Nokea
A client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?
- A. "Keep the stoma uncovered."
- B. "Keep the stoma dry."
- C. "Have a family member perform stoma care initially until you get used to the procedure."
- D. "Keep the stoma moist."
Correct Answer: B
Rationale: It is important to keep the stoma dry to prevent infection and skin irritation. Excess moisture can lead to skin breakdown around the stoma site, increasing the risk of infection. It is recommended to keep the stoma clean and dry to promote healing and prevent complications.
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Which is a common, serious complication of rheumatic fever?
- A. Seizures
- B. Cardiac arrhythmias
- C. Pulmonary hypertension
- D. Cardiac valve damage
Correct Answer: D
Rationale: Rheumatic fever is an inflammatory disease that can develop after a streptococcal infection, such as strep throat. One of the most serious complications of rheumatic fever is cardiac involvement, specifically damage to the heart valves. This occurs due to the body's immune response attacking the heart valves as a result of molecular mimicry between streptococcal antigens and human tissues. The damage to the heart valves can result in conditions like mitral valve stenosis or regurgitation, which can lead to heart failure if not managed appropriately. Therefore, cardiac valve damage is a common and serious complication of rheumatic fever that requires monitoring and treatment to prevent long-term consequences.
Which is the major cause of death for children older than 1 year?
- A. Cancer
- B. Heart disease
- C. Unintentional injuries
- D. Congenital anomalies
Correct Answer: C
Rationale: Unintentional injuries are the major cause of death for children older than 1 year. These include accidents such as drownings, car accidents, fires, falls, and poisoning. Children are curious and naturally explore their environment, which can put them at risk for accidents. It is important for parents and caregivers to create safe environments for children, supervise them closely, and take appropriate safety precautions to prevent these injuries. By being mindful of potential hazards and actively working to prevent accidents, we can help reduce the incidence of unintentional injuries and protect children's well-being.
The following are warning signs of cancer. Which one is not?
- A. Change In bladder and bowel habits
- B. Weight gain
- C. Indigestion or difficulty in swallowing
- D. Nagging cough or hoarseness
Correct Answer: B
Rationale: Weight gain is not typically considered a warning sign of cancer. In fact, unexplained weight loss is more commonly associated with certain types of cancer. The other options all relate to symptoms that could potentially be warning signs of cancer and are worth discussing with a healthcare professional for further evaluation.
A client has the following blood lab values: platelets 50,000/ul, RBC's 3.5 (X 106), hemoglobin 10 g/dl, hematocrit 30 percent, WBCs 10,000/ul. Which nursing instruction should be included in the teaching plan?
- A. Bleeding precautions
- B. Isolation to prevent infection
- C. Seizure precautions
- D. Control of pain with analgesics
Correct Answer: A
Rationale: The client's platelet count of 50,000/ul is significantly low (normal range is around 150,000-450,000/ul). A low platelet count places the client at risk for bleeding tendencies. Therefore, the most appropriate nursing instruction to include in the teaching plan is bleeding precautions. This would involve educating the client on measures to prevent bleeding such as avoiding activities that may cause injury, using a soft toothbrush, avoiding tight clothing, and being cautious while shaving.
You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is
- A. vincristine
- B. cyclophosphamide
- C. cisplatin
- D. methotrexate
Correct Answer: C
Rationale: Cisplatin is a cornerstone in the treatment of germ cell tumors.