Nokea
For a patient with osteogenic sarcoma, you would be particularly vigilant for elevations in which laboratory value?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Hematocrit
Correct Answer: B
Rationale: Osteogenic sarcoma, a bone cancer, often triggers hypercalcemia bone destruction releases calcium into blood, risking arrhythmias or kidney damage, a life-threatening shift demanding close watch. Sodium and potassium imbalances aren't bone-specific, more tied to general metabolism or treatment side effects. Hematocrit reflects anemia, common in cancer but not osteogenic sarcoma's hallmark. Calcium's spike, linked to osteolysis, makes it the nurse's focus elevations signal tumor activity or progression, prompting urgent interventions like fluids or bisphosphonates, a vigilance rooted in this cancer's skeletal impact and metabolic havoc.
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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.
Pulmonary rehabilitation is one of the most effective interventions in the management of COPD. The primary goals of this program are to:
- A. Ensure the patient eats appropriately, takes their medication as prescribed and exercises every day
- B. Involve the patient in the multidisciplinary team and knows how to manage their condition
- C. Reduce symptoms, improved QOL, increase physical and emotional participation in everyday life
- D. Prevent deterioration, avoid hospitalisation and support the carers
Correct Answer: C
Rationale: Pulmonary rehab reclaims COPD life less wheeze, better QOL, more daily grit, physical and emotional. Diet-meds-exercise is narrow; team play's a means; prevention's a perk, not core. Nurses drive this, a chronic lift.
Which of the following is a treatment option for a client with infective endocarditis?
- A. Bedrest
- B. Antimicrobials
- C. Diet modification
- D. Antihypertensive
Correct Answer: B
Rationale: Infective endocarditis bacterial valve infection needs antimicrobials to kill pathogens like *Streptococcus*, the root cause, halting damage and sepsis. Bedrest aids recovery but doesn't treat. Diet tweaks support health, not infection. Antihypertensives manage pressure, irrelevant to endocarditis's microbial core. Nurses anticipate antibiotics, often IV for weeks, targeting the source, a priority to save valves and lives in this high-mortality condition, aligning with infectious disease protocols.
Choose the CORRECT statement Babies born from mothers with gestational diabetes:
- A. Are at a high risk of being born with diabetes
- B. Are usually hypoglycaemic due to maternal insulin drug therapy
- C. Are usually of higher birth weight
- D. Are always given a glucose challenge test
Correct Answer: C
Rationale: Gestational diabetes fattens babies high maternal sugar pumps fetal growth, a hefty birth norm. They don't inherit diabetes at birth, hypo's rare unless mom's on insulin, tests aren't routine. Nurses track this, a chronic womb echo.
The immediate nursing care to be provided to a patient presenting with a suspected ischaemic stroke include:
- A. Position on left lateral side, insert nasogastric tube, conduct an ECG and insert an IV line
- B. Primary/Secondary survey, give analgesia, 4th hourly neuro obs and vital signs, maintain oral intake
- C. Primary/Secondary survey, 4th hourly neuro obs and vital signs, monitor BGL and maintain nil by mouth
- D. 4th hourly neuro obs and vital signs, monitor BGL, insert an IV line and reduce intracranial pressure by positioning and reduced stimulation
Correct Answer: C
Rationale: Stroke hits fast surveys spot deficits, neuro obs track brain, vitals catch crashes, BGL rules out mimics, and nil by mouth preps for scans or clots, a tight first step. Lateral's for airways, not here; analgesia's late; IVs and ICP control follow. Nurses nail this, racing for tPA windows, a chronic precursor's acute kickoff.