Nokea
A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?
- A. Encourage several small meals daily
- B. Provide skin care to maintain skin integrity
- C. Assist the patient with hygiene, as needed
- D. Assess the integrity of the patient's oral mucosa regularly
Correct Answer: B
Rationale: Myelosuppression from chemo or cancer slashes white cells, making infection a top killer sepsis often starts at breached barriers like skin. Maintaining skin integrity via cleansing and protection stops bugs (e.g., Staph) from sneaking in, directly tackling this risk. Small meals fight malnutrition, a secondary factor, not the leading death driver. Hygiene helps, but it's broad, not specific to the prime entry point. Oral mucosa checks catch stomatitis, another risk, but skin's the bigger battlefield in oncology stats. Nurses prioritize this, knowing intact skin's the first defense against fatal infections in these fragile patients.
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A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
- A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
- B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
- C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
- D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.
Correct Answer: C
Rationale: Terminal pancreatic cancer pain's relentless around-the-clock opioids with breakthrough doses keep it tamed, per hospice norms. Waiting for 5/10 lags; IV isn't inherently better oral's fine. Nonopioids at max opioid miss the mark escalation's the play. Nurses in oncology teach this steady dosing plus rescues nails chronic cancer pain, a win if families get it.
NASH contributes to the risk of cardiovascular disease via which mechanism in the liver?
- A. Reduced production of VLDL
- B. Reduced production of glucose
- C. Increased production of CRP
- D. Increased production of HDL
Correct Answer: C
Rationale: NASH ups heart risk CRP, inflammation's flag, flares from liver, not VLDL drop, glucose dip, or HDL boost. Nurses spot this, a chronic CV spark.
What is essential in an ecological approach to health behaviour?
- A. People should be approached in their natural environment
- B. People learn behaviour in a layered environment
- C. People aim to find a balance between risk and health
- D. If it is beneficial to one's health, it is also sustainable
Correct Answer: B
Rationale: Ecological health layered worlds shape acts, not just spots, balance, or green wins. Nurses weave this, a chronic context web.
While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as the priority in the client's care?
- A. Ineffective peripheral tissue perfusion
- B. Alteration in body image
- C. Impaired skin integrity
- D. Alteration in activity tolerance
Correct Answer: C
Rationale: Varicose veins with ulcerations, edema, and heaviness scream venous stasis impaired skin integrity tops the list as open sores risk infection, a pressing threat needing immediate wound care. Ineffective perfusion drives the issue, but skin breakdown's acuity trumps. Body image matters emotionally, less urgently. Activity tolerance lags behind active complications. Nurses prioritize skin integrity, addressing ulcers' vulnerability, a direct care focus to halt deterioration in this chronic venous picture, aligning with safety and healing goals.
Dexmedetomidine:
- A. Is recognized as an α₠receptor agonist.
- B. Increases the minimum alveolar concentration of volatile agents.
- C. Causes bradycardia.
- D. Has a loading dose of 0.5-1.0 μg kgâ»Â¹.
Correct Answer: C
Rationale: Dexmedetomidine is a highly selective α₂-adrenergic receptor agonist, not αâ‚, used for sedation with minimal respiratory depression. It reduces the minimum alveolar concentration of volatile anesthetics by enhancing sedation and analgesia, not increasing it. Bradycardia is a well-known side effect due to its sympatholytic action, decreasing heart rate via vagal stimulation and reduced catecholamine release. The standard loading dose is indeed 0.5-1.0 μg kgâ»Â¹ over 10 minutes, followed by infusion, aligning with clinical protocols. At high infusion rates, respiratory depression is unlikely, distinguishing it from opioids. Bradycardia's prominence as a side effect stems from its mechanism activation of α₂ receptors in the brainstem and periphery inhibits sympathetic outflow, making it a critical consideration in perioperative management, especially in patients with cardiovascular comorbidities.