Nokea
Chemotherapy has a major role in many childhood CNS tumors. In which of the following tumors is chemotherapy not effective?
- A. pilocytic astrocytoma
- B. craniopharyngioma
- C. pineoblastoma
- D. supratentorial primitive neuroectodermal tumors (SPNETs)
Correct Answer: A
Rationale: Pilocytic astrocytomas are generally low-grade and less responsive to chemotherapy compared to other listed tumors.
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The physician prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
- A. "Be sure to take glipizide 30 minutes before meals."
- B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly."
- C. "You won't need to check you blood glucose level after you start taking glipizide."
- D. "Take glipizide after a metal to prevent heartburn."
Correct Answer: A
Rationale: A. "Be sure to take glipizide 30 minutes before meals."
Mr. Umali, 52-year-old male is being evaluated for acute ulcerative colitis. im preparing Mr. Umali for a barium enema, the nurse can expect that he will be:
- A. contraindicated with cathartics
- B. given an oil retention enema the morning of the study
- C. instructed to swallow six radiopaque tablets the evening before the study
- D. positioned in ahigh fowler's position immediately following the procedure
Correct Answer: A
Rationale: In preparing a 52-year-old male patient like Mr. Umali for a barium enema to evaluate acute ulcerative colitis, the nurse can expect that he will be contraindicated with cathartics. Cathartics, which are substances that induce bowel movements, are generally contraindicated in patients being evaluated for acute colitis as they can exacerbate the condition and cause additional discomfort. In contrast, using oil retention enemas or radiopaque tablets may not be suitable for a patient with acute ulcerative colitis. Positioning in a high Fowler's position following the procedure is not related to the preparation for a barium enema in this case.
The entire process of toilet training need not be hurried and it can take
- A. 2 months
- B. 4 months
- C. 6 months
- D. 8 months
Correct Answer: C
Rationale: Toilet training typically takes around 6 months, though this varies from child to child.
A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client?
- A. Anticipatory grieving
- B. Disturbed body image
- C. Impaired swallowing
- D. Chronic low self-esteem
Correct Answer: A
Rationale: Anticipatory grieving is an appropriate nursing diagnosis for a client diagnosed with gallbladder cancer due to the nature of the diagnosis and the symptoms experienced. Gallbladder cancer carries a poor prognosis and can have a significant impact on the client's emotional well-being. The client may experience feelings of sadness, fear, and loss related to the cancer diagnosis and its implications on their health and future. The presence of symptoms such as yellow skin, weight loss, fatigue, and epigastric pain can further contribute to the client's distress and feelings of grief. As the client navigates the challenges associated with the cancer diagnosis and treatment, providing emotional support and assistance in coping with their feelings of anticipatory grief is essential for holistic care.
The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate?
- A. pH
- B. Osmolality
- C. Creatinine
- D. Protein level
Correct Answer: C
Rationale: Creatinine is a waste product produced by muscle metabolism that is normally filtered by the glomerulus in the kidneys and excreted in urine. The level of creatinine in the urine is a direct reflection of the glomerular filtration rate (GFR). As GFR decreases in conditions such as acute renal failure, the amount of creatinine excreted in the urine also decreases. Therefore, measuring creatinine levels in the urine is a useful clinical indication of the glomerular filtration rate and kidney function. pH, osmolality, and protein level may provide additional information but are not as directly linked to GFR as creatinine levels.