Nokea
Of the following, the WORST prognostic factor in pediatric osteosarcoma is
- A. primary pelvic bone tumor
- B. poor histologic response to treatment
- C. bony metastases at the time of diagnosis
- D. lung metastases at the time of diagnosis
Correct Answer: B
Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.
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What is the best initial action for the nurse to take?
- A. Try to have the client breathe slower or
- B. Give O2 via nasal cannula into the paper bag
- C. Administer sodium bicarbonate
- D. Monitor the client's fluid balance
Correct Answer: A
Rationale: The best initial action for the nurse to take when a client is experiencing hyperventilation is to try to have the client breathe slower. This is because hyperventilation is often caused by rapid, shallow breathing and slowing down the breathing pattern can help restore normal gas exchange and alleviate symptoms. Providing oxygen via a nasal cannula or administering sodium bicarbonate would not directly address the underlying issue of hyperventilation. Monitoring fluid balance is important for overall assessment but not the priority when dealing with acute respiratory distress due to hyperventilation.
An adult is diagnosed with disseminated intravascular coagulation. The nurse should identify that the client is at risk for which of the following nursing diagnosis?
- A. Risk for increased cardiac output related to fluid volume excess
- B. Disturbed sensory perception related to bleeding into tissues
- C. Alteration in tissue perfusion related to bleeding and diminished blood flow
- D. Risk for aspiration related to constriction of the respiratory musculature
Correct Answer: C
Rationale: Disseminated intravascular coagulation (DIC) is a serious condition that involves widespread activation of coagulation leading to microthrombi formation in blood vessels throughout the body. This process can lead to consumption of clotting factors and platelets, causing both bleeding and thrombosis. In the context of DIC, there is a risk for altered tissue perfusion due to the combination of bleeding and microthrombi formation, which can impair blood flow to vital organs and tissues. This condition can ultimately result in organ dysfunction and failure, making it a significant concern in the care of a client with DIC. Therefore, the correct nursing diagnosis for a client with DIC is alteration in tissue perfusion related to bleeding and diminished blood flow.
A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. What should the nurse recommend the infant be given?
- A. Skim milk
- B. Whole cow's milk
- C. Commercial iron-fortified formula
- D. Commercial formula without iron
Correct Answer: C
Rationale: When a mother decides to discontinue breastfeeding, it is important for the infant to receive an appropriate alternative that provides essential nutrients, including iron. Commercial iron-fortified formula ensures that the infant is receiving adequate iron, which is crucial for healthy growth and development. Skim milk is not recommended for infants under age 1 due to its high protein and mineral content, which can strain the baby's immature kidneys. Whole cow's milk is also not suitable before age 1 because it lacks essential nutrients such as iron and vitamin E, and can lead to iron deficiency anemia. Commercial formula without iron would not provide enough iron for the infant's needs, making commercial iron-fortified formula the most appropriate choice for the 5-month-old infant.
A 72-year-old chemist has left lower lobe pneumonia. His nurse checks his oxygen saturation and the result is 86%. Which of the ff. actions by the nurse is best?
- A. Call the physician for an order for oxygen.
- B. No action necessary; this is a normal SaO
Correct Answer: A
Rationale: An oxygen saturation (SaO2) level of 86% is significantly below the normal range of 95-100%. This indicates hypoxemia, which means the body is not getting enough oxygen. In a patient with pneumonia, low oxygen saturation can lead to further respiratory compromise and potential organ damage. Therefore, it is essential for the nurse to notify the physician promptly to obtain an order for supplemental oxygen to correct the hypoxemia and improve the patient's oxygen saturation levels. Delay in addressing low oxygen levels can have serious consequences for the patient's health and recovery.
A young couple of a 2-month-old baby girl with excessive crying seeks medical advice. The LEAST important advice is to
- A. master the situation in a relaxed manner
- B. adhere to precry cues
- C. change milk formula
- D. avoid sensory overstimulation
Correct Answer: C
Rationale: Changing the milk formula is less critical unless there is evidence of intolerance or allergy.