Nokea
A healthy 20-day-old male examination reveals a palpable liver margin below the right costal margin; lab findings: white blood count, 18700/mm3; hemoglobin, 8.8 g/dl; blast cells, 10%; the BEST approach for the management is consistent with acute myeloproliferative disorder
- A. intensive chemotherapy
- B. low dose chemotherapy pulses
- C. bone marrow transplantation
- D. close follow up
Correct Answer: A
Rationale: Intensive chemotherapy is the standard approach for managing acute myeloproliferative disorders.
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Which gauge IV cannula should the nurse choose when preparing to initiate a blood transfusion?
- A. 18
- B. 24
- C. 22
- D. 28
Correct Answer: A
Rationale: An 18-gauge IV cannula is the most appropriate choice when preparing to initiate a blood transfusion. This larger size allows for the rapid administration of blood products, which is important to prevent clotting and ensure a stable flow of the transfusion. Smaller gauge sizes, such as 22, 24, or 28, may be too slow for transfusion purposes and could potentially lead to delays or complications during the procedure. Therefore, the optimal choice for initiating a blood transfusion is an 18-gauge IV cannula.
About 500 children have just been exposed to radiation from a nuclear power plant accident. The most appropriate first step in your treatment of these children should be to
- A. prescribe potassium iodide to protect the thyroid
- B. order thyroid function tests
- C. order complete blood counts (CBCs)
- D. do nothing acutely; evaluate in 4-6 weeks
Correct Answer: A
Rationale: Potassium iodide can protect the thyroid from radioactive iodine exposure, which is a critical first step in radiation exposure.
A one month old infant is admitted for confirmation of the diagnosis of ventricular septal defect. During the initial admission assessment, the nurse would expect to find:
- A. Bradycardia at rest
- B. Bounding peripheral pulses
- C. An activity related cyanosis
- D. A murmur at the left sternal border. 105
Correct Answer: D
Rationale: A ventricular septal defect (VSD) is a congenital heart defect where there is an abnormal opening between the two ventricles of the heart. One of the hallmark signs of VSD is the presence of a murmur, specifically a holosystolic murmur, which is typically heard best at the left sternal border due to the turbulent blood flow through the defect. This murmur is a key finding during the initial assessment of a patient with a suspected VSD. Other common symptoms of VSD include poor feeding, failure to thrive, tachypnea, and frequent respiratory infections.
Mr. Reyes is extremely confused. The nurse provide new information slowly and in small amounts because;
- A. Confusion or delirium can be a defense against further stress
- B. Destruction of brain cells has occurred, interrupting mental activity
- C. Teaching based on information progressing from the simple to the complex
- D. A minimum of information should be given, since he is unaware of surrounding
Correct Answer: A
Rationale: Providing new information slowly and in small amounts to a confused individual, like Mr. Reyes, is important because confusion or delirium can be a defense mechanism against further stress. By giving information gradually, it allows the individual to better absorb and process the information without becoming overwhelmed, which can further exacerbate their confusion. This approach also helps reduce the risk of causing additional stress or agitation in the individual, thus promoting a more conducive environment for cognitive processing and understanding.
When a client is receiving blood which of the ff nursing actions is essential to determine if chilling is the result of an emerging complication or of infusing cold blood?
- A. Monitoring the client's temperature before, during, and after transfusion
- B. Documenting the client's temp after the transfusion
- C. Documenting the temp of the blood before the transfusion
- D. Comparing the client's temp with the temp of the blood
Correct Answer: A
Rationale: Monitoring the client's temperature before, during, and after transfusion is essential to determine if chilling is the result of an emerging complication or of infusing cold blood. By consistently monitoring the client's temperature at different points in the transfusion process, healthcare providers can identify any significant changes that may indicate a complication. This allows for timely intervention and appropriate management of any issues related to the blood transfusion. Comparing the client's temperature with the temperature of the blood is important but alone it may not provide a comprehensive assessment of the client's condition during the transfusion process. So, the best course of action is to monitor the client's temperature at various time points to ensure accurate assessment and early detection of any complications.