Nokea
A six-month-old infant is receiving ribavirin for the treatment of respiratory syncytial virus. Ribavirin is administered via which one of the following routes?
- A. Oral
- B. IM
- C. IV
- D. Aerosol
Correct Answer: D
Rationale: Ribavirin is not supplied in an oral form. Ribavirin is administered by aerosol in order to decrease the duration of viral shedding within the infected tissue. Ribavirin is not approved for IV use to treat respiratory syncytial virus. Ribavirin is a synthetic antiviral agent supplied as a crystalline powder that is reconstituted with sterile water. A Small Aerosol Particle Generator unit aerosolizes the medication for delivery by oxygen hood, croup tent, or aerosol mask.
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The nurse should know that according to current thinking, the most important prognostic factor for a client with breast cancer is:
- A. Tumor size
- B. Axillary node status
- C. Client's previous history of disease
- D. Client's level of estrogen-progesterone receptor assays
Correct Answer: B
Rationale: Although tumor size is a factor in classification of cancer growth, it is not an indicator of lymph node spread. Axillary node status is the most important indicator for predicting how far the cancer has spread. If the lymph nodes are positive for cancer cells, the prognosis is poorer. The client's previous history of cancer puts her at an increased risk for breast cancer recurrence, especially if the cancer occurred in the other breast. It does not predict prognosis, however. The estrogen-progesterone assay test is used to identify present tumors being fed from an estrogen site within the body. Some breast cancers grow rapidly as long as there is an estrogen supply such as from the ovaries. The estrogen-progesterone assay test does not indicate the prognosis.
Which information should be given to the client using a TENS unit?
- A. Electrocution may occur if you use water with this unit.'
- B. Skin irritation may occur with prolonged use of the unit.'
- C. The unit can be placed anywhere on the body without fear of adverse reactions.'
- D. A cream or lotion should be applied to the skin before applying the unit.'
Correct Answer: B
Rationale: Prolonged use of a TENS unit can cause skin irritation due to electrode adhesion or electrical stimulation. Electrocution is not a risk with battery-operated units, placement requires specific guidance, and lotions may interfere with electrode contact.
A 5-year-old child is hospitalized for an acute illness. The nurse encourages the family to bring her favorite objects from home. What is the nurse's rationale?
- A. To reduce fear of the unknown
- B. To keep the child calm
- C. To establish a trusting relationship
- D. To prevent or minimize separation anxiety
Correct Answer: D
Rationale: Favorite objects from home assist in creating a familiar setting, preventing or minimizing separation anxiety.
A patient is diagnosed with secondary syphilis. The nurse can expect the patient to have:
- A. Copper penny' rash on the palms of the hands and soles of the feet
- B. Localized tumors in the skin, bones, and liver
- C. Chancres and lymphadenopathy
- D. General paresis
Correct Answer: A
Rationale: Secondary syphilis presents with a maculopapular rash, often on the palms and soles, described as ‘copper penny’ lesions. Chancres occur in primary syphilis, tumors (gummas) in tertiary syphilis, and general paresis is a late neurosyphilis complication.
A 70-year-old homeless woman is admitted with pneumonia. She is weak, emaciated, and febrile. The physician orders enteral feedings intermittently by nasogastric tube. When inserting the nasogastric tube, once the tube passes through the oropharynx, the nurse will instruct the client to:
- A. Tilt her head backwards
- B. Swallow as tube passes
- C. Hold breath as tube passes
- D. Cough as tube passes
Correct Answer: B
Rationale: Swallowing assists with insertion of tube and closes off airway.