Nokea
Anthracycline (doxorubicin) on rare occasion causes acute inflammatory myocardial injury, but more classically results in dilated cardiomyopathy (DCM) in up to 30% of patients with a cumulative dose of doxorubicin exceeding
- A. 250 mg/m²
- B. 350 mg/m²
- C. 450 mg/m²
- D. 550 mg/m²
Correct Answer: D
Rationale: A cumulative dose of doxorubicin exceeding 550 mg/m² is associated with increased risk of dilated cardiomyopathy.
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A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, located on the lateral surface of the lower leg. After wide margin resection, the nurse provides discharge teaching. It is most important for the nurse to emphasize the need to observe for changes in which characteristic?
- A. Elasticity of the skin
- B. Appearance of any moles
- C. Muscle aches and pains
- D. Pigmentation of the skin
Correct Answer: B
Rationale: Monitoring for changes in moles is critical for early detection of new or recurrent melanoma, which is essential for timely intervention.
Regarding reflex anoxic seizures in children:
- A. ECG-rhythm strip is a must
- B. Asystole may be associated
- C. There is increased risk of epilepsy in adults
- D. Carbamazepine is the drug of choice
Correct Answer: B
Rationale: Reflex anoxic seizures in children are often triggered by a sudden noxious stimulus leading to transient asystole (cessation of heart activity). An ECG-rhythm strip is not always necessary there is no increased risk of epilepsy in adults and carbamazepine is not the drug of choice. Trauma can be a precipitating factor but the most relevant option is asystole.
A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?
- A. Osmolarity
- B. Glucose
- C. Albumin
- D. Platelets
Correct Answer: B
Rationale: Hydrocortisone can affect blood glucose levels, making it important to monitor for hyperglycemia.
A 15-year-old female reports fainting at school in class on two occasions. The adolescent's orthostatic blood pressures are normal. The primary care pediatric nurse practitioner suspects a cardiac cause for these episodes and will order which tests before referring her to a pediatric cardiologist?
- A. 12-lead electrocardiogram
- B. Echocardiogram
- C. Tilt table testing
- D. Treadmill exercise testing
Correct Answer: A
Rationale: A 12-lead ECG is useful for initial evaluation.
The nurse determines that a client who arrives in the preoperative holding area before surgery is allergic to bananas. Which action should the nurse implement prior to taking the client into the operative area?
- A. Replace latex-containing devices in the OR with alternate synthetic materials
- B. Administer an antihistamine before surgery.
- C. Notify the surgeon about the client's allergy to bananas.
- D. Prepare to administer an epinephrine injection during surgery
Correct Answer: A
Rationale: Banana allergy is associated with latex allergy. Replacing latex-containing devices prevents potential allergic reactions during surgery.