Nokea
DiGeorge syndrome is a primary immune deficiency caused by:
- A. Failure of B cells to mature
- B. Congenital lack of thymic tissue
- C. Failure of formed elements of blood to develop
- D. Selective IgG deficiency
Correct Answer: B
Rationale: DiGeorge syndrome is caused by a congenital lack of thymic tissue, which plays a crucial role in T cell development and maturation, leading to immune deficiency. Choice A is incorrect because DiGeorge syndrome primarily affects T cells, not B cells. Choice C is incorrect as it is too broad and not specific to the thymus. Choice D is incorrect as selective IgG deficiency is a different condition unrelated to DiGeorge syndrome.
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A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
- B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
- C. Tamoxifen may cause weight gain, so patients should monitor their diet.
- D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.
Correct Answer: A
Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.
A female patient is taking combined hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted to have a blood pressure of 176/102 mm Hg. The patient is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other patient teaching should be provided based on her current medication regimen?
- A. Instruct on a low-salt diet.
- B. Instruct to discontinue the contraceptives.
- C. Instruct on the use of relaxation techniques to decrease stress.
- D. Instruct on the rationale for increasing the contraceptive dose.
Correct Answer: A
Rationale: Women on hormonal contraceptives and antihypertensives like enalapril should be counseled to adopt a low-salt diet if severe hypertension occurs. This dietary modification can help in managing blood pressure levels. Instructing to discontinue the contraceptives is crucial in cases of severe hypertension as it poses an increased risk of cardiovascular events. Instructing on relaxation techniques may have some benefits in reducing stress levels but addressing the root cause, such as discontinuing contraceptives in this scenario, is more critical. There is no rationale for increasing the contraceptive dose when hypertension is present; in fact, it should be stopped to prevent complications.
In osteoporosis, what is the expected therapeutic action of raloxifene (Evista)?
- A. It decreases bone resorption and increases bone density.
- B. It stimulates the formation of new bone.
- C. It increases calcium absorption in the intestines.
- D. It decreases the excretion of calcium through the kidneys.
Correct Answer: A
Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in strengthening bones, reducing the risk of fractures, and improving bone health in patients with osteoporosis. Choice B is incorrect because raloxifene does not directly stimulate the formation of new bone but rather prevents bone loss. Choice C is incorrect as raloxifene does not primarily affect calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not primarily decrease the excretion of calcium through the kidneys.
A 30-year-old female has suffered a third-degree burn to her hand after spilling hot oil in a kitchen accident. Which teaching point by a member of her care team is most appropriate?
- A. Your hand will likely heal without the need for a skin graft.
- B. You might experience a loss of sensation in your hand after it heals.
- C. Be sure to keep your hand elevated to reduce swelling.
- D. We will need to monitor you for infection as your hand heals.
Correct Answer: D
Rationale: In third-degree burns, infection is a major concern due to the extensive damage to the skin. Monitoring for infection is crucial. Choice A is incorrect because third-degree burns often require skin grafts due to the severity of the injury. Choice B is incorrect as loss of sensation is more common in nerve damage and not necessarily in burns. Choice C is incorrect because while elevation can help with swelling in minor burns, it is not the most critical concern in third-degree burns.
A client is admitted with a suspected aortic dissection. What is the priority nursing intervention?
- A. Administer antihypertensive medications as prescribed.
- B. Prepare the client for emergency surgery.
- C. Administer intravenous fluids to maintain blood pressure.
- D. Monitor the client's urine output closely.
Correct Answer: B
Rationale: The correct answer is B: Prepare the client for emergency surgery. Aortic dissection is a life-threatening emergency that often necessitates immediate surgical intervention to prevent rupture and further complications. Administering antihypertensive medications (choice A) may be necessary but is not the priority over surgical intervention. While maintaining blood pressure with intravenous fluids (choice C) is important, the urgent need for surgery takes precedence. Monitoring urine output (choice D) is essential for assessing renal function but is not the priority in this critical situation.