Nokea
In which of the following diseases would bone marrow transplantation not be indicated in a newly diagnosed client?
- A. Severe aplastic anemia
- B. Severe combined immunodeficiency
- C. Acute lymphocytic leukemia
- D. Chronic myeloid leukemia
Correct Answer: C
Rationale: The correct answer is C, acute lymphocytic leukemia. In this disease, bone marrow transplantation is not indicated as it is a systemic cancer affecting the blood and bone marrow itself. Transplanting diseased bone marrow would not be effective in treating the underlying cancer. In contrast, severe aplastic anemia (A) and severe combined immunodeficiency (B) are conditions where bone marrow transplantation can help replace dysfunctional bone marrow with healthy stem cells. Chronic myeloid leukemia (D) may also benefit from bone marrow transplantation as a treatment option to replace cancerous cells with healthy ones.
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Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Which interventions should the nurse include when administering this medication?
- A. Restrict fluid intake.
- B. Monitor liver function studies.
- C. Administer the medication with an antacid.
- D. Instruct the client to avoid exposure to the sun.
Correct Answer: B
Rationale: Correct Answer: B - Monitor liver function studies.
Rationale:
1. Ketoconazole is known to have hepatotoxic side effects.
2. Monitoring liver function studies is essential to detect any signs of liver damage early.
3. Regular monitoring allows for timely intervention if hepatic toxicity occurs.
Other Choices:
A: Restricting fluid intake is not necessary for ketoconazole administration.
C: Administering ketoconazole with an antacid may reduce its absorption.
D: Avoiding sun exposure is not directly related to ketoconazole administration for candidiasis.
A preschool child is seen in the clinic, and the nurse anticipates a diagnosis of leukemia. Which reaction does the nurse anticipate this child will exhibit upon diagnosis?
- A. Acceptance, especially if able to discuss the disease with children their own age
- B. Thoughts that they caused their illness and are being punished
- C. Understanding of what cancer is and how it is treated
- D. Unawareness of the illness and its severity
Correct Answer: D
Rationale: The correct answer is D because preschool-aged children typically lack the cognitive capacity to fully understand complex medical conditions like leukemia and its severity. They may not grasp the concept of illness or the implications of a cancer diagnosis. Preschoolers are unlikely to exhibit acceptance (Choice A) as they may struggle to comprehend the situation. They are also not likely to blame themselves for causing the illness (Choice B) as this requires a more advanced understanding of cause and effect. While some children may have a basic understanding of cancer and its treatment (Choice C), they are unlikely to fully comprehend the disease's complexities. Overall, the most likely reaction for a preschooler diagnosed with leukemia is unawareness due to their developmental stage.
What is the primary purpose of a transitional object?
- A. It helps the parents deal with the guilt they feel when they leave the child.
- B. It keeps the child quiet at bedtime.
- C. It is effective in decreasing anxiety in the toddler.
- D. It decreases negativism and tantrums in the toddler.
Correct Answer: C
Rationale: The primary purpose of a transitional object is to decrease anxiety in the toddler. The object provides comfort and security when the child is separated from their caregiver, reducing feelings of distress. It serves as a source of emotional support and helps the child manage their emotions independently. The other choices are incorrect because they focus on the parent's feelings (A), behavior modification (D), or simply keeping the child quiet (B), rather than addressing the emotional needs of the child.
Patient on cyclosporine post-transplant. Most concerning symptom?
- A. Bleeding gums
- B. Nontender groin swelling
- C. Occasional nausea
- D. Numbness and tingling of feet
Correct Answer: B
Rationale: The most concerning symptom for a patient on cyclosporine post-transplant is nontender groin swelling (Choice B) due to the risk of developing nephrotoxicity from cyclosporine. Groin swelling may indicate lymphoproliferative disorder or nephrotic syndrome, both associated with cyclosporine use. Bleeding gums (Choice A) may be due to gum disease but are not directly related to cyclosporine. Occasional nausea (Choice C) is a common side effect of cyclosporine but is usually mild and not as concerning. Numbness and tingling of feet (Choice D) may indicate peripheral neuropathy, which can be a side effect of cyclosporine but is less concerning than the potential kidney damage indicated by groin swelling.
Which drug is a platelet inhibitor?
- A. Clopidogrel (Plavix)
- B. Enoxaparin (Lovenox)
- C. Reteplase (Retavase)
- D. Warfarin (Coumadin)
Correct Answer: A
Rationale: The correct answer is A: Clopidogrel (Plavix). Clopidogrel is a platelet inhibitor that works by inhibiting the platelet activation and aggregation process. It specifically targets the ADP receptor on platelets, preventing them from clumping together. This action helps to prevent blood clots from forming, making it an effective antiplatelet medication. Enoxaparin (B) is a low molecular weight heparin that works by inhibiting factors Xa and IIa, making it an anticoagulant rather than a platelet inhibitor. Reteplase (C) is a thrombolytic agent that works by converting plasminogen to plasmin, aiding in the breakdown of blood clots. Warfarin (D) is an anticoagulant that works by inhibiting the synthesis of vitamin K-dependent clotting factors.