Nokea
As the surgical incision is closed, who are the personnel in-charge in counting the needles, sponges, and instruments?
- A. the surgeon and anesthesiologist
- B. the surgeon and the registered
- C. the circulating and scrub nurse nurse first assistant
- D. the anesthesiologist and anesthetist
Correct Answer: C
Rationale: During the surgical procedure, the circulating nurse, scrub nurse, and nurse first assistant are responsible for keeping track of all instruments, needles, and sponges used. As the surgical incision is being closed, the circulating nurse and the scrub nurse/nurse first assistant conduct a final count of all needles, sponges, and instruments to ensure that nothing is accidentally left inside the patient's body. This is a critical step in preventing retained surgical items (RSI), which can lead to serious complications for the patient. It is part of the standard protocol in the operating room to have these specific personnel take charge of counting and verifying all items before the procedure is concluded.
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A client has squamous cell cancer of the right lung that has metastasized to the brain. In addition to chemotherapy for lung cancer, the physician prescribes lomustine (CeeNU), 100 mg/m2 as a single dose, to treat the brain metastasis. What are the major administration and excretion routes of lomustine?
- A. Oral administration and urinary
- B. I.V. administration and urinary excretion
- C. I.V administration and fecal excretion
- D. Oral administration and fecal excretion
Correct Answer: B
Rationale: Lomustine (CeeNU) is typically administered intravenously (I.V.), making choice B the correct administration route. Lomustine is metabolized in the liver and excreted primarily through the kidneys via urine, which accounts for its urinary excretion. Therefore, the major administration route for lomustine is intravenous (I.V.) and the major excretion route is urinary.
The most significant form of meningitis is:
- A. Bacterial
- B. Septic
- C. Aseptic
- D. Viral
Correct Answer: A
Rationale: Bacterial meningitis is considered the most significant form of meningitis because it is a serious, life-threatening condition that requires immediate medical attention. Bacterial meningitis is caused by bacteria infecting the protective membranes covering the brain and spinal cord. It can lead to complications such as brain damage, hearing loss, and even death if not treated promptly with antibiotics. Bacterial meningitis is more severe than viral or aseptic meningitis, hence why it is considered the most significant form.
Which of the ff adverse reactions may occur when a client is taking danazol (Danocrine) for fibrocystic breast disease?
- A. Nausea
- B. Amenorrhea
- C. Confusion
- D. Hypotension
Correct Answer: B
Rationale: Danazol (Danocrine) is a synthetic androgen that is used to treat conditions such as fibrocystic breast disease. One of the known adverse effects of danazol is the development of amenorrhea, which refers to the absence of menstrual periods. This occurs because danazol suppresses ovarian function by inhibiting the release of gonadotropins, leading to decreased production of estrogen and progesterone. Amenorrhea associated with danazol use is typically reversible upon discontinuation of the medication. Nausea, confusion, and hypotension are not common adverse reactions associated with danazol use for fibrocystic breast disease.
Aisa is to have blood transfusion. Which of the following problems is most likely associated with blood transfusion?
- A. Serum hepatitis
- B. Pulmonary edema
- C. Allergic response
- D. Hemolytic reaction Situation: Joel is a toddler who has classical hemophilia.
Correct Answer: D
Rationale: A hemolytic reaction is the most likely problem associated with blood transfusion. A hemolytic reaction occurs when the body's immune system attacks the transfused blood, leading to the destruction of red blood cells. This reaction can cause serious complications, including kidney damage, shock, and even death. It is crucial for healthcare providers to carefully match blood types and perform compatibility testing before administering a blood transfusion to minimize the risk of a hemolytic reaction. Serum hepatitis, pulmonary edema, and allergic responses are potential complications of blood transfusions, but hemolytic reactions pose the most immediate and severe threat to the patient's health.
A 3-year-old with croup has the following vital signs: HR 90, RR 44, BP 100/52, T 98.8°F. The parents ask if these are normal. The nurse's best response is:
- A. Your son's blood pressure is elevated.
- B. Your son's temperature is elevated.
- C. Your son's respiratory rate is elevated; a normal rate for his age is 20-30 breaths per minute.
- D. Your son's heart rate is elevated.
Correct Answer: C
Rationale: The elevated respiratory rate is concerning since normal for a 3- to 6-year-old is about 20-30 breaths per minute.