Nokea
A client with cancer that has metastazised to the liver is started on chemotherapy- His physician has specified divided doses of the antimetabolite. The client asks why he could take the drug in divided doses. The appropriate response is:
- A. " There really is no reason your doctor just wrote the orders that way."
- B. "This schedule will reduce the side effect of the drug."
- C. "Divided doses produce greater cytotoxic effects on the diseased cells."
- D. "Because these drugs prevent cell division, they are more effective in divided doses,"
Correct Answer: D
Rationale: The correct response is D, "Because these drugs prevent cell division, they are more effective in divided doses."
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The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketonic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?
- A. Elevated serum acetone level
- B. Serum alkalosis
- C. Serum ketone bodies
- D. Below-normal serum potassium level
Correct Answer: D
Rationale: Hyperosmolar hyperglycemic nonketonic syndrome (HHNS) is characterized by extremely elevated blood glucose levels without significant ketosis. Unlike diabetic ketoacidosis (DKA), patients with HHNS usually do not have high levels of ketone bodies in their blood or urine. Therefore, the nurse should anticipate below-normal serum potassium levels in a client with HHNS, as hyperglycemia can lead to profound potassium losses through osmotic diuresis. Monitoring and treating electrolyte imbalances, including hypokalemia, are crucial in managing HHNS. It is important to correct these imbalances promptly to prevent further complications.
The thymus gland role with the immune system is which of the following?
- A. Maturates B cells
- B. Maturates platelets
- C. Maturates red blood cells
- D. Maturates T cells
Correct Answer: D
Rationale: The thymus gland plays a crucial role in the immune system as it is primarily responsible for the maturation and differentiation of T lymphocytes (T cells). T cells are essential for cell-mediated immunity and play a key role in recognizing and attacking pathogens such as bacteria, viruses, and cancer cells. The thymus is where immature T cells mature and undergo education to ensure they can distinguish between self and non-self antigens effectively. This process is crucial for the proper functioning of the immune system to protect the body from infections and diseases.
Why would a Heimlich maneuver be performed on a client?
- A. To increase the absorption of the prescribed medication
- B. To clear the airway if the client cannot speak or breathe after swallowing food
- C. To reduce the potential for injuries as a result of falls
- D. To maintain extremities in proper anatomic position CARING FOR CLIENT WITH HEAD AND SPINAL CORD TRAUMA
Correct Answer: B
Rationale: The Heimlich maneuver, also known as abdominal thrusts, is performed on a client to clear the airway if the client is choking and cannot speak or breathe after swallowing food. The maneuver involves applying upward pressure on the abdomen in an effort to forcefully expel the object blocking the airway. It is a crucial life-saving technique that can prevent the client from suffocating due to an obstructed airway. In cases of choking emergencies, the Heimlich maneuver should be administered promptly to effectively remove the obstruction and restore breathing.
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
- A. fibroblastic
- B. chondroblastic
- C. parosteal
- D. periosteal
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.
Which symptoms should the nurse expect to observe during the physical assessment of an adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa?
- A. Dysmenorrhea and oliguria
- B. Tachycardia and tachypnea
- C. Heat intolerance and increased blood pressure
- D. Lowered body temperature and brittle nails
Correct Answer: B
Rationale: An adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa is likely to exhibit tachycardia (rapid heart rate) and tachypnea (rapid breathing). These symptoms are common manifestations of the body's response to malnutrition and starvation. Tachycardia occurs as a compensatory mechanism to maintain an adequate supply of oxygen to vital organs, while tachypnea helps to eliminate excess carbon dioxide due to metabolic imbalances. It is essential for the nurse to recognize these signs during the physical assessment as they indicate the severity of the condition and the need for immediate intervention to prevent further complications. Dysmenorrhea and oliguria, heat intolerance and increased blood pressure, and lowered body temperature and brittle nails are not typically associated with the physical manifestations of anorexia nervosa.