Nokea
A surgical intervention that can cause substantial remission of myasthenia gravis is:
- A. Esophagostomy
- B. Thymectomy
- C. Myomectomy
- D. Spleenectomy
Correct Answer: B
Rationale: Thymectomy is a surgical procedure that involves the removal of the thymus gland. The thymus is a key component of the immune system and is believed to play a role in the development of myasthenia gravis (MG). In some cases, particularly in younger patients with early onset MG or with thymoma (a tumor of the thymus), thymectomy can lead to substantial remission of MG symptoms or even a cure. By removing the thymus gland, the abnormal immune response in MG may be reduced, resulting in improved muscle strength and decreased symptoms. It is worth noting that thymectomy is not always indicated for all patients with MG and should be considered on a case-by-case basis in consultation with a healthcare provider specialized in neuromuscular diseases.
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A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client?
- A. Anticipatory grieving
- B. Disturbed body image
- C. Impaired swallowing
- D. Chronic low self-esteem
Correct Answer: A
Rationale: Anticipatory grieving is an appropriate nursing diagnosis for a client diagnosed with gallbladder cancer due to the nature of the diagnosis and the symptoms experienced. Gallbladder cancer carries a poor prognosis and can have a significant impact on the client's emotional well-being. The client may experience feelings of sadness, fear, and loss related to the cancer diagnosis and its implications on their health and future. The presence of symptoms such as yellow skin, weight loss, fatigue, and epigastric pain can further contribute to the client's distress and feelings of grief. As the client navigates the challenges associated with the cancer diagnosis and treatment, providing emotional support and assistance in coping with their feelings of anticipatory grief is essential for holistic care.
For children receiving steroid therapy, which of the following regimens is most appropriate for perioperative management?
- A. Prednisone 1 mg/kg given 24 and 12 hours before surgery
- B. Dexamethasone 0.6 mg/kg IV given 24 and 12 hours before surgery
- C. Hydrocortisone 5 mg/kg IV given 24 and 12 hours before surgery
- D. Methylprednisolone 10 mg/kg IV given 24 and 12 hours before surgery
Correct Answer: C
Rationale: Hydrocortisone is commonly used for perioperative steroid coverage due to its mineralocorticoid and glucocorticoid effects.
A client agreed to become an organ donor is pronounced dead. What is the most important factor in selecting a transplant recipient?
- A. Blood relationship
- B. Compatible blood and tissue types
- C. Sex and size
- D. Need
Correct Answer: B
Rationale: The most important factor in selecting a transplant recipient for an organ that has been donated by a deceased donor is ensuring compatibility in terms of blood and tissue types. Matching these factors between the donor and recipient minimizes the risk of rejection and increases the likelihood of a successful transplant. Compatibility ensures that the recipient's body is less likely to identify the transplanted organ as foreign and mount an immune response against it. Blood relationship, sex, and size are important factors to consider but they are secondary to compatibility in terms of blood and tissue types when it comes to organ transplantation. Ultimately, the goal is to have the best chance of a successful transplant by ensuring a good match between the donor organ and the recipient.
Chemotherapy has a major role in many childhood CNS tumors. In which of the following tumors is chemotherapy not effective?
- A. pilocytic astrocytoma
- B. craniopharyngioma
- C. pineoblastoma
- D. supratentorial primitive neuroectodermal tumors (SPNETs)
Correct Answer: A
Rationale: Pilocytic astrocytomas are generally low-grade and less responsive to chemotherapy compared to other listed tumors.
While examining a 2-year-old child, Nurse Galina sees that the anterior fontanel is open. She should:
- A. Notify the doctor
- B. Look for other signs of abuse
- C. Recognize this as a normal finding
- D. Ask about a family history of Tay-Sachs disease
Correct Answer: C
Rationale: Nurse Galina should recognize an open anterior fontanel as a normal finding in a 2-year-old child. The anterior fontanel is a soft spot on a baby's skull where the skull bones have not yet fused together. It usually closes by the time a child is 18 to 24 months old. The open fontanel at 2 years of age is within the normal range of closure, and it is not a cause for concern in this case. No need to notify the doctor, look for other signs of abuse, or ask about a family history of Tay-Sachs disease based on this finding.