Nokea
A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer?
- A. Alteplase
- B. Aspirin
- C. Clopidogrel
- D. Heparin
Correct Answer: A
Rationale: The correct answer is A: Alteplase. Alteplase is a thrombolytic medication used to dissolve blood clots and is crucial in treating acute ischemic cerebrovascular events caused by thrombus. It helps restore blood flow to the affected area of the brain. Aspirin (B) and Clopidogrel (C) are antiplatelet medications that prevent clot formation but do not dissolve existing clots. Heparin (D) is an anticoagulant that does not directly dissolve clots like Alteplase. Administering Alteplase promptly is essential to minimize brain damage in such emergencies.
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Cooley's anemia is:
- A. Sickle cell an.
- B. thalassemia major
- C. high ESR
- D. aplastic an.
Correct Answer: B
Rationale: Cooley's anemia is another term for thalassemia major, a genetic disorder characterized by abnormal hemoglobin production leading to severe anemia. The correct answer is B because Cooley's anemia specifically refers to thalassemia major. Sickle cell anemia (A) is a different genetic disorder caused by abnormal hemoglobin shape. High ESR (C) is a nonspecific marker of inflammation and does not directly relate to Cooley's anemia. Aplastic anemia (D) is a condition where the bone marrow does not produce enough blood cells, not related to Cooley's anemia.
Half life of plat. Is:
- A. 1-2days
- B. 3-4days
- C. 5-6days
- D. 7-8days
Correct Answer: B
Rationale: The correct answer is B: 3-4 days. The half-life of a substance is the time it takes for half of the original amount to decay. In this case, since the half-life of platinum is 3-4 days, it means that after 3-4 days, half of the initial amount of platinum will have decayed. This answer is correct because it accurately represents the time frame for platinum decay. The other choices are incorrect because they do not correspond to the known half-life of platinum. Choice A (1-2 days), C (5-6 days), and D (7-8 days) are outside the typical half-life range for platinum, making them incorrect options.
A client is having a bone marrow biopsy today. What action by the nurse takes priority?
- A. Administer pain medication first.
- B. Ensure valid consent is on the chart.
- C. Have the client shower in the morning.
- D. Premedicate the client with sedatives.
Correct Answer: B
Rationale: The correct answer is B: Ensure valid consent is on the chart. This is the priority because the client must provide informed consent before undergoing a bone marrow biopsy. Without valid consent, the procedure cannot proceed ethically or legally. Administering pain medication (choice A) or sedatives (choice D) may be important for the client's comfort but obtaining consent is essential. Having the client shower in the morning (choice C) is not directly related to the immediate safety or success of the biopsy.
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
- A. A 2-cm nontender supraclavicular node
- B. A 1-cm mobile and nontender axillary node
- C. An inability to palpate any superficial lymph nodes
- D. Firm inguinal nodes in a patient with an infected foot
Correct Answer: A
Rationale: The correct answer is A: A 2-cm nontender supraclavicular node. This finding is concerning because supraclavicular nodes are not normally palpable. Enlarged supraclavicular nodes can indicate metastatic cancer. B is incorrect because mobile and nontender axillary nodes are usually benign. C is incorrect as the inability to palpate superficial nodes may be normal. D is incorrect as firm inguinal nodes could indicate a localized infection or inflammation.
The mean cell volume of the patient is 90 fl and the reticulocyte production index is low. Which of the following is the most possible cause of anemia in this patient?
- A. Thalassemia
- B. Vitamin B12 deficiency
- C. Aplastic anemia
- D. Sideroblastic anemia
Correct Answer: C
Rationale: Rationale: A low reticulocyte production index indicates decreased bone marrow response to anemia. Aplastic anemia is characterized by bone marrow failure leading to pancytopenia, causing anemia. Thalassemia results in microcytic anemia, not macrocytic. Vitamin B12 deficiency causes macrocytic anemia due to impaired DNA synthesis. Sideroblastic anemia leads to microcytic anemia due to defective heme synthesis. Therefore, the most likely cause of anemia in this patient with a low reticulocyte production index and normal mean cell volume is aplastic anemia.