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Monthly examination (BSE) can help in early detection of breast CA. When do you perform BSE?
- A. once a month after menstruation
- B. every ether month after menstruation
- C. once a month before menstruation
- D. every other month before menstruation
Correct Answer: A
Rationale: The correct answer is A: once a month after menstruation. Performing BSE at this time helps ensure consistent examination when breasts are less tender or swollen, making it easier to detect abnormalities. Performing it once a month ensures regular monitoring for any changes. Choices B, C, and D are incorrect because they do not provide the recommended frequency or timing for an effective BSE. BSE should be done monthly after menstruation to increase the chances of early detection of breast cancer.
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A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?
- A. Stool hematest
- B. Abdominal computed tomography (CT)
- C. Carcinoembryonic antigen (CEA) scan
- D. Sigmoidoscopy
Correct Answer: D
Rationale: The correct answer is D: Sigmoidoscopy. Sigmoidoscopy is a direct visualization procedure that allows for examination of the lower part of the colon and rectum, where colorectal cancer commonly occurs. This procedure can help identify any abnormal growths or polyps that may indicate cancer. Stool hematest (A) detects blood in stool but does not confirm colorectal cancer. Abdominal CT (B) provides imaging of the abdomen but may not definitively diagnose colorectal cancer. CEA scan (C) measures a tumor marker associated with colorectal cancer but is not a definitive diagnostic test. Thus, sigmoidoscopy is the most appropriate diagnostic study for confirming colorectal cancer.
What size of suction catheter would Wilma use for James, who is 6 feet 5 inches in height and weighing approximately 145 lbs?
- A. Fr. 5
- B. Fr. 12
- C. Fr. 10
- D. Fr. 18
Correct Answer: A
Rationale: The correct size of suction catheter for James would be Fr. 5. The selection of suction catheter size is based on the patient's height and weight, as well as the secretions to be cleared. A Fr. 5 catheter is appropriate for an average adult like James, as it balances between being too small or too large. Fr. 12 and Fr. 18 are too large for his size and could cause trauma, while Fr. 10 is slightly larger than needed, increasing the risk of mucosal damage. Therefore, Fr. 5 is the most suitable choice for James.
The couple with the lowest risk of having a child with sickle cell disease is the one in which the:
- A. Father is HbS and mother is HbS
- B. Father is HbAS and the mother is
- C. Father is HbS and mother is HbAS HbAS
- D. Father is HbA and the mother is HbS
Correct Answer: D
Rationale: The correct answer is D because sickle cell disease is an autosomal recessive genetic disorder. The disease is caused by inheriting two copies of the abnormal hemoglobin gene (HbS). In choice D, the father is HbA (normal) and the mother is HbS (carrier). This combination ensures that the child will inherit one normal gene and one abnormal gene, making them a carrier like the mother but not affected by the disease. Choices A, B, and C all involve at least one parent who carries the HbS gene, increasing the risk of the child having sickle cell disease.
For a client with polycythemia vera, how can the nurse help decrease the risk for thrombus formation?
- A. Teach the client how to perform isometric exercises
- B. Help the client don thromboembolic stocking or support hose during waking hours
- C. Advise drinking 3 quarts (L) of fluid per day
- D. Instruct the client to rest immediately if chest pain develops A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET I THE HEMATOLOGIC SYSTEM
Correct Answer: B
Rationale: The correct answer is B: Help the client don thromboembolic stocking or support hose during waking hours. This intervention helps decrease the risk for thrombus formation in polycythemia vera by promoting venous return and preventing blood pooling in the lower extremities. Compression stockings improve circulation and reduce the risk of blood clots. Isometric exercises (choice A) may increase blood pressure and heart rate, potentially worsening the risk of thrombus formation. Drinking excess fluid (choice C) can lead to hypervolemia and increase the risk of clotting. Resting immediately if chest pain develops (choice D) is important but does not directly address the prevention of thrombus formation in polycythemia vera.
The client is suspected of having myasthenia gravis. Edrophonium (Tensilon) 2 mg is administered intravenously to determine the diagnosis. Which of the following indicates that the client has myasthenia gravis?
- A. Joint pain following administration of the medication
- B. Feelings of faintness, dizziness, hypotension, and signs of flushing in the client
- C. A decrease in muscle strength within 30 to 60 seconds following administration of the medication.
- D. An increase in muscle strength within 30 to 60 seconds following administration of the medication
Correct Answer: C
Rationale: The correct answer is C because in myasthenia gravis, which is characterized by muscle weakness and fatigue, the administration of edrophonium will temporarily improve muscle strength due to increased availability of acetylcholine at the neuromuscular junction. This improvement should be noted within 30 to 60 seconds after the administration of the medication.
Choice A is incorrect because joint pain is not a typical response to edrophonium in the context of myasthenia gravis.
Choice B is incorrect because feelings of faintness, dizziness, hypotension, and flushing are more indicative of a cholinergic crisis, which occurs when too much edrophonium is administered.
Choice D is incorrect because an increase in muscle strength post-edrophonium administration would not be expected in a client with myasthenia gravis.