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Hepatoblastoma is a neoplasm of undifferentiated precursors of hepatocytes. It is of different histological classification; which type predict the MOST favorable outcome?
- A. mixed type of pure epithelial and mesenchymal elements
- B. type of pure epithelial histology
- C. type of mixed fetal and embryonal histology
- D. type of undifferentiated histology
Correct Answer: B
Rationale: Pure epithelial histology, particularly fetal type, is associated with the best prognosis.
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A 50-year-old African American patient is diagnosed with anemia. Where can the nurse assess for pallor?
- A. Scalp
- B. Chest
- C. Axillae
- D. Conjunctivae
Correct Answer: D
Rationale: When assessing for pallor in a patient with anemia, the nurse should specifically look at the conjunctivae (the membranes that cover the white part of the eyes). In individuals with anemia, the lack of red blood cells can result in paleness in the conjunctivae, which can be observed as a pale or whitish color. This area is especially useful for assessing pallor in individuals with darker skin tones, such as African Americans, where pallor may be less noticeable on other areas of the body.
A 72-year-old chemist has left lower lobe pneumonia. His nurse checks his oxygen saturation and the result is 86%. Which of the ff. actions by the nurse is best?
- A. Call the physician for an order for oxygen.
- B. No action necessary; this is a normal SaO
Correct Answer: A
Rationale: An oxygen saturation (SaO2) level of 86% is significantly below the normal range of 95-100%. This indicates hypoxemia, which means the body is not getting enough oxygen. In a patient with pneumonia, low oxygen saturation can lead to further respiratory compromise and potential organ damage. Therefore, it is essential for the nurse to notify the physician promptly to obtain an order for supplemental oxygen to correct the hypoxemia and improve the patient's oxygen saturation levels. Delay in addressing low oxygen levels can have serious consequences for the patient's health and recovery.
You are meeting parents of a 1.5-year-old boy who has suboptimal growth. He has been delivered prematurely at the gestational age of 32 weeks. Examination reveals a healthy child with growth parameters below normal for age. You reassure the parents that their child will catch his normal growth with time. Of the following, the growth parameter that should be corrected at this age is
- A. weight
- B. height
- C. body mass index
- D. head circumference
Correct Answer: A
Rationale: Premature infants often experience suboptimal weight gain initially due to their early birth. However, they tend to 'catch up' in weight over time as they mature, making weight the most relevant parameter to correct.
A client diagnosed with systemic lupus erythematosus (SLE) comes to the emergency department with severe back pain. She reports that she first felt pain after manually opening her garage door and that she is taking prednisone daily. When adverse effect of long-term corticosteroid therapy is most likely responsible for the pain?
- A. Hypertension
- B. Muscle wasting
- C. Osteoporosis
- D. Truncal obesity
Correct Answer: C
Rationale: Osteoporosis is the most likely adverse effect of long-term corticosteroid therapy responsible for the severe back pain experienced by the client with systemic lupus erythematosus (SLE). Corticosteroids such as prednisone can lead to bone resorption and calcium loss, resulting in weakened bones and increased risk of fractures. Back pain in this case could be a sign of vertebral compression fractures due to osteoporosis induced by prolonged corticosteroid use. It is important for healthcare providers to monitor bone health in patients on long-term corticosteroid therapy and consider strategies to prevent or manage osteoporosis.
The nurse is preparing an intravenous infusion of phenytoin (Dilantin) as prescribed by the physician for the client with seizures. Which of the following solutions will the nurse plan to use to dilute this medication?
- A. Dextrose 5%
- B. Lactated Ringer's solution
- C. Normal saline solution
- D. Dextrose 5% and half-normal saline (0.45%)
Correct Answer: C
Rationale: Phenytoin (Dilantin) is known to be incompatible with dextrose solutions (such as dextrose 5% or dextrose 5% and half-normal saline). Therefore, the nurse would plan to use normal saline solution to dilute phenytoin in order to ensure medication effectiveness and prevent any potential adverse reactions. Lactated Ringer's solution is not commonly used for diluting phenytoin as normal saline solution is the preferred choice due to compatibility considerations.