Nokea
A neonate has severe congenital abnormalities that make death imminent, and the NICU team believes that further attempts at treatment or feeding are not warranted and that palliative care only should be provided. When speaking with the parents about this, which of the following is the best approach?
- A. Tell the parents that the team suggests that all food and treatment will be withheld.
- B. Tell the parents that the team suggests a change in care plan to focus on comfort measures.
- C. Tell the parents that any further efforts at treatment are futile as the infant is dying.
- D. Tell the parents that the best thing is to let nature take its course.
Correct Answer: B
Rationale: Focusing on comfort measures (B) communicates compassionately that palliative care prioritizes the neonate's comfort, aligning with the parents' emotional needs. Withholding food/treatment (A) is harsh, futility (C) is blunt, and letting nature take its course (D) lacks clarity.
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Intra-arterial chemotherapy primarily benefits the client by applying greater concentrations of medication directly to the malignant tumor. An additional benefit of intra-arterial chemotherapy is:
- A. Prevention of nausea and vomiting
- B. Treatment of micro-metastasis
- C. Eradication of bone pain
- D. Prevention of therapy-induced anemia
Correct Answer: B
Rationale: Intra-arterial chemotherapy can treat micro-metastases by delivering high drug concentrations to the tumor and surrounding areas.
After several hospitalizations for respiratory ailments, a 6-month-old has been diagnosed as having HIV. The infant's respiratory ailments were most likely due to:
- A. Pneumocystis carinii
- B. Cytomegalovirus
- C. Cryptosporidiosis
- D. Herpes simplex
Correct Answer: A
Rationale: Pneumocystis carinii (now Pneumocystis jirovecii) is a common cause of pneumonia in HIV-infected infants.
The nurse is calculating the Apgar score for a newborn. Findings are as follows: Heart rate: 110, Respiratory effort: good cry, Muscle tone: some flexion of extremities, Reflex irritability: grimace, Color: completely pink. What is the Apgar score for this neonate?
- A. 7
- B. 8
- C. 9
- D. 10
Correct Answer: C
Rationale: Heart rate 110 (2), good cry (2), some flexion (1), grimace (1), pink (2) = 9.
A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:
- A. Estrogen levels are low.
- B. Lutenizing hormone is high.
- C. The endometrial lining is thin.
- D. The progesterone level is low.
Correct Answer: B
Rationale: A surge in luteinizing hormone triggers ovulation, the time when conception is most likely.
Which of the following actions does NOT require the use of standard precautions?
- A. contact with blood
- B. contact with urine
- C. contact with sweat
- D. contact with vomit
Correct Answer: C
Rationale: Standard precautions are required for contact with blood, urine, and vomit due to potential infectious agents. Sweat is not considered a significant risk for transmission.