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A patient with chronic hepatitis C has been receiving interferon alfa-2a (Roferon-A) injections for the last month. Which information gathered during a visit in the home to conduct an interview and physical assessment is most important to communicate to the physician?
- A. The patient has chronic nausea and vomiting.
- B. The patient is giving the medication by the IM route to her lateral thigh.
- C. The patient has a temperature of 99.7°F orally.
- D. The patient complains of chronic fatigue,muscle aches and anorexia.
Correct Answer: A
Rationale: Chronic nausea and vomiting can lead to dehydration and malnutrition which are serious complications that need to be addressed. While the other symptoms are common side effects of interferon therapy they are less urgent than persistent nausea and vomiting.
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A nurse has presented an educational program to a community group on Lyme disease. What statement by a participant indicates the need to review the material?
- A. I should take precautions against ticks, especially in the summer.
- B. A red rash that looks like a bull's-eye may be one of the symptoms.
- C. If Lyme disease is not treated successfully, it is usually fatal.
- D. For Stage I disease, antibiotics are usually needed for 14 to 21 days.
Correct Answer: C
Rationale: Step 1: Lyme disease is rarely fatal if treated promptly.
Step 2: Choice C states that Lyme disease is usually fatal if not treated successfully, which is incorrect.
Step 3: Therefore, this statement indicates a need for review as it spreads misinformation.
Step 4: Choices A, B, and D are accurate and align with the information provided in the educational program.
Step 5: In summary, the need to review the material is highlighted by the inaccurate statement in choice C, as the other choices provide correct information on Lyme disease.
A patient has come to the ambulatory care clinic with a sprain. The nurse correctly differentiates a grade 2 sprain from a grade 3 sprain with the assessment of which finding?
- A. Pain
- B. Swelling
- C. Bleeding into the joint
- D. Minor loss of function
Correct Answer: D
Rationale: The correct answer is D: Minor loss of function. A grade 2 sprain involves partial tearing of the ligament, leading to moderate pain, swelling, and a significant loss of function. In contrast, a grade 3 sprain involves complete tearing of the ligament, resulting in severe pain, significant swelling, and major loss of function. By assessing for minor loss of function, the nurse can differentiate between the two grades of sprains. Choices A, B, and C are incorrect because they do not specifically differentiate between a grade 2 and grade 3 sprain based on the level of functional impairment.
What stimulates aldosterone secretion from the adrenal cortex?
- A. Excessive water intake
- B. Increased serum osmolality
- C. Decreased serum potassium
- D. Decreased sodium and water
Correct Answer: D
Rationale: Aldosterone secretion is stimulated by decreased sodium and water levels (renin-angiotensin-aldosterone system activation) and low blood pressure.
For which type of malignancy should the nurse expect the use of the intravesical route of regional chemotherapy delivery?
- A. Bladder
- B. Leukemia
- C. Osteogenic sarcoma
- D. Metastasis to the brain
Correct Answer: A
Rationale: Intravesical chemotherapy is used for bladder cancer to deliver drugs directly into the bladder.
Which group(s) of microorganisms is (are) thought to be the oldest living organisms?
- A. eukaryotes
- B. heterotrophic prokaryotes
- C. Archaea
- D. viruses
Correct Answer: C
Rationale: The correct answer is C: Archaea. Archaea are thought to be the oldest living organisms due to their unique characteristics and genetic similarities to the earliest forms of life. They are known for thriving in extreme environments, resembling conditions on early Earth. Other choices are incorrect because eukaryotes are more complex and evolved later, heterotrophic prokaryotes came after autotrophic prokaryotes, and viruses are not considered living organisms.