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A client with advanced liver cancer is scheduled for chemotherapy. As part of the chemotherapy regimen, the nurse expects the physician to prescribe:
- A. Fluoxymesterone (Halotestin)
- B. Fluorouracil (5-fluorouracil, 5 FU [Fluoroplex])
- C. Tamoxifen (Nolvadex)
- D. Megestrol (Megace)
Correct Answer: B
Rationale: The correct answer is B: Fluorouracil (5-fluorouracil, 5 FU [Fluoroplex]). Fluorouracil is commonly used in chemotherapy for liver cancer to inhibit cancer cell growth. It is a pyrimidine analog that interferes with DNA synthesis. Fluoxymesterone (A) is an androgen used in hormone replacement therapy, not in liver cancer treatment. Tamoxifen (C) is an antiestrogen used in breast cancer treatment, not liver cancer. Megestrol (D) is a progestin used in hormone therapy for breast cancer and endometrial cancer, not liver cancer. Therefore, the correct choice is B as it directly targets cancer cell growth in liver cancer treatment.
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A nurse completes a thorough database and carries out nursing interventions based on priority diagnoses. Which action will the nurse take next?
- A. Assessment
- B. Planning
- C. Implementation
- D. Evaluation
Correct Answer: D
Rationale: The correct answer is D: Evaluation. After implementing nursing interventions based on priority diagnoses, the nurse must evaluate the effectiveness of these interventions to determine if the desired outcomes have been achieved. Evaluation is crucial to assess the progress, make necessary modifications, and ensure the effectiveness of the care provided. Assessment (A) is already completed before interventions are carried out. Planning (B) involves developing a care plan based on assessment findings. Implementation (C) is the actual carrying out of the interventions. Therefore, the next step after implementing nursing interventions is to evaluate their effectiveness.
Which method of data collection will the nurse use to establish a patient’s database?
- A. Reviewing the current literature to determine evidence-based nursing actions
- B. Checking orders for diagnostic and laboratory tests
- C. Performing a physical examination
- D. Ordering medications
Correct Answer: C
Rationale: The correct answer is C: Performing a physical examination. This method allows the nurse to gather objective data directly from the patient's body, such as vital signs, appearance, and physical findings. It is essential for establishing a patient's baseline health status and identifying any abnormalities or changes. Reviewing literature (A) is important but not a method of data collection. Checking orders (B) is part of the assessment process but does not involve direct data collection. Ordering medications (D) is a clinical intervention and not a data collection method.
The nurse is caring for a client with type I diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:
- A. I.M. or subcutaneous glucagon.
- B. I.V. bolus of dextrose 50%.
- C. 15 to 20 g of a fast-acting carbohydrate such as orange juice.
- D. 10 U of fast-acting insulin.
Correct Answer: C
Rationale: The correct answer is C: 15 to 20 g of a fast-acting carbohydrate such as orange juice. In this scenario, the client is experiencing hypoglycemia, which can lead to confusion and abnormal behavior. Administering fast-acting carbohydrates like orange juice will help quickly raise the blood sugar levels. This is the first-line treatment for conscious patients with hypoglycemia.
Choice A (I.M. or subcutaneous glucagon) is used for unconscious patients or when oral intake is not possible. Choice B (I.V. bolus of dextrose 50%) is too aggressive for a conscious patient and may lead to complications. Choice D (10 U of fast-acting insulin) would further lower the blood sugar levels and worsen the situation.
Administering fast-acting carbohydrates is the safest and most effective approach for conscious patients with hypoglycemia to quickly raise their blood sugar levels and resolve their symptoms.
In giving health instructions, the nurse should infrom the client about the risk fsctors associated with coronary artery disease. Which of the following controllable risk factors is closely linked to the development of MI?
- A. Age
- B. high cholesterol levels
- C. medication usage
- D. gender
Correct Answer: B
Rationale: Step 1: High cholesterol levels contribute to the buildup of plaque in arteries, leading to atherosclerosis and increasing the risk of coronary artery disease.
Step 2: Atherosclerosis can result in a blockage of blood flow to the heart, causing a myocardial infarction (MI).
Step 3: Age is a risk factor for CAD but not directly linked to MI development.
Step 4: Medication usage may impact risk factors but is not a direct cause of MI.
Step 5: Gender can influence risk but is not the primary factor in MI development.
Which statement, from a participant attending the class on AIDS prevention, indicates an understanding on how to reduce transmission of HIV?
- A. Mother’s who are HIV positive should still be encouraged to breastfeed their babies because beast milk is superior to cow’s milk
- B. I think a needle exchange program, where clean needles are exchanged for dirty needles, should be offered in every city
- C. Females taking birth control pills are protected from getting HIV
- D. It’s okay to use natural skin condoms since they offer the same protection as the latex condoms
Correct Answer: B
Rationale: The correct answer is B. This statement shows an understanding of reducing HIV transmission by promoting harm reduction strategies like needle exchange programs, which help prevent sharing of contaminated needles. This approach is evidence-based and effective in reducing the spread of HIV among injection drug users.
Choice A is incorrect because breastfeeding by HIV-positive mothers can transmit the virus to infants. Choice C is incorrect as birth control pills do not protect against HIV, only against pregnancy. Choice D is incorrect as natural skin condoms do not provide the same level of protection against HIV as latex condoms do.