Nokea
During the teaching session for a patient who has a new diagnosis of acute leukemia, the patient is restless and looks away without making eye contact. The patient asks the nurse to repeat the information about the complications associated with chemotherapy. Based on this assessment, which nursing diagnosis is appropriate for the patient?
- A. Risk for ineffective adherence to treatment related to denial of need for chemotherapy
- B. Acute confusion related to infiltration of leukemia cells into the central nervous system
- C. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment
- D. Risk for ineffective health maintenance related to possible anxiety about leukemia diagnosis
Correct Answer: D
Rationale: New leukemia diagnosis plus restlessness and repeat requests scream anxiety risk for ineffective health maintenance' fits, as it ties to coping, not denial , brain infiltration , or disinterest . Nurses in oncology spot this fear fogs learning, needing slower, calmer teaching to stick.
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Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity.
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity.
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds.
- D. The ratio of respiratory effort and respiratory rate.
Correct Answer: A
Rationale: Spirometry is the gold standard for COPD diagnosis and staging, measuring airflow obstruction. The ratio of forced expiratory volume in 1 second (FEVâ‚) to forced vital capacity (FVC) FEVâ‚/FVC quantifies limitation; a value <0.7 post-bronchodilator confirms COPD, with FEVâ‚ percentage grading severity (e.g., GOLD stages). Residual volume (RV) to FVC isn't standard in basic spirometry RV requires advanced testing (e.g., plethysmography) and reflects air trapping, not routine staging. FVC versus a 6-second exhale (FEV₆) approximates in some settings but isn't the clinical norm for COPD. Respiratory effort and rate aren't spirometric; they're observational. FEVâ‚/FVC's precision, per Deravin and Anderson (2019), tracks obstruction progression and guides therapy, making it foundational for assessing COPD's irreversible nature.
Which of the following medication is recommended for all patients with NAFLD in improving liver histology?
- A. Statins
- B. Aspirins
- C. Ursodeoxycholic acid
- D. None of the above
Correct Answer: D
Rationale: NAFLD no med fits all; statins, aspirin, ursodiol, E lack universal proof. Nurses skip this chronic blanket pill.
The pathophysiology of Asthma differs from COPD as:
- A. It is characterised by airflow limitation
- B. There is abnormal inflammatory response to exposure to noxious particles or gases
- C. The airflow limitation is reversible
- D. It is considered an obstructive lung disease
Correct Answer: C
Rationale: Asthma's twist reversible airflow block sets it apart from COPD's fixed choke. Both obstruct, inflame to triggers, but asthma's airways bounce back with puffs. Nurses spot this, a chronic split for treatment.
The nurse is caring for a 4-year-old child following surgical removal of a stage I neuroblastoma. Which of the following interventions will be most appropriate for this child?
- A. Applying aloe vera lotion to irradiated areas of skin
- B. Administering antiemetics as prescribed for nausea
- C. Giving medications as ordered via least invasive route
- D. Maintaining isolation as prescribed to avoid infection
Correct Answer: C
Rationale: Post-surgical care for a stage I neuroblastoma (localized, surgically resected) focuses on recovery with minimal invasiveness, making giving medications via the least invasive route preferably oral most appropriate for a 4-year-old. This reduces trauma, anticipates needs like pain relief, antiemetics, or steroids (e.g., dexamethasone for swelling), and suits a stable post-op child without chemotherapy or radiation yet, as stage I often requires surgery alone. Aloe vera implies radiation, not indicated here post-surgery. Antiemetics are useful but too narrow broader medication needs apply. Isolation isn't standard for stage I post-op unless immunosuppression emerges later. This intervention balances efficacy and comfort, aligning with pediatric nursing's goal to minimize distress while ensuring effective postoperative management.
The following are true about education for insulin therapy EXCEPT:
- A. It can only be done by nurses
- B. Different subjects to be covered at different stages of insulin therapy
- C. Improves adherence to insulin therapy
- D. It takes time
Correct Answer: A
Rationale: Insulin teaching docs, educators join nurses, staged topics boost sticking, time and prep pay off; nurse-only's bunk. Nurses weave this chronic learning web, not solo.