Nokea
Inhaled medications, such as bronchodilators and glucocorticoids are the main medication treatment methods for COPD. What is the biggest reason for ineffective outcomes?
- A. Patient compliance with dose prescription
- B. Incorrect use of the device
- C. Incorrect prescribing
- D. Reduced drug inhalation due to respiratory disease
Correct Answer: B
Rationale: COPD inhalers flop most when puffed wrong technique, not timing, trumps compliance, bad scripts, or weak lungs. Spacers, shaky hands nurses fix this, a chronic breath's weak link.
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A 7-year-old child with osteosarcoma is being treated with chemotherapy. Which medication would the nurse expect the physician to order most commonly as a prophylaxis against Pneumocystis jirovecii?
- A. Trimethoprim-sulfamethoxazole
- B. Ketoconazole
- C. Filgastim
- D. Prednisone
Correct Answer: A
Rationale: Osteosarcoma chemotherapy compromises the immune system, increasing susceptibility to opportunistic infections like Pneumocystis jirovecii pneumonia (PCP), a serious risk in immunocompromised children. Trimethoprim-sulfamethoxazole (TMP-SMX) is the most common prophylactic antibiotic for PCP, effectively preventing this lung infection by targeting its causative organism. Ketoconazole treats fungal infections but not PCP, which is caused by a fungus-like organism requiring specific therapy. Filgrastim stimulates neutrophil production to combat neutropenia, not PCP directly. Prednisone, a corticosteroid, suppresses immunity and reduces tumor-related edema but doesn't prevent infections and may increase risk. The nurse anticipates TMP-SMX due to its established role in pediatric oncology protocols, ensuring protection against a preventable, potentially fatal complication during chemotherapy.
In monitoring patients who are at risk for spinal cord compression related to tumor growth, what is the most likely early manifestation?
- A. Sudden-onset back pain
- B. Motor loss
- C. Constipation
- D. Urinary hesitancy
Correct Answer: A
Rationale: Spinal cord compression from tumors often starts with sudden back pain 95% of cases due to vertebral pressure or nerve irritation, an early red flag demanding urgent imaging and intervention to prevent paralysis. Motor loss, like weakness, emerges later as nerves compress further. Constipation and urinary hesitancy signal advanced autonomic involvement, not initial signs. Pain's prevalence and timing make it the nurse's focus catching it early triggers steroids or surgery, halting progression in cancer patients where spinal integrity dictates function and survival, a critical monitoring priority.
What is the highest likelihood that a doctor acquires HIV from a needlestick injury from an HIV pt?
- A. 0.30%
- B. 2%
- C. 5%
- D. 10%
Correct Answer: A
Rationale: HIV needlestick 0.3% odds, not 2-30's wild leaps. Nurses glove up, a chronic prick stat.
A female client is being treated for a deep-vein thrombus she developed post-operatively about one week ago and was treated with unfractionated heparin. Today she presents to the clinic with petechiae on bilateral hands and feet. Laboratory results show a platelet count of 42,000/mm³. The nurse is concerned about a drug reaction and anticipates the client has which of the following?
- A. Heparin-induced thrombocytopenia (HIT)
- B. Hemophilia A (classic hemophilia)
- C. Thrombotic thrombocytopenic purpura (TTP)
- D. Sickle cell crisis
Correct Answer: A
Rationale: Heparin can backfire petechiae and a platelet plunge to 42,000/mm³ post-DVT treatment scream HIT, an immune reaction trashing platelets, risking clots. Hemophilia's genetic, not drug-tied. TTP adds fever, neuro signs absent here. Sickle crisis pains, not bleeds like this. Nurses suspect HIT, anticipating heparin cessation and alternatives, a twist in this anticoagulation tale.
The emergency management of the patient with acute asthma does not include:
- A. Performing a rapid physical examination
- B. Performing spirometry or peak flow on arrival
- C. Giving oxygen and short acting bronchodilator
- D. Close monitoring to determine efficacy of treatment and improvement or deterioration
Correct Answer: B
Rationale: Acute asthma's rush exam, O2, bronchodilators, tight watch saves breath fast. Spirometry's a no too tough mid-wheeze, delays care. Nurses skip it, a chronic flare's urgent dodge.