Nokea
A client with suspected lung cancer is scheduled for thoracentesis as part of the diagnostic workup. The nurse reviews the client's history for conditions that might contraindicate this procedure. Which condition is a contraindication for thoracentesis?
- A. A seizure disorder
- B. Anemia
- C. Chronic obstructive pulmonary disease
- D. A bleeding disorder
Correct Answer: D
Rationale: A bleeding disorder is a contraindication for thoracentesis because the procedure involves inserting a needle through the chest wall into the pleural space to drain fluid. Individuals with a bleeding disorder are at an increased risk of bleeding complications during and after the procedure. It is important to ensure adequate clotting function before performing a thoracentesis to prevent excessive bleeding. If a client has a bleeding disorder, alternative diagnostic methods may need to be considered to minimize the risks associated with the procedure.
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Which of the following is information the nurse would be correct in giving the patient about smoking and its effect on BP?
- A. It is associated with stages 1 and 2 hypertension.
- B. It does not affect BP regulation.
- C. It vasodilates the peripheral blood vessels.
- D. It causes sustained BP elevation.
Correct Answer: D
Rationale: Smoking is a known risk factor for hypertension. Chronic smoking leads to sustained elevation in blood pressure by causing vasoconstriction of the blood vessels, increasing heart rate, and promoting the formation of plaques in the arteries. This can contribute to the development of hypertension over time. Therefore, the nurse would be correct in informing the patient that smoking causes sustained elevation in blood pressure.
a school-age child is admitted in vaso-occlusive sickle cell crisis. the child's care should include which of the following?
- A. correction of acidosis.
- B. adequate hydration, pain management.
- C. pain management, administration of heparin.
- D. adequate oxygenation, replacement of factor viii
Correct Answer: B
Rationale: In a vaso-occlusive sickle cell crisis, it is crucial to focus on adequate hydration and pain management. Hydration is essential to prevent further sickling of red blood cells, which can exacerbate tissue damage and pain. Pain management is a key aspect of care as vaso-occlusive crises often cause severe pain that requires prompt and effective treatment. Administering heparin is not indicated in a vaso-occlusive sickle cell crisis as it is primarily used for conditions like deep vein thrombosis. Correcting acidosis and replacing factor VIII are also not typically part of the management of a vaso-occlusive sickle cell crisis.
Which of the ff finding would confirm that a female client has mastitis? Choose all that apply
- A. A crack in the nipple or the areola
- B. Multiple lumps within the breast tissue
- C. Swollen, firm, and hard breasts
- D. Enlargement of the axillary lymph nodes
Correct Answer: C
Rationale: Mastitis is an inflammatory condition of the breast tissue, often caused by an infection. Common symptoms of mastitis in a female client include swollen, firm, and hard breasts. These changes in breast tissue texture are indicative of inflammation and infection. Other possible signs of mastitis may include redness, warmth, and tenderness in the affected breast. The presence of swollen, firm, and hard breasts would confirm the diagnosis of mastitis in a female client.
A seizure characterized by loss of consciousness and tonic spasms of the trunk and extremities rapidly followed by repetitive generalized clonic jerking is classified as:
- A. Focal seizure
- B. Jacksonian seizure
- C. Generalized seizure
- D. Partial seizure
Correct Answer: C
Rationale: The description provided aligns with the characteristics of a generalized seizure. Generalized seizures involve abnormal electrical activity in the entire brain, leading to loss of consciousness and widespread motor symptoms, such as tonic (stiffening) and clonic (jerking) movements affecting both sides of the body. Examples of generalized seizures include tonic-clonic seizures (formerly known as grand mal seizures) where there is a sequence of tonic stiffness followed by clonic jerking. In contrast, focal (partial) seizures originate in a specific area of the brain and may result in localized symptoms before possibly spreading to involve both sides of the brain. Jacksonian seizures specifically refer to focal seizures with motor symptoms that spread in a stepwise fashion, starting from one part of the body.
When is isotretinoin (Accutane) indicated for the treatment of acne during adolescence?
- A. The acne has not responded to other treatments.
- B. The adolescent is or may become pregnant.
- C. The adolescent is unable to give up foods causing acne.
- D. Frequent washing with antibacterial soap has been unsuccessful.
Correct Answer: A
Rationale: Isotretinoin (Accutane) is a potent medication used for severe acne that has not responded to other treatments, such as topical medications or antibiotics. It is typically considered as a last resort due to its potential side effects and risks. Adolescents with resistant, severe acne who have not seen improvement with other therapies may be good candidates for isotretinoin treatment. It is important for the prescribing healthcare provider to carefully assess the severity of the acne and weigh the benefits against the potential risks before initiating isotretinoin therapy.