Nokea
A client with cancer is receiving chemotherapy with a known vesicant. The client's IV has been in place for 72 hours. The nurse determines that a new IV site cannot be obtained, and leaves the present IV in place. What is the greatest clinical risk related to this situation?
- A. Impaired skin integrity
- B. Fluid volume excess
- C. Acute pain and anxiety
- D. Peripheral neurovascular dysfunction
Correct Answer: A
Rationale: Vesicants can cause severe tissue damage if they extravasate, leading to impaired skin integrity.
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Cristina, a mother of a 4-year-old child tells the nurse that her child is a very poor eater. What’s the nurse’s best recommendation for helping the mother increase her child’s nutritional intake?
- A. Allow the child to feed herself
- B. Use specially designed dishes for children – for example, a plate with the child’s favorite cartoon character
- C. Only serve the child’s favorite foods
- D. Allow the child to eat at a small table and chair by herself
Correct Answer: A
Rationale: Allowing the child to feed herself promotes independence and may increase interest in eating.
What are THREE associated echo findings for an infant with wide spaced nipples and a webbed neck?
- A. LV systolic dysfunction
- B. Blunted abdominal aortic Doppler
- C. Bicuspid aortic valve
- D. All of the above
Correct Answer: D
Rationale: These are common echo findings that can be associated with congenital syndromes affecting the heart.
A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without becoming nauseated and vomiting. Which finding should the nurse report to the healthcare provider.
- A. Belching
- B. Amber urine
- C. Yellow sclera
- D. Flatulence
Correct Answer: C
Rationale: Yellow sclera indicates jaundice, which is a sign of bile duct obstruction and requires immediate medical attention.
In which of the following valve lesions, Dimensionless Index (DI) is used as an echocardiographic parameter to assess the severity of the lesion?
- A. Aortic stenosis
- B. Aortic regurgitation
- C. Mitral regurgitation
- D. Mitral stenosis
Correct Answer: A
Rationale: Dimensionless Index (DI) is used to assess the severity of aortic stenosis.
Recognised features of brucellosis include:
- A. Osteomyelitis
- B. Liver granuloma
- C. Pericarditis
- D. Splenomegaly
Correct Answer: D
Rationale: Splenomegaly