Nokea
Ms. CC's laboratory values indicate hemoconcentration secondary to fluid loss. Which of the following intravenous solutions would be most appropriate during initial fluid replacement therapy?
- A. 10% dextrose and saline
- B. 5% dextrose and water
- C. 5% dextrose and water with 60 mEq
- D. Distilled water KCl
Correct Answer: A
Rationale: In hemoconcentration due to fluid loss, the primary goal is to rapidly expand the intravascular volume and correct the deficit. The most appropriate intravenous solution for initial fluid replacement therapy in this case is 10% dextrose and saline. This solution is isotonic, which means it has an osmolarity close to that of blood and is effective in quickly restoring intravascular volume without causing significant shifts in electrolytes. The saline component helps to replenish lost electrolytes while the dextrose provides energy and helps prevent hypoglycemia. The combination of dextrose and saline is beneficial for addressing both intravascular volume depletion and dehydration causing hemoconcentration.
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For a client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?
- A. "Client verbalizes feelings of anxiety."
- B. "Client doesn't guess at prognosis."
- C. "Client uses any effective method to reduce tension."
- D. "Client stops seeking information."
Correct Answer: C
Rationale: The expected outcome that would be appropriate for a client with newly diagnosed cancer experiencing anxiety related to the threat of death would be "Client uses any effective method to reduce tension." This outcome focuses on the client actively engaging in coping strategies to reduce their anxiety. It is important for the client to actively participate in managing their anxiety by utilizing various methods to promote relaxation and reduce tension. It is a more proactive and empowering goal compared to simply verbalizing feelings of anxiety or stopping seeking information. By actively using effective methods to reduce tension, the client is taking steps to improve their emotional well-being and cope with the anxiety related to the cancer diagnosis.
which of the following is a characteristic in a child with acute lymphocytic leukemia?
- A. fatigability
- B. persistent fever of unknown cause
- C. tendency to bruise easily
- D. all of the above are correct
Correct Answer: D
Rationale: Children with acute lymphocytic leukemia commonly present with a combination of symptoms which can include fatigability, persistent fever of unknown cause, and a tendency to bruise easily. Fatigue is a common complaint in children with leukemia due to anemia caused by decreased production of healthy red blood cells. Persistent fevers can be a sign of infection, anemia, or other complications related to leukemia. Additionally, children with leukemia may have a low platelet count, leading to easy bruising or bleeding tendencies. Therefore, all of the characteristics mentioned in the options are correct for a child with acute lymphocytic leukemia.
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock? (Select all that apply.)
- A. Thirst and diminished urinary output
- B. Irritability and apprehension
- C. Cool extremities and decreased skin turgor
- D. Confusion and somnolence
Correct Answer: C
Rationale: Cool extremities and decreased skin turgor (C) are indications of poor perfusion as shock progresses. The body is shunting blood away from the peripheries to maintain perfusion to vital organs.
Which of the following is MOST likely considered a risk factor for extraneural metastasis in primary brain tumors?
- A. age less than 10 year
- B. female gender
- C. ventriculoperitoneal (VP) shunt insertion
- D. supratentorial tumor
Correct Answer: A
Rationale: Younger age is a significant risk factor for extraneural metastasis in pediatric brain tumors.
Laboratory studies indicate a client's blood pressure level is 185mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most occlusive diagnostic information about the client's glucose utilization?
- A. A fasting blood glucose test
- B. A test of serum glycosylated hemoglobin (HbA1c)
- C. A 6-hour glucose tolerance test
- D. A test for urine ketones
Correct Answer: C
Rationale: A 6-hour glucose tolerance test would yield the most occlusive diagnostic information about the client's glucose utilization in this case. The elevated blood pressure level of 185 mg/dL two hours after breakfast indicates poor glucose regulation. A glucose tolerance test involves monitoring the client's blood glucose levels over a period of time after ingesting a glucose solution. This test provides a comprehensive assessment of how the body processes glucose, revealing any abnormalities in glucose metabolism beyond fasting levels, such as postprandial (after-meal) glucose spikes and prolonged hyperglycemia. This can help identify conditions like insulin resistance, impaired glucose tolerance, or diabetes, which may not be evident from a fasting blood glucose test alone. Glycosylated hemoglobin (HbA1c) reflects average blood sugar levels over the past 2-3 months and would not provide immediate information about the client's current glucose metabolism. Urine ketones