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A client with stage IV bone cancer is admitted to the hospital for pain control. The client verbalizes continuous, severe pain of 8 on a 1 to 10 scale. Which intervention should the nurse implement?
- A. Administer opioid and non-opioid medication simultaneously
- B. Administer only opioid medication as prescribed.
- C. Encourage the client to practice relaxation techniques
- D. Delay medication administration until reassessment.
Correct Answer: A
Rationale: Combining opioid and non-opioid medications provides more effective pain relief for severe cancer-related pain.
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The most common cause of bacterial meningitis in children under 5 years is:
- A. Neisseria meningitidis
- B. Haemophilus influenzae
- C. Streptococcus pneumoniae
- D. Listeria monocytogenes
Correct Answer: C
Rationale: Streptococcus pneumoniae is the leading cause of bacterial meningitis in children under 5 years, especially in those who are not immunized.
What is cardiac power output (CPO) in a patient with acute anterior wall ST-elevation myocardial infarction and left ventricular failure? His mean arterial pressure was 60 mm Hg and cardiac output calculated on echo was 2.91l min−1.
- A. 0.48
- B. 0.38
- C. 0.58
- D. 0.68
Correct Answer: C
Rationale: Cardiac power output is calculated as (MAP × cardiac output) / 451. For the given values, the correct calculation gives a value of 0.58.
All of the following are part of acute aortic syndrome, except
- A. Aortic dissection
- B. Acute aortic regurgitation
- C. Intramural hematoma
- D. Penetrating atherosclerotic ulcer
Correct Answer: B
Rationale: Acute aortic regurgitation is not typically considered part of acute aortic syndrome.
Characteristic indices in anaemia of chronic inflammation:
- A. Increased MCV
- B. Decreased ferritin
- C. Decreased transferrin
- D. Normal MCHC
Correct Answer: C
Rationale: Decreased transferrin: In anaemia of chronic inflammation, transferrin levels decrease due to inflammatory cytokines, which affect iron metabolism and its availability for erythropoiesis.
A 12-year-old child whose body mass index (BMI) is greater than the 95th percentile has a blood pressure at the 98th percentile for age, sex, and height. After lifestyle changes that include diet and exercise, the child's BMI drops to the 90th percentile, but the blood pressure remains the same. What is the primary care pediatric nurse practitioner's next step in treating this child?
- A. Continued close monitoring of blood pressure
- B. Ordering an echocardiogram
- C. Prescribing an ACE inhibitor medication
- D. Referral to a nephrologist or cardiologist
Correct Answer: D
Rationale: Children who have persistent BP elevation after lifestyle changes are made should be referred to a nephrologist or cardiologist who has experience using antihypertensive agents in children.