Nokea
Autonomic neuropathies affecting people with chronic diabetes affect many body systems. Which of the following is not a clinical manifestation of this problem?
- A. Tachycardia
- B. Mental confusion
- C. Urinary retention
- D. Anhidrosis
Correct Answer: B
Rationale: Diabetes' nerve mess fast heart, pee stalls, no sweat autonomic signs. Confusion's brain sugar or stroke, not this. Nurses clock these, a chronic nerve quirk.
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The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective?
- A. After cancer has not recurred for 5 years, it is considered cured.
- B. The cancer will be cured if the entire tumor is surgically removed.
- C. I will need follow-up examinations for many years after treatment before I can be considered cured.
- D. Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation.
Correct Answer: C
Rationale: Stage III breast cancer's advanced local spread means long-term vigilance, not a quick cured' label. Five years recurrence-free is a milestone, but not universal some hit sooner, others never. Surgery alone won't cut it; chemo and radiation tag-team it. Never cured' overstates control's the goal, but cure's possible. Nurses in oncology drill this: years of follow-ups track sneaky recurrence, key for stage III's tricky prognosis.
The nurse is caring for a client who was recently diagnosed with hemophilia. Which of the following laboratory tests is consistent with that diagnosis?
- A. Prolonged activated partial thromboplastin time
- B. Prolonged prothrombin time
- C. Decreased platelet count
- D. Decreased bleeding time
Correct Answer: A
Rationale: Hemophilia factor VIII or IX lack stretches aPTT, as intrinsic clotting lags, a lab fit for this X-linked bleed fest. PT stays normal extrinsic path's fine. Platelets don't drop; bleeding time's off-base. Nurses spot prolonged aPTT, confirming hemophilia's clotting chaos, guiding factor therapy in this bloody diagnosis.
A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan?
- A. Donor bone marrow is transplanted through a sternal or hip incision.
- B. Hospitalization is required for several weeks after the stem cell transplant.
- C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
- D. Transplant of the donated cells can be very painful because of the nerves in the tissue lining the bone.
Correct Answer: B
Rationale: HSCT for leukemia means 2-4 weeks in hospital engraftment's slow, and infection risk's sky-high in isolation. No incision it's IV. No OR it's bedside. Pain's minimal no bone nerves hit. Nurses in oncology stress this long haul, sterile stay, not surgical drama, prepping patients for the real grind.
In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.
Which of the following nursing interventions would be appropriate for a client with sickle cell disease?
- A. Prepare the client for surgery
- B. Encourage fluid intake
- C. Provide a warm environment
- D. Keep the client strictly NPO
Correct Answer: B
Rationale: Sickle cell's sticky cells crave hydration fluids thin blood, easing vaso-occlusion, a top intervention to cut crisis. Surgery's rare, warmth helps pain, NPO starves. Nurses push intake, preventing sickling, a hydration win in this hemoglobin war.