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A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?
- A. A client with a swollen and painful left great toe
- B. Client who reports dyspnea
- C. Client with a blood pressure of 180/98 mm Hg
- D. Client who reports calf tenderness and swelling
Correct Answer: B
Rationale: Polycythemia vera thickens blood, risking clots dyspnea signals possible pulmonary embolism, a life-threatening emergency needing instant assessment per ABCs. Toe pain suggests gout, common but less acute. Hypertension, a chronic issue here, waits behind respiratory distress. Calf tenderness hints at DVT, urgent but not immediately fatal like embolism. Nurses triage dyspnea first, ensuring airway and oxygenation, a critical call in this hyperviscous condition prone to thrombotic crises.
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The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective?
- A. Lime sherbet
- B. Blueberry yogurt
- C. Fresh strawberries
- D. Cream cheese bagel
Correct Answer: B
Rationale: Liver cancer tanks metabolism yogurt's protein and fat (high biologic value) fuel repair and calories, beating sherbet's sugar , strawberries' low heft , and cream cheese's protein-light bagel . Nurses in oncology push this dense nutrition fights cachexia, a liver patient's foe, showing teaching stuck.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
Which is the most common organism infecting coral cuts?
- A. non-cholera vibrio
- B. mycobacterium marinum
- C. aeromonas species
- D. strep pyogenes
Correct Answer: D
Rationale: Coral cuts strep pyogenes streaks in, not vibrio, mycobacterium, aeromonas, or E. coli's swim. Nurses hit this chronic skin ripper.
What do you tell patients is the most important risk factor for lung cancer when you are teaching about lung cancer prevention?
- A. Cigarette smoking
- B. Exposure to environmental/occupational carcinogens
- C. Exposure to environmental tobacco smoke (ETS)
- D. Pipe or cigar smoking
Correct Answer: A
Rationale: Cigarette smoking towers as lung cancer's top risk 80-90% of cases tie to its carcinogens like tar and nicotine, a dose-dependent killer dwarfing other factors. Environmental/occupational exposures like asbestos amplify risk, especially with smoking, but lack its prevalence. ETS hikes risk by 35%, significant yet secondary. Pipe or cigar smoking carries risk, less than cigarettes due to inhalation patterns. Teaching smoking as paramount drives home its preventable dominance, urging cessation as the gold-standard defense, a nurse's key message to slash lung cancer odds, backed by epidemiology and public health campaigns.
The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
- A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer
- B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer
- C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer
- D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition
Correct Answer: B
Rationale: With a positive screening test and family history, she's high-risk tamoxifen, a SERM, cuts breast cancer odds by 50% in such cases, per NCI trials. It blocks estrogen fueling tumors, a proven chemoprevention move. Diet helps (antioxidants, less fat), but it's not enough solo. Exercise (30 min/day) trims risk via weight control, but tamoxifen's got stronger data here. Saying little can be done' ignores options genetics load the gun, but lifestyle and drugs can unload it. Nurses in oncology push tamoxifen for its edge, tailoring advice to her risk profile.