Nokea
A nurse is assessing a dark-skinned client for pallor. What action is best?
- A. Assess the conjunctiva of the eye.
- B. Have the client open the hand widely.
- C. Look at the roof of the client's mouth.
- D. Palpate for areas of mild swelling.
Correct Answer: A
Rationale: The correct answer is A: Assess the conjunctiva of the eye. This is because pallor, which is paleness of the skin, can be difficult to detect on dark skin. The conjunctiva of the eye is a mucous membrane that is not pigmented and can provide a more accurate indication of pallor. Options B, C, and D are not ideal for assessing pallor in a dark-skinned client as they may not show paleness accurately. B is more related to checking for pallor in fair-skinned individuals. C and D are not reliable indicators of pallor in any skin type.
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A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effects?
- A. Dusky nail beds
- B. Petechiae
- C. Enlarged spleen
- D. Swollen calf
Correct Answer: C
Rationale: The correct answer is C: Enlarged spleen. Filgrastim stimulates the production of neutrophils, which can lead to splenomegaly as the spleen stores a large number of these cells. This can cause symptoms such as abdominal discomfort or fullness. Dusky nail beds (A), petechiae (B), and swollen calf (D) are not typically associated with filgrastim therapy and are more likely related to other conditions or medications.
Which of the following is associated with normocytic normochromic anaemia?
- A. Iron deficiency
- B. Primaquine
- C. Pregnancy
- D. Sickle cell disease
Correct Answer: C
Rationale: Normocytic normochromic anemia is characterized by normal-sized red blood cells with normal hemoglobin content. Pregnancy is associated with this type of anemia due to increased blood volume and iron demands. Iron deficiency anemia (choice A) is typically microcytic hypochromic. Primaquine (choice B) is not known to cause normocytic normochromic anemia. Sickle cell disease (choice D) results in hemolytic anemia with abnormal red blood cell morphology. Thus, the correct answer is C as it aligns with the characteristics of normocytic normochromic anemia.
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?
- A. Aspirin
- B. Heparin
- C. Warfarin
- D. Erythropoietin
Correct Answer: B
Rationale: The correct answer is B: Heparin. An aPTT level of 28 seconds is below the therapeutic range for heparin, indicating a subtherapeutic dose. The nurse should notify the healthcare provider to adjust the heparin dosage to achieve the desired anticoagulant effect. Aspirin (choice A) does not affect aPTT levels. Warfarin (choice C) affects PT/INR, not aPTT. Erythropoietin (choice D) is not related to aPTT levels.
In a study to investigate the rates of central line–acquired bacterial infections, it is discovered that patient length of stay (LOS) is not normally distributed but is highly right-skewed. What is the correct relationship between the mean, median, and mode of LOS?
- A. The mean is less than the median but greater than the mode.
- B. The mean is equal to the median and the mode.
- C. The mean is greater than the median and mode.
- D. The mean and median will both be less than the mode.
Correct Answer: C
Rationale: The correct answer is C: The mean is greater than the median and mode. In a highly right-skewed distribution, the mean is pulled towards the higher end by the extreme values, making it greater than the median, which is the middle value. The mode is the most frequent value, which is typically lower than the mean in a right-skewed distribution. In summary, the mean is influenced by extreme values, causing it to be greater than both the median and the mode in a highly right-skewed distribution.
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арретitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?
- A. Vestibular system
- B. Cerebral cortex
- C. Hypothalamus
- D. Vomiting center
Correct Answer: E
Rationale: I'm sorry, but it seems there was a mistake in providing the correct answer. The answer should be D: Vomiting center. Ondansetron and aprepitant work by inhibiting signaling in the vomiting center of the brain, which helps control nausea and vomiting. The vomiting center is located in the medulla oblongata, part of the brainstem responsible for coordinating the vomiting reflex. Choices A, B, and C are incorrect because the vestibular system is involved in balance and spatial orientation, the cerebral cortex is responsible for higher brain functions, and the hypothalamus plays a role in regulating various bodily functions but not directly in controlling vomiting.