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A client has been scheduled for a Schilling test. What instruction will the nurse give the client?
- A. Take nothing mouth fro 12 hours prior to the test
- B. Collect his urine for 12 hours
- C. Administer a fleet enema the evening before the test
- D. Empty his bladder immediately before the test
Correct Answer: B
Rationale: The correct instruction the nurse will give to the client scheduled for a Schilling test is to collect his urine for 12 hours. The Schilling test is a diagnostic test used to assess the body's ability to absorb vitamin B12. The test involves collecting urine samples over a period of 24 hours after the client ingests a small amount of radioactive vitamin B12. By collecting urine for 12 hours, the healthcare provider will be able to analyze the excretion of the vitamin and determine the client's ability to absorb vitamin B12. Instructions such as fasting, enema administration, or emptying the bladder before the test are not typically associated with the Schilling test procedure.
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. Which of the following laboratory test results would the nurse expect to find in a client diagnosed with Hashimoto's thyroiditis?
- A. Thyroxine (T4), 22 ug/dl; triiodothyronine (T3), 320ng/dl; thyroid-stimulating hormone
- B. (TSH) undetectable
- C. T4, 22 ug/dl; T3, 200 ng/dl; TSH 0.1 uIU/ml
- D. T4, 2 ug/dl; t3, 35 ng/dl; TSH 45 uIU/ml
Correct Answer: E
Rationale: Hashimoto's thyroiditis is an autoimmune disorder that results in an underactive thyroid gland (hypothyroidism). The key lab findings typically seen in Hashimoto's thyroiditis include elevated thyroid antibodies (such as anti-thyroid peroxidase and anti-thyroglobulin antibodies), decreased levels of thyroxine (T4) and triiodothyronine (T3), and an elevated thyroid-stimulating hormone (TSH) level.
Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with:
- A. Cell division or mitosis during the M phase of the cell cycle.
- B. Normal cellular processes during the S phase of the cell cycle.
- C. The chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific).
- D. One or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle- nonspecific).
Correct Answer: D
Rationale: Antimetabolites interfere with the synthesis of nucleic acids, specifically RNA and DNA. By disrupting one or more stages of RNA and/or DNA synthesis, antimetabolites disrupt the normal cellular processes required for cell division and replication, ultimately leading to inhibition of cell proliferation. This makes them effective agents in targeting rapidly dividing cells, such as cancer cells, which rely heavily on nucleic acid synthesis for their rapid growth. The mechanism of action of antimetabolites is cell cycle-nonspecific, meaning they can affect cells at various stages of the cell cycle rather than being specific to a particular phase like M or S phase.
Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her, "We are sick of Mom always sitting with you in the hospital and playing with you. It isn't fair that you get everything and we have to stay with the neighbors." Which is the nurse's best assessment of this situation?
- A. The siblings are immature and probably spoiled.
- B. Jealousy and resentment are common reactions to the illness or hospitalization of a sibling.
- C. Family has ineffective coping mechanisms to deal with chronic illness.
- D. The siblings need to better understand their sister's illness and needs.
Correct Answer: B
Rationale: Jealousy and resentment are common reactions among siblings when one child requires more attention due to illness or hospitalization. It is natural for siblings to feel left out, overlooked, or envious of the extra attention the sick child is receiving. These feelings do not necessarily indicate immaturity or being spoiled but rather a normal emotional response to a challenging family situation. It is important for healthcare providers to recognize and address these feelings to support the entire family in coping with the chronic illness of one of their members.
Which is a function of brown adipose tissue (BAT) in the newborn?
- A. Provides ready source of calories in the newborn period
- B. Insulates the body against lowered environmental temperature
- C. Protects the newborn from injury during the birth process
- D. Generates heat for distribution to other parts of body
Correct Answer: D
Rationale: Brown adipose tissue (BAT) is specialized adipose tissue found in newborns and hibernating mammals, whose primary function is to generate heat through non-shivering thermogenesis. This heat generation is essential for maintaining body temperature in newborns, especially as they have a larger surface area-to-volume ratio, which results in greater heat loss compared to adults. BAT produces heat by metabolizing stored lipids and disrupting the normal process of cellular respiration, leading to the production of heat instead of ATP. The heat generated by BAT is then distributed throughout the body to help maintain a stable core body temperature in newborns, who are not yet able to regulate their body temperature as effectively as adults.
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?
- A. Administering aspirin if the temperature exceeds 102â—‹1 F (38.8â—‹0 C)
- B. inspecting the skin for petechiae once every shift
- C. providing for frequent rest periods
- D. Placing the client in strict isolation
Correct Answer: C
Rationale: Providing for frequent rest periods is the most appropriate intervention for a client newly diagnosed with radiation-induced thrombocytopenia. Thrombocytopenia is characterized by a decreased number of platelets, which are essential for blood clotting. Clients with thrombocytopenia are at an increased risk for bleeding and bruising. Therefore, it is important to prevent activities that may lead to injury or bleeding. Providing frequent rest periods allows the client to conserve energy and minimize the risk of trauma that could lead to bleeding complications. This intervention helps manage the symptoms associated with thrombocytopenia and promotes the client's safety and well-being.