Nokea
Cortical stimulation:
- A. Occurs before resection of a tumour.
- B. Localizes areas involved with hearing.
- C. Occurs by indirect application of electrodes.
- D. Allows identification of Wernicke's area, which is involved in the comprehension of language.
Correct Answer: D
Rationale: Cortical stimulation in awake craniotomy maps eloquent brain areas before tumor resection to avoid functional loss. It's performed pre-resection to define safe boundaries, localizing motor, sensory, and language areas, including hearing-related regions in the temporal lobe. Electrodes are applied directly to the cortex, not indirectly, for precision. Wernicke's area, in the dominant temporal lobe, is critical for language comprehension, and stimulation identifies it by eliciting speech errors (e.g., paraphasia). Seizures can occur, managed with cold saline irrigation, not warm. The ability to pinpoint Wernicke's area is pivotal, as its preservation ensures postoperative language function, balancing oncologic goals with quality of life in eloquent cortex surgeries.
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A male client is presenting with radiating chest pain. Which of the following would the nurse recognize as indicators that an acute myocardial infarction may be occurring?
- A. Positive troponin markers
- B. ST elevation on EKG on two contiguous leads
- C. Pain relieved with rest
- D. Diaphoresis
Correct Answer: B
Rationale: MI's hallmark ST elevation in contiguous leads flags acute infarction, showing transmural injury, a nurse's red alert for cath lab prep. Troponins rise later, confirming damage. Rest-relieved pain fits angina, not MI. Diaphoresis tags along but isn't diagnostic alone. EKG's immediacy nails this, driving urgent care in this chest pain crisis.
The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
- A. Poor oral intake
- B. Frequent loose stools
- C. Complaints of nausea and vomiting
- D. Increase in carcinoembryonic antigen (CEA)
Correct Answer: D
Rationale: Colorectal cancer's chemo tracks via CEA rising levels signal progression or resistance, a red flag for therapy tweak, needing provider input. Poor intake, diarrhea, and nausea are side effects, manageable with nursing care diet, fluids, antiemetics unless extreme. CEA's uptick, a tumor marker, trumps symptoms, hinting at disease outpacing treatment. Nurses flag this, pushing for scans or regimen shifts, a critical catch in this cancer's chemo dance.
Which of the following is NOT associated with obesity?
- A. Non-Alcoholic Fatty Liver Disease
- B. Obstructive Sleep Apnea
- C. Increased mortality
- D. Type 1 Diabetes Mellitus
Correct Answer: D
Rationale: Obesity piles on NAFLD, apnea, death risk, back ache; type 1's autoimmune, not fat-driven. Nurses link this chronic weight web, not islet crash.
Which of the following is the surgical treatment of choice for end-stage heart failure?
- A. Cardiac resynchronization therapy (CRT)
- B. Percutaneous angiogram
- C. Genetic counseling
- D. Ventricular assist devices (VADs)
Correct Answer: D
Rationale: End-stage heart failure, when drugs and pacing fail, leans on ventricular assist devices mechanical pumps aiding circulation, a bridge to transplant or destination therapy. CRT syncs ventricles, less invasive, but VADs tackle severe pump collapse. Angiograms diagnose, not treat; genetic counseling's irrelevant. Nurses prep for VADs, managing post-op risks, the go-to surgical fix in this terminal cardiac scenario.
When assignments are being made for clients with alterations related to gastrointestinal (GI) cancer, which client would be the most appropriate to delegate to an LPN/LVN?
- A. A client with severe anemia secondary to GI bleeding
- B. A client who needs enemas and antibiotics to control GI bacteria
- C. A client who needs preoperative teaching for bowel resection surgery
- D. A client who needs central line insertion for chemotherapy
Correct Answer: B
Rationale: Delegating in GI cancer care hinges on scope LPN/LVNs handle routine tasks like administering enemas and antibiotics, a straightforward intervention to curb bacteria, fitting their training under RN oversight. Severe anemia from bleeding demands RN assessment for stability or transfusion, beyond LPN scope. Preoperative teaching requires detailed education and evaluation, an RN's domain. Central line insertion involves advanced skills and risks, reserved for RNs or specialists. Enemas and antibiotics align with LPN/LVN capabilities, optimizing team roles while keeping complex care with RNs, a practical choice in managing GI cancer's multifaceted needs safely and efficiently.