An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider?
- A. Patient complains of severe fatigue.
- B. Patient voids every hour during the day.
- C. Patient takes only 50% of meals and refuses snacks.
- D. Patient has crackles up to the midline posterior chest.
Correct Answer: D
Rationale: High-rate fluids (175 mL/hr) plus chemo in an older colorectal patient can swamp the heart crackles to midline yell heart failure, trumping fatigue , peeing , or poor eating . Nurses in oncology flag this lungs drowning need stat help, a fluid overload crisis.
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Which of the following cancer patients could potentially be placed together as roommates?
- A. A patient with a neutrophil count of 1000/mm³
- B. A patient who underwent debulking of a tumor to relieve pressure
- C. A patient receiving high-dose chemotherapy after a bone marrow harvest
- D. A patient who is post-op laminectomy for spinal cord compression
Correct Answer: B
Rationale: Roommate pairing hinges on infection risk and care needs. The debulking patient tumor reduced for symptom relief and post-laminectomy patient spinal decompression both underwent palliative surgeries, not inherently immunocompromised, making them compatible. A neutrophil count of 1000/mm³ signals moderate neutropenia, needing isolation to dodge infections. High-dose chemotherapy post-bone marrow harvest obliterates immunity, demanding strict protection. The surgical pair's stability, lacking acute immune suppression, allows safe cohabitation, a nurse's practical call to optimize space and reduce cross-infection risks in cancer care settings.
Triglycerides in VLDL particles can be passed on to HDL particles. Question: Which enzyme mediates this process?
- A. Cholesteryl ester transfer protein (CETP)
- B. Hepatic lipase (HL)
- C. Hormone sensitive lipase (HSL)
- D. Lipoprotein lipase (LPL)
Correct Answer: A
Rationale: CETP swaps triglycerides VLDL to HDL, not lipase cutters. Nurses know this, a chronic lipid shuffle.
Which vaccination should not be given to HIV sufferers?
- A. ADT
- B. Pneumococcal
- C. MMR
- D. DPT
Correct Answer: C
Rationale: MMR's live HIV's immune slump says no, unlike ADT, pneumococcal, DPT, or dead polio's safety. Nurses nix live shots, a chronic viral risk dodge.
A 79 year old woman is told by his GP that she has postural hypertension. Which of the following BP is she likely to be having?
- A. A drop of 15 mmHg/10 mmHg within 3 minutes of standing
- B. A drop of 17 mmHg/10 mmHg within 3 minutes of standing
- C. A drop of 21 mmHg/10 mmHg within 3 minutes of standing
- D. A rise of 5 mmHg/10 mmHg within 3 minutes of standing
Correct Answer: C
Rationale: Postural hypotension 21/10 drop flags, not rises or mild dips. Nurses catch this chronic stand slip (assuming typo meant hypotension).
A client admitted for sickle cell crisis is distraught after learning her child also has the disease. What response by the nurse is best?
- A. Both you and the father are equally responsible for passing it on
- B. There are many good treatments for sickle cell disease these days
- C. It's not your fault; there is no way to know who will have this disease
- D. It's understandable that you are upset about this news. Would you like to talk about what you're feeling?
Correct Answer: D
Rationale: Sickle cell's genetic blow autosomal recessive hits emotionally. Acknowledging distress and offering to talk validates feelings, fostering coping over blame or facts alone. Blaming genetics risks guilt, while touting treatments sidesteps her pain. Denying fault misleads carriers are predictable via screening but misses empathy. Nurses prioritize therapeutic communication, opening dialogue to process this crisis, a compassionate bridge to support mother and child through sickle cell's lifelong challenges.
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