Nokea
An intra-venous drug user with endocarditis has a TOE and multiple blood cultures taken. He is most likely to have:
- A. tricuspid valve involvement and s.aureus on blood culture
- B. tricuspid valve involvement and enterococci on blood culture
- C. mitral valve involvement and mixed growth on blood culture
- D. tricuspid valve involvement and candida on blood culture
Correct Answer: A
Rationale: IVDU endocarditis tricuspid flops, Staph aureus spikes, not enterococci, mixed, candida, or blanks. Nurses hear this chronic junkie beat.
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Which nursing action should be included in the plan of care for a client returning to the surgical unit following a left modified radical mastectomy with dissection of axillary lymph nodes?
- A. Obtain permanent breast prosthesis before the patient is discharged from the hospital
- B. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes
- C. Place a pink bracelet on the client warning against venipunctures or blood pressures in the left arm
- D. Insist that the patient examine the surgical incision when the initial dressings are removed
Correct Answer: C
Rationale: Mastectomy with axillary dissection risks lymphedema a pink bracelet flags the left arm, barring venipuncture or BP cuffs to prevent swelling, a priority in post-op care. Prosthesis comes later, post-healing. PCA teaching avoids rigid timing PRN's key. Forcing incision checks risks distress, not healing. Nurses lock in this bracelet, safeguarding lymph flow, a must-do in this surgical aftermath to dodge chronic arm woes.
A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?
- A. Assessing the IV site every hour
- B. Educating the client on side effects
- C. Monitoring the client for nausea
- D. Providing warm packs for comfort
Correct Answer: A
Rationale: Chemotherapy drugs administered via peripheral IV can be vesicants, meaning they can cause severe tissue damage if they leak (extravasate) into surrounding tissues. Peripheral lines are more prone to this than central lines due to smaller vein size and less secure placement. Assessing the IV site hourly or per facility policy is the most important action to prevent extravasation, ensuring the line remains patent and no swelling, redness, or pain develops. Early detection allows prompt intervention, like stopping the infusion, to minimize harm. Educating about side effects and monitoring for nausea are key aspects of care but address systemic effects, not the immediate risk of local tissue injury. Warm packs might soothe discomfort but could worsen damage if extravasation occurs. Prioritizing IV site assessment reflects the nurse's role in safety and prevention, critical in oncology where chemotherapy's potency demands vigilant monitoring to protect the client from serious complications.
What is the term used in epidemiology to indicate the frequency of the occurrence of a condition?
- A. Incidence
- B. Prevalence
- C. Relative risk
- D. Odd ratio
Correct Answer: B
Rationale: Prevalence counts everyone with a condition now total diabetes cases snapshot unlike incidence's newbies, risk's ratios, or odds' gambles. It's the epidemiologist's bread-and-butter for chronic burdens, a nurse's gauge of how many need care today.
Which atypical pneumonia can be vaccinated against?
- A. coxiella burnetii
- B. mycoplasma pneumoniae
- C. chlamydia pneumoniae
- D. legionella
Correct Answer: A
Rationale: Coxiella Q fever has a vaccine, not mycoplasma, chlamydia duo, or legionella. Nurses jab this chronic farm bug shield.
The emergency management of the patient with acute asthma does not include:
- A. Performing a rapid physical examination
- B. Performing spirometry or peak flow on arrival
- C. Giving oxygen and short acting bronchodilator
- D. Close monitoring to determine efficacy of treatment and improvement or deterioration
Correct Answer: B
Rationale: Acute asthma's rush exam, O2, bronchodilators, tight watch saves breath fast. Spirometry's a no too tough mid-wheeze, delays care. Nurses skip it, a chronic flare's urgent dodge.