Nokea
According to Johnson and Chang (2014), people living with chronic illness are more likely than the general population to:
- A. Have significantly reduced activity and subsequent loss of independence
- B. Be required to see their doctor more regularly
- C. Experience periods of hospitalisation as a consequence of acute flare-ups of their underlying chronic disease
- D. Stay home and reduce their activity and social interactions
Correct Answer: A
Rationale: Chronic illness curbs activity arthritis, COPD slash mobility, stealing independence, a standout hit over frequent doctor visits, hospital stays from flares, or self-imposed isolation. Those ripple too, but reduced function's the core burden, reshaping daily life. Nurses prioritize this, boosting support, a chronic truth where physical loss leads.
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In the UK, orthognathic surgery is likely to:
- A. Be undertaken in specialist craniofacial surgery units rather than in maxillofacial surgery units.
- B. Be associated with a high incidence of postoperative nausea and vomiting.
- C. Require a nasal rather than an oral tracheal tube when a Le Fort I osteotomy is performed.
- D. Require admission of the patient to a high-dependency unit.
Correct Answer: B
Rationale: Orthognathic surgery corrects jaw deformities in the UK, typically by maxillofacial surgeons, not solely craniofacial units (reserved for complex congenital cases). Postoperative nausea and vomiting (PONV) are common due to blood swallowing, prolonged surgery, and opioids risk factors per Apfel criteria. Le Fort I osteotomy (maxillary) often uses oral intubation; nasal tubes suit mandibular focus or surgeon preference, not a requirement. High-dependency unit (HDU) admission isn't routine most recover in general wards unless complications (e.g., airway) arise. Cleft palate repair precedes, not follows, orthognathic work. PONV's prevalence reflects surgical and anaesthetic challenges, necessitating robust antiemetic prophylaxis.
The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching?
- A. The patient has a history of dental caries.
- B. The patient swims several days each week.
- C. The patient snacks frequently during the day.
- D. The patient showers each day with mild soap.
Correct Answer: B
Rationale: Abdominal radiation fries skin swimming in chlorinated or salt water during treatment risks irritation or infection in that tender zone. Dental caries don't tie in. Snacking might help nutrition, not hurt. Mild soap showers are fine. Nurses in oncology flag this no swimming' protects radiated skin, a teaching must to dodge complications.
A 50-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic?
- A. Smoking is the reason you are here
- B. The doctor left orders for you not to smoke
- C. You are anxious about the surgery. Do you see smoking as helping?
- D. Smoking is OK right now, but after your surgery it is contraindicated
Correct Answer: C
Rationale: Anxiety's screaming here naming it and asking if smoking helps opens a door to his feelings, not a lecture. Blaming smoking shames him, spiking stress. Citing orders shuts down dialogue. Greenlighting it's reckless nicotine constricts vessels, risking surgical healing, especially post-lung resection. Therapeutic nursing in oncology digs into emotions, guiding patients through fear without judgment, key for pre-op calm.
A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate?
- A. Don't you have any friends that will raise the children for you?'
- B. Would you like to talk about options for the care of your children?'
- C. For now you need to concentrate on getting well and not worrying about your children.'
- D. Many patients with cancer live for a long time, so there is time to plan for your children.'
Correct Answer: B
Rationale: Metastatic ovarian cancer's end-stage she's scared for her kids. Asking about options opens a lifeline, validating her fear without shutting it down. Friends assumes too much; get well' dodges reality; long time' sugarcoats. Nurses in oncology lean in here listening, planning ease her burden, a human touch amid grim odds.
The nurse is caring for a 6-year-old child with leukemia who is having an oncological emergency. Which of the following signs and symptoms would indicate hyperleukocytosis?
- A. Bradycardia and distinct S1 and S2 sounds
- B. Wheezing and diminished breath sounds
- C. Respiratory distress and poor tissue perfusion
- D. Intermittent fever and frequent vomiting
Correct Answer: C
Rationale: Hyperleukocytosis, a leukemia emergency with white blood cell counts over 100,000/mm³, causes blood hyperviscosity, leading to venous stasis and microvessel occlusion by blast cells. This results in respiratory distress (from lung infarction or hypoxemia) and poor tissue perfusion (from impaired circulation), critical signs requiring urgent intervention like leukapheresis or hydration. Bradycardia and clear heart sounds don't fit tachycardia might occur from hypoxia, not bradycardia. Wheezing and diminished breath sounds suggest asthma or infection, not hyperleukocytosis's systemic impact. Fever and vomiting are non-specific and less acute here. Nurses recognizing these symptoms prioritize airway and circulation support, aligning with oncology's focus on rapid response to life-threatening complications in pediatric leukemia care.