Nokea
A nurse sets an infusion pump to infuse 1 L of D5NS at the rate of $100 \mathrm{~mL} / \mathrm{hr}$. How many hours will it take to complete the infusion?
- A. 8
- B. 10
- C. 12
- D. 14
Correct Answer: B
Rationale: Math rules IV timing 1 L (1000 mL) at 100 mL/hr divides to 10 hours, a straightforward calc nurses nail for fluid planning. Missteps like 8 or 12 flub the rate; 14's way off. Precision here ensures hydration or med delivery hits the mark, a basic skill keeping care on track.
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A 56-year-old patient comes to the walk-in clinic for scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history for colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?
- A. Diarrhea/Constipation related to altered bowel patterns
- B. Knowledge Deficit related to disease process and diagnostic procedure
- C. Risk for Fluid Volume Deficit related to rectal bleeding and diarrhea
- D. Anxiety related to unknown outcomes and perceived threat to body integrity
Correct Answer: D
Rationale: The patient's anger and threat to leave during colonoscopy teaching signal emotional distress overriding physical symptoms. Anxiety stemming from uncertain outcomes and perceived bodily threat fits, as colorectal cancer risk tied to polyps and family history heightens fear, blocking education uptake. Diarrhea/constipation reflects symptoms but isn't immediately urgent with scant bleeding. Knowledge deficit exists but is secondary fear drives the refusal, not just ignorance. Fluid volume risk is plausible with bleeding, yet no data suggests acute loss; stability allows focus on emotions. Addressing anxiety first calms the patient, enabling teaching and care, a priority in this tense encounter where psychological barriers could delay critical colorectal screening and intervention.
In which illness can hydrophobia be seen?
- A. tetanus
- B. malaria
- C. rabies
- D. EBV
Correct Answer: C
Rationale: Hydrophobia rabies' brain hates water, not tetanus' clench, malaria's sweat, EBV's glands, or HSV's sores. Nurses clock this chronic rabies red flag.
An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider?
- A. Patient complains of severe fatigue.
- B. Patient voids every hour during the day.
- C. Patient takes only 50% of meals and refuses snacks.
- D. Patient has crackles up to the midline posterior chest.
Correct Answer: D
Rationale: High-rate fluids (175 mL/hr) plus chemo in an older colorectal patient can swamp the heart crackles to midline yell heart failure, trumping fatigue , peeing , or poor eating . Nurses in oncology flag this lungs drowning need stat help, a fluid overload crisis.
Which of the following cancer patients could potentially be placed together as roommates?
- A. A patient with a neutrophil count of 1000/mm³
- B. A patient who underwent debulking of a tumor to relieve pressure
- C. A patient receiving high-dose chemotherapy after a bone marrow harvest
- D. A patient who is post-op laminectomy for spinal cord compression
Correct Answer: B
Rationale: Roommate pairing hinges on infection risk and care needs. The debulking patient tumor reduced for symptom relief and post-laminectomy patient spinal decompression both underwent palliative surgeries, not inherently immunocompromised, making them compatible. A neutrophil count of 1000/mm³ signals moderate neutropenia, needing isolation to dodge infections. High-dose chemotherapy post-bone marrow harvest obliterates immunity, demanding strict protection. The surgical pair's stability, lacking acute immune suppression, allows safe cohabitation, a nurse's practical call to optimize space and reduce cross-infection risks in cancer care settings.
While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
- A. Stopping the administration of the drug immediately
- B. Notifying the patient's physician
- C. Continuing the infusion but decreasing the rate
- D. Applying a warm compress to the infusion site
Correct Answer: A
Rationale: Doxorubicin's a vesicant swelling and pain scream extravasation, where it leaks into tissue, risking severe necrosis. Stopping the IV stat is priority to limit damage; delaying could worsen injury. Notifying the physician follows, but action comes first. Slowing the infusion keeps pumping toxin into the site disastrous. Warm compresses might spread the drug, unlike ice, which can help post-stoppage per protocol. Nurses must act fast, knowing vesicants like doxorubicin (an anthracycline) demand immediate cessation and often antidotes (e.g., dexrazoxane), critical in oncology to prevent permanent harm from chemo mishaps.