Nokea
For care of a patient who has oral cancer, which task would be appropriate to delegate to the LPN/LVN?
- A. Assist the patient to brush and floss
- B. Explain when brushing and flossing are contraindicated
- C. Give antacids and sucralfate suspension as ordered
- D. Recommend saliva substitutes
Correct Answer: C
Rationale: LPN/LVNs excel in medication administration within their scope, making giving antacids and sucralfate ordered for oral cancer's mucosal protection ideal. Brushing and flossing assistance fits nursing assistants, a basic task. Explaining contraindications requires RN-level judgment to assess risks like bleeding or infection. Recommending saliva substitutes needs physician or pharmacist input, beyond LPN/LVN authority. Medication delivery leverages their training, easing symptoms like pain or ulcers, ensuring safe, supervised care in oral cancer's complex management, a practical delegation choice.
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Which of the following procedures are performed for a client with a pericardial effusion?
- A. Thoracotomy
- B. Pericardiocentesis
- C. Coronary artery bypass graft
- D. Thoracentesis
Correct Answer: B
Rationale: Pericardial effusion fluid around the heart threatens tamponade, compressing cardiac output. Pericardiocentesis drains this via needle or catheter, relieving pressure, a targeted fix for this diagnosis. Thoracotomy, an open chest surgery, is overkill unless complications escalate. Coronary bypass addresses arterial blockages, unrelated to effusion. Thoracentesis taps pleural fluid, not pericardial. Nurses prep for pericardiocentesis, anticipating its urgency in restoring function, a procedure matching the condition's anatomy and risk, critical for stabilizing clients in this cardiac emergency.
After change-of-shift report on the oncology unit, which patient should the nurse assess first?
- A. Patient who has a platelet count of 82,000/µL after chemotherapy
- B. Patient who has xerostomia after receiving head and neck radiation
- C. Patient who is neutropenic and has a temperature of 100.5°F (38.1°C)
- D. Patient who is worried about getting the prescribed long-acting opioid on time
Correct Answer: C
Rationale: Neutropenia plus 100.5°F screams infection sepsis looms, outranking low platelets (A bleeding's later), dry mouth , or opioid timing . Nurses in oncology bolt here fever in a white-cell wasteland's a killer, needing stat eyes.
Which of the following health determinants is NOT a component of Lalonde's model?
- A. Biological factors
- B. Physical environment
- C. Health care
- D. Attitude to life
Correct Answer: D
Rationale: Lalonde's grid biology, environment, care, not attitude shapes health, not mindsets. Nurses map this, a chronic model cut.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
Which does not cause genital ulceration?
- A. syphilis
- B. herpes simplex infection
- C. HIV
- D. lymphogranuloma venereum
Correct Answer: C
Rationale: HIV no direct ulcers; syphilis, herpes, LGV, chancroid carve sores. Nurses rule this chronic outlier.