Nokea
One of the side effects of INH administration is peripheral neuropathy. To prevent this effect, Nurse Carlos teaches Andrew to:
- A. have a strict low cholesterol diet
- B. get extra bed rest 
- C. supplement the diet with pyridoxine
- D. avoid excessive sun exposure
Correct Answer: C
Rationale: Pyridoxine, also known as vitamin B6, is necessary for the prevention of INH-induced peripheral neuropathy. INH can lead to a deficiency of vitamin B6 in the body, which in turn can cause nerve damage and peripheral neuropathy. By supplementing the diet with pyridoxine, the risk of developing peripheral neuropathy as a side effect of INH administration can be minimized. It is an important preventive measure recommended for those undergoing treatment with INH to ensure the proper functioning of the nervous system and prevent nerve damage.
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A client has cancer that has me tastasized to her bones. She is complaining of increased thirst, polyuria and decreased muscle tone. Her lab values are: Na 139mEq/L, k 4 mEq/L, Cl 103 mEq/L, and Ca 8 mg/dl. What electrolyte imbalance is present?
- A. Hypocalcemia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypochloremia
Correct Answer: C
Rationale: The patient's symptoms of increased thirst, polyuria, decreased muscle tone, and the lab value of high calcium (8 mg/dl) indicate hypercalcemia. Hypercalcemia is commonly seen in cancer patients due to cancer metastasis to the bones, leading to the release of calcium. The other electrolyte levels (sodium, potassium, and chloride) are within normal range, ruling out other electrolyte imbalances. Multiple myeloma is a common malignancy associated with bone metastases and hypercalcemia. Symptoms of hypercalcemia may include thirst, frequent urination, weakness, confusion, and muscle pain. Treatment of hypercalcemia may involve hydration, loop diuretics, bisphosphonates, and addressing the underlying cause.
The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate?
- A. pH
- B. Osmolality
- C. Creatinine
- D. Protein level
Correct Answer: C
Rationale: Creatinine is a waste product produced by muscle metabolism that is normally filtered by the glomerulus in the kidneys and excreted in urine. The level of creatinine in the urine is a direct reflection of the glomerular filtration rate (GFR). As GFR decreases in conditions such as acute renal failure, the amount of creatinine excreted in the urine also decreases. Therefore, measuring creatinine levels in the urine is a useful clinical indication of the glomerular filtration rate and kidney function. pH, osmolality, and protein level may provide additional information but are not as directly linked to GFR as creatinine levels.
Rickets is caused by a deficiency in:
- A. vitamin A.
- B. vitamin C.
- C. vitamin D and calcium.
- D. folic acid and iron.
Correct Answer: C
Rationale: Rickets is a condition that primarily affects children and is characterized by softening and weakening of the bones, leading to skeletal deformities. This condition is caused by a deficiency in vitamin D and calcium. Vitamin D helps the body absorb calcium from the diet, and together they play a crucial role in bone health and development. Without enough vitamin D and calcium, the bones cannot mineralize properly, resulting in the characteristic symptoms of rickets. Other nutrients like vitamin A, vitamin C, folic acid, and iron do not directly cause rickets.
Regarding speech production, the routine use of sentence sequences; conversational give and-take is usually achieved by age of
- A. 3 yr
- B. 4 yr
- C. 5 yr
- D. 6 yr
Correct Answer: C
Rationale: Children typically develop the ability to use sentence sequences and engage in conversational give-and-take by age 5.
Early this morning a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who has now nausea, a temperature of 105F (40.5C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
- A. Diabetic ketoacidosis
- B. Hypoglycemia
- C. Thyroid crisis
- D. Tetany
Correct Answer: C
Rationale: The signs and symptoms described - nausea, elevated temperature, tachycardia, and extreme restlessness - are indicative of a thyroid crisis, also known as thyroid storm. A thyroid storm is a life-threatening condition that can occur after thyroid surgery such as a subtotal thyroidectomy. It is characterized by an exaggerated state of hyperthyroidism, leading to a surge of thyroid hormones in the bloodstream. This can result in severe symptoms such as high fever, tachycardia, nausea, agitation, and even confusion or delirium.