D. Reconstructive surgery
Correct Answer: C
Rationale: A bilateral mastectomy here is prophylactic removing nonvital breasts to prevent cancer in a high-risk patient with a positive tumor marker and family history. It's about risk reduction, not treatment of existing disease. Salvage surgery tackles recurrence after a less aggressive initial approach, like resecting a regrown tumor. Palliative surgery eases symptoms (e.g., pain from obstruction) in advanced cases, not prevention. Reconstructive surgery restores form or function post-treatment, like breast reconstruction after curative mastectomy. Prophylactic fits this preemptive strike, driven by genetic or familial risk (e.g., BRCA mutations), a growing trend in oncology to outpace cancer's onset, guided by nurses supporting informed, tough choices.
What is an important independent risk factor for the development of type 2 diabetes mellitus?
- A. Alcohol use
- B. Ethnicity
- C. Socioeconomic status
- D. All three options above
Correct Answer: B
Rationale: Ethnicity stands tall South Asians, Hispanics outpace Caucasians in type 2 risk, genes and fat patterns at play. Alcohol's murky, socioeconomic status shapes access, not biology nurses see heritage trump these, a chronic marker needing tailored screens.
According to Johnson and Chang (2014) the role of the nurse and other health professions in chronic disease is to:
- A. Support the person in managing their condition more effectively
- B. Provide care to manage the disease process
- C. Ensure the patient takes their medications and avoids all risk factors
- D. Decide as a team on the best approach to manage the condition and direct the implementation of this care
Correct Answer: A
Rationale: Nurses in chronic care empower supporting self-management beats just treating, enforcing meds, or dictating plans. It's about patients steering their diabetes or asthma, with pros as guides, not bosses. Care's given, compliance nudged, teams plan, but support's the heart, a chronic win where autonomy rules.
After receiving the hand-off report, which client should the oncology nurse see first?
- A. Client who is afebrile with a heart rate of 108 beats/min
- B. Older client on chemotherapy with mental status changes
- C. Client who is neutropenic and in protective isolation
- D. Client scheduled for radiation therapy today
Correct Answer: B
Rationale: In oncology nursing, prioritizing care is critical due to the complexity of cancer patients' conditions. An older client on chemotherapy with mental status changes is the priority because this could signal sepsis or infection, especially since chemotherapy-induced neutropenia often masks typical signs like fever in the elderly. Mental confusion might be the only early clue, and delayed assessment could lead to rapid deterioration or death. A heart rate of 108 beats/min without fever suggests tachycardia, possibly from dehydration or anxiety, but it's less urgent without other red flags. A neutropenic client in isolation needs monitoring, but no acute change is noted. The client scheduled for radiation has a planned treatment, not an immediate crisis. Assessing the older client first allows the nurse to rule out or address a life-threatening issue, aligning with the principle of prioritizing unstable patients in acute care settings.