Nokea
An oncology patient has just returned from the postanesthesia care unit after an open hemicolectomy. This patient's plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome
- B. Assess the patient's fine motor skills once per shift
- C. Assess the patient's wound for dehiscence every 4 hours
- D. Maintain the patient's head of bed at 45 degrees or more at all times
Correct Answer: C
Rationale: Post-hemicolectomy, wound dehiscence splitting open is a killer risk, tied to infection or poor healing, needing checks every 4 hours. Compartment syndrome's a fracture thing, not gut surgery. Fine motor's irrelevant here neuro's not the issue. High head-of-bed helps breathing but isn't universal post-op. Nurses in oncology prioritize this, catching leaks or redness early, critical after cancer gut surgery.
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After change-of-shift report on the oncology unit, which patient should the nurse assess first?
- A. Patient who has a platelet count of 82,000/µL after chemotherapy
- B. Patient who has xerostomia after receiving head and neck radiation
- C. Patient who is neutropenic and has a temperature of 100.5°F (38.1°C)
- D. Patient who is worried about getting the prescribed long-acting opioid on time
Correct Answer: C
Rationale: Neutropenia plus 100.5°F screams infection sepsis looms, outranking low platelets (A bleeding's later), dry mouth , or opioid timing . Nurses in oncology bolt here fever in a white-cell wasteland's a killer, needing stat eyes.
The nurse educates the client that besides an echocardiogram, which of the following tests is the best tool for diagnosing heart failure?
- A. Pulmonary artery catheter
- B. Mitigated angiographic (MUGA) scan
- C. B-type natriuretic peptide (BNP)
- D. Radionuclide studies
Correct Answer: C
Rationale: BNP, a blood test, spikes with heart stretch heart failure's calling card, outshining invasive tools for diagnosis. Pulmonary catheters measure pressures, not routine. MUGA scans ejection fraction, less direct. Radionuclide's vague here. Nurses teach BNP's ease and accuracy, a biomarker gold standard, syncing with echo to nail heart failure's fluid tale.
Which of the following is a treatment option for a client with sickle cell disease?
- A. NPO diet
- B. Blood product administration
- C. Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) only
- D. Arthrocentesis
Correct Answer: B
Rationale: Sickle cell's vaso-occlusion and anemia crave blood transfusions boost oxygen, unsickling cells, a go-to fix. NPO starves, NSAIDs alone weak for crisis pain, arthrocentesis irrelevant. Nurses bank on blood, easing hypoxia, a lifeline in this hemoglobin havoc, trumping lesser aids.
In the treatment of COPD:
- A. Inhaled long-acting β₂ agonists are a first-line treatment for breathlessness.
- B. Most patients require maintenance use of oral corticosteroids.
- C. The dosage of oral theophylline needs to be reduced in patients commenced on erythromycin.
- D. Long-term oxygen therapy is indicated in a stable patient with a Paâ‚“â‚‚ of 8.5 kPa.
Correct Answer: C
Rationale: COPD management focuses on symptom relief and preventing exacerbations. Inhaled long-acting β₂ agonists are indeed used for breathlessness but are not always first-line; short-acting bronchodilators often precede them. Maintenance oral corticosteroids are not standard due to significant side effects; inhaled corticosteroids are preferred. Theophylline, a bronchodilator, has its metabolism inhibited by erythromycin (a CYP3A4 inhibitor), increasing plasma levels and toxicity risk, necessitating dose reduction. Long-term oxygen therapy is indicated for severe hypoxemia (Paₓ₂ < 7.3 kPa or 7.3-8 kPa with complications), not at 8.5 kPa, which is relatively normal. Non-invasive ventilation is reserved for acute exacerbations, not first-line treatment. The interaction between theophylline and erythromycin is a critical pharmacological consideration in COPD management, making it the standout correct statement.
Which of the following management activities is not part of the nursing care of a patient with COPD?
- A. Achieving airway clearance and improving breathing patterns
- B. Ensuring the patient stays in bed and does not exert themselves causing increased dyspnoea
- C. Improving activity tolerance and assisting with lifestyle modification
- D. Monitoring and managing potential complications
Correct Answer: B
Rationale: COPD nursing pushes clearance, tolerance, and complication watch active goals. Bedrest flops deconditions, worsens breathlessness, a chronic care no-no nurses dodge.