Nokea
Mr. RR is to have a brain scanning. Nursing intervention in preparation for this test includes:
- A. Discontinuing any anticonvulsant therapy
- B. Obtaining consent for the treatment
- C. Explaining to Mr. RR that although his head will be supported in place for a period of time, the test will not be painful.
- D. Informing Mr. RR that nausea and headache are frequent following this test
Correct Answer: C
Rationale: The nursing intervention in preparation for a brain scanning test such as an MRI or CT scan should include explaining to the patient (Mr. RR in this case) that although his head will be supported in place for a period of time during the test, the procedure itself will not be painful. Providing this explanation helps to alleviate any anxiety or fear Mr. RR may have about the test and ensures that he feels comfortable and well-informed before the procedure. This communication is key to promoting a positive patient experience and ensuring cooperation during the test. It also helps in managing patient expectations and reducing any potential stress or discomfort during the scanning process.
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A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?
- A. Heart rate, respiratory rate, and bloodpressure
- B. Recent exposure to communicable diseases
- C. Number of immunizations received
- D. Height and weight
Correct Answer: A
Rationale: In this situation, the priority data the nurse should obtain first is the vital signs including heart rate, respiratory rate, and blood pressure of the child. This information will help assess the child's current physiological status and potential effects of ingesting the aspirin. Aspirin overdose in children can lead to serious complications such as metabolic acidosis, respiratory distress, and cardiovascular instability. Monitoring the vital signs will provide crucial information to guide appropriate interventions and determine the severity of the child's condition. Height and weight (option D) are important for routine assessments but not the priority in this urgent situation. Recent exposure to communicable diseases (option B) and number of immunizations received (option C) are not relevant to the immediate management of the child's aspirin ingestion.
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.
The patient is having difficulty coping with her new diagnosis of lymphoma. Which response by the nurse is most helpful?
- A. "Don't worry. You'll be okay."
- B. "The treatments you are receiving will make you feel better very soon."
- C. "Who do you usually go to when you have a problem?"
- D. "Have you made end-of-life decisions?"
Correct Answer: C
Rationale: Option C, "Who do you usually go to when you have a problem?" is the most helpful response by the nurse in this situation. This response allows the patient to identify her support system and opens up a conversation about coping mechanisms and sources of emotional support. It helps the nurse understand who the patient leans on during difficult times and enables the nurse to involve these individuals in providing support and encouragement to the patient as she copes with her new diagnosis of lymphoma. By exploring the patient's typical sources of support, the nurse can assist in strengthening her coping mechanisms and emotional well-being during this challenging time.
A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100mcg IM daily. Which substance influences Vitamin B12 absorption?
- A. Intrinsic factor
- B. Histamine
- C. Hydrochloric acid
- D. Liver enzyme
Correct Answer: A
Rationale: Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is essential for the absorption of vitamin B12 in the intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is absorbed in the ileum of the small intestine. Without intrinsic factor, vitamin B12 absorption is significantly impaired, leading to conditions like pernicious anemia, which is a type of megaloblastic anemia caused by vitamin B12 deficiency. By administering cyanocobalamin (Betalin-12) intramuscularly, the need for intrinsic factor in the absorption process is bypassed, which is necessary in cases where intrinsic factor production or function is disrupted.
A 25-year old with hepatitis may be anicteric and symptomless. In the early part of the hepatic inflammatory disorder, the most likely symptom/sign is:
- A. dark urine
- B. occult blood in stools
- C. ascites
- D. anorexia
Correct Answer: D
Rationale: In the early part of the hepatic inflammatory disorder, the most likely symptom/sign is anorexia. Anorexia refers to a decreased appetite or lack of interest in food, which is commonly seen in patients with liver diseases such as hepatitis. Anorexia in the setting of liver inflammation indicates a disruption in the normal metabolic processes of the liver. This symptom is often accompanied by general malaise, fatigue, and weight loss. Dark urine (choice A) may occur later in the disease progression due to the buildup of bilirubin in the blood. Occult blood in stools (choice B) may be a sign of gastrointestinal bleeding, which can be a complication of advanced liver disease but is not typically an early symptom. Ascites (choice C) is the accumulation of fluid in the peritoneal cavity and is usually a late sign of liver dysfunction.