Nokea
Laboratory confirmation of the diagnosis in Question 1 can best be obtained by measuring the toxic compound's concentration in which of the following?
- A. Urine
- B. Blood
- C. Hair
- D. Saliva
Correct Answer: A
Rationale: Mercury levels are most accurately measured in urine, especially in cases of chronic exposure.
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Which client has the highest risk of ovarian cancer?
- A. 30-year old woman taking contraceptives
- B. 45-year old woman who has never been pregnant
- C. 40-year old woman with three children
- D. 36-year old woman who had her first child at age 22
Correct Answer: B
Rationale: One of the major risk factors for ovarian cancer is nulliparity, which means never having been pregnant. This is because pregnancy and childbirth have a protective effect against ovarian cancer. Women who have never been pregnant are at a higher risk of developing ovarian cancer compared to women who have had children. Age is also a significant risk factor for ovarian cancer, with the risk increasing as women get older. Therefore, the 45-year old woman who has never been pregnant has the highest risk of ovarian cancer among the given clients.
Extraneural metastasis from primary brain tumors is MOST commonly likely to occur in which tumor?
- A. medulloblastoma
- B. primitive neuroectodermal tumor (PNET)
- C. ependymoma
- D. malignant glioma
Correct Answer: A
Rationale: Medulloblastoma is notorious for extraneural spread, particularly to bones and bone marrow.
A client with rheumatoid arthritis is about to begin aspirin therapy to reduce inflammation. When teaching the client about aspirin, the nurse discusses adverse reactions to prolonged aspirin therapy. These include:
- A. Weight gain
- B. Respiratory acidosis
- C. Fine motor tremors
- D. Bilateral hearing loss
Correct Answer: D
Rationale: Prolonged aspirin therapy can lead to a rare side effect known as aspirin-induced hearing loss, which manifests as bilateral hearing loss. This adverse reaction is typically associated with higher doses of aspirin and longer durations of use. It is important for healthcare providers to monitor for signs of hearing loss in patients receiving long-term aspirin therapy, especially those with rheumatoid arthritis or other inflammatory conditions, to prevent irreversible damage to the hearing. Weight gain, respiratory acidosis, and fine motor tremors are not commonly associated with prolonged aspirin therapy.
In the newborn, intramuscular phytonadione (vitamin K) is administered into which muscle?
- A. Deltoid
- B. Dorsogluteal
- C. Vastus medialis
- D. Vastus lateralis
Correct Answer: D
Rationale: In newborns, intramuscular phytonadione (vitamin K) is typically administered into the vastus lateralis muscle. This muscle is located on the front of the thigh and is a commonly used site for IM injections in infants due to its large muscle mass, accessibility, and low risk of hitting major nerves or blood vessels. The vastus lateralis muscle is considered a safe and effective site for administering medications to newborns.
The primary critical observation for Apgar scoring is the:
- A. Heart rate
- B. Respiratory rate
- C. Presence of meconium
- D. Evaluation of the Moro reflex
Correct Answer: A
Rationale: The primary critical observation for Apgar scoring is the heart rate. This is because the heart rate is vital for life and immediate assessment of the infant's heart rate provides crucial information about the baby's overall well-being and response to the birthing process. The Apgar score assesses five components: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color. Among these components, the heart rate is considered the most critical because it directly reflects the infant's cardiovascular status and their ability to maintain adequate perfusion of vital organs. Therefore, for quick assessment and immediate intervention, the heart rate is prioritized as the primary observation in Apgar scoring.