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A client states that their legs have pain with walking that decreases with rest. The nurse observes absence of hair on the client's lower extremities and the client has a thread, weakened posterior tibial pulse. What would be the best position to have the client's legs?
- A. Elevated above the heart
- B. Slightly bent with three pillows under the knees
- C. Crossed at the knee
- D. Hanging down
Correct Answer: D
Rationale: PAD's claudication pain with walking, eased by rest plus hairless legs and weak pulses cry ischemia. Hanging legs down boosts gravity-fed flow, easing pain, the best position here. Elevation cuts supply, worsening it. Bending or crossing risks pressure. Nurses dangle limbs, enhancing perfusion, a practical fix in this arterial crunch.
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A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?
- A. Slow rate of mitosis of cancer cells
- B. Different proteins in the cell membrane
- C. Differing size of the cells
- D. Different molecular structure in the cells
Correct Answer: B
Rationale: Malignant breast cancer cells flaunt tumor-specific antigens (e.g., CEA) on their membranes, unlike benign ones from the same tissue think of it as a wanted' sign for the immune system. Mitosis isn't slow it's fast in malignant cells. Size varies, not the defining split. Molecular structure shifts, but membrane proteins are the standout marker. Nurses use this to explain why her cancer's a threat those antigens tag it as invasive, a core oncology lesson for scared patients piecing it together.
Which of the following appropriately describes diastolic dysfunction?
- A. The rate of filling of the ventricles during diastole is slowed
- B. The left ventricle is dilated
- C. The preload (end ventricular diastolic volume) is increased
- D. The left ventricular ejection fraction is decreased
Correct Answer: A
Rationale: Diastolic dysfunction stiffens ventricles slowed filling in diastole nails it, as relaxation flops, hiking pressure. Dilated LV or high preload fits systolic; low EF's not here preserved in HFpEF. Dyssynchrony's another beast. Clinicians peg this slow fill, a chronic heart kink distinct from pump fail.
The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?
- A. Tumor lysis syndrome (TLS)
- B. Syndrome of inappropriate antidiuretic hormone (SIADH)
- C. Disseminated intravascular coagulation (DIC)
- D. Hypercalcemia
Correct Answer: A
Rationale: Non-Hodgkin lymphoma's fast cell turnover, plus recent chemo, primes for TLS dead cells dump potassium, phosphorus, and uric acid, risking kidney failure days post-treatment. SIADH (low sodium) and hypercalcemia (bone mets) are less tied to this timeline. DIC's bleeding chaos isn't lymphoma's usual post-chemo hit. Nurses hunt TLS signs fatigue, nausea, arrhythmias knowing it's a fatal oncology curveball if missed early.
The nurse is caring for a client with type 2 diabetes who has been hospitalized with severe hyperglycemia. Which of the following topics will be most important to include in discharge teaching?
- A. Effect of endogenous insulin on transportation of glucose into cells
- B. Function of the liver in formation of glycogen and gluconeogenesis
- C. Impact of the client's family history on likelihood of developing diabetes
- D. Symptoms indicating that the client should contact the health care provider
Correct Answer: D
Rationale: Discharge teaching for type 2 diabetes post-hyperglycemia hinges on crisis prevention knowing when symptoms like thirst or confusion scream for help beats insulin mechanics, liver roles, or family odds. Clients need actionable cues to self-manage, not just theory; recognizing trouble and calling in keeps them out of the ER. Physiology's useful, genetics informative, but spotting escalation's life-saving, a chronic care must nurses drill into patients for real-world control.
Choose the CORRECT statement Babies born from mothers with gestational diabetes:
- A. Are at a high risk of being born with diabetes
- B. Are usually hypoglycaemic due to maternal insulin drug therapy
- C. Are usually of higher birth weight
- D. Are always given a glucose challenge test
Correct Answer: C
Rationale: Gestational diabetes fattens babies high maternal sugar pumps fetal growth, a hefty birth norm. They don't inherit diabetes at birth, hypo's rare unless mom's on insulin, tests aren't routine. Nurses track this, a chronic womb echo.