Nokea
A factory worker suffered a chemical burn to the eye and arrives at the Emergency department. What is the first action of the nurse?
- A. Apply a cold compress to the injured eye
- B. Apply a light bandage to the eye
- C. perform an assessment on the client
- D. flush the eye continuously with sterile solution
Correct Answer: D
Rationale: The first action should be to flush the eye continuously with a sterile solution to remove the chemical and prevent further damage to the eye. This is important in cases of chemical burns to prevent the chemical from causing more harm or spreading to other parts of the eye. It is crucial to start immediate irrigation to promote the best possible outcome and help alleviate the pain and potential long-term damage. Once the eye has been thoroughly flushed, further assessment and appropriate treatment can be provided by the healthcare team.
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A client with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty six-hours later, the client's urine output suddenly rises above 200mL/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse's suspicion of diabetes insipidus?
- A. Above-normal urine and serum osmolality levels
- B. Below-normal urine and serum osmolality levels
- C. Above-normal urine osmolality level, below-normal serum osmolality level
- D. Below- normal urine osmolality level, above-normal serum osmolality level
Correct Answer: B
Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to adequately concentrate urine, leading to excessive dilute urine production. In diabetes insipidus, both urine and serum osmolality levels are typically below normal due to the dilution of urine. When urine output suddenly rises above 200mL/hour in a client with severe head trauma, it may indicate diabetes insipidus, especially if the urine and serum osmolality levels are below normal. This abnormality in osmolality levels is due to the impaired ability of the kidneys to concentrate urine, resulting in decreased urine osmolality and subsequent dilution of the serum osmolality.
A client is receiving methotrexate (Mexate), 12g/m2 IV to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells?
- A. Probenecid (Benemid)
- B. Cytarabine (ara-C, cystosine arabinoside [Cytosar-U])
- C. Thioguanine (6-thioguanine, 6-TG)
- D. Leucovorin (Citrovorum factor or folinic acid [wellcovirin])
Correct Answer: D
Rationale: Leucovorin, also known as folinic acid, is given concurrently with methotrexate therapy to protect normal cells from the toxic effects of methotrexate. Methotrexate is a folate antagonist that affects both cancer cells and normal cells. Leucovorin is a reduced form of folic acid that bypasses the enzyme targeted by methotrexate, allowing normal cells to continue using folate for DNA synthesis. This rescue therapy helps prevent or reduce the side effects of methotrexate, such as mucositis, myelosuppression, and other toxic effects on normal cells. It is important to administer leucovorin at the appropriate times following methotrexate administration to maximize its protective effect while maintaining the efficacy of the chemotherapy.
You are meeting with parents of a 12-year-old girl who recently diagnosed with papillary thyroid carcinoma (PTC). The statement that should be included in your discussion is
- A. PTC has a grim overall prognosis
- B. FTC do not require radioactive iodine therapy
- C. supraphysiologic levothyroxine therapy is required during long-term follow-up
- D. calcitonin/carcinogenic antigen monitoring is required during the course of treatment
Correct Answer: C
Rationale: Levothyroxine suppression therapy is standard in differentiated thyroid cancer.
Which of the ff is the most important factor in the nursing management of a client with CFS?
- A. Teaching the client how to avoid aggravating the disease
- B. Informing the client about the drug therapy that will provide significant improvement
- C. Advising the client to alter the diet and environment
- D. Educating the client about the disease process and its limitations
Correct Answer: D
Rationale: Educating the client about the disease process and its limitations is the most important factor in the nursing management of a client with Chronic Fatigue Syndrome (CFS). Providing information about the disease, its symptoms, potential triggers, and the importance of self-care is crucial in empowering the client to manage their condition effectively. Understanding the limitations imposed by CFS can help the client make necessary adjustments in their lifestyle, activities, and energy management. Education also plays a key role in setting realistic expectations and preventing exacerbation of symptoms by avoiding overexertion or pushing beyond their limits. By understanding the disease process and its impact, the client can actively participate in their care and strive for better quality of life.
Which manifestation is more specific to occur in anaplastic large cell lymphoma (ALCL) than other types of non-Hodgkin lymphoma?
- A. primary bone marrow involvement
- B. intestinal involvement
- C. CNS involvement
- D. primary mediastinal involvement
Correct Answer: D
Rationale: Primary mediastinal involvement is a hallmark feature of ALCL.