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Patients with lymphoma are at risk for infection. Which of the ff. activities increases this risk?
- A. Going to church
- B. Cleaning the house
- C. Taking a walk outside
- D. Watching television
Correct Answer: C
Rationale: Patients with lymphoma are at higher risk for infections because their immune system is often compromised due to the disease itself or treatment such as chemotherapy. Going outside for a walk exposes the patient to various environmental factors including pathogens, bacteria, and viruses that can increase the risk of infections. In contrast, going to church, cleaning the house, and watching television do not necessarily pose the same level of risk for infection as being outside in the open air. It is therefore important for patients with lymphoma to avoid unnecessary exposure to potential sources of infection to reduce their risk of developing infections.
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Which of the following would the nurse teach the adolescent is a complication of corticosteroids used in the treatment of JRA?
- A. Fat loss.
- B. Adrenal stimulation.
- C. Immune suppression.
- D. Hypoglycemia.
Correct Answer: C
Rationale: Corticosteroids, such as prednisone, are commonly used in the treatment of juvenile rheumatoid arthritis (JRA) to reduce inflammation and pain. However, one of the complications associated with corticosteroid use is immune suppression. Corticosteroids can suppress the immune system by reducing the activity and effectiveness of white blood cells, making individuals more susceptible to infections. It is important for healthcare providers, including nurses, to educate adolescents and their families about the risks and possible complications of corticosteroid therapy, including immune suppression.
The patient is dangling at the bedside and states, "Oh, my stomach is tearing open." Which of the following actions should the nurse immediately take when dehiscence occurs?
- A. Have patient sit upright in a chair.
- B. Have patient lie down.
- C. Slow IV fluids.
- D. Obtain a sterile suture set.
Correct Answer: B
Rationale: When dehiscence, which is the separation of the layers of a surgical incision, occurs in a patient, it is important to have the patient lie down. This position will help decrease intra-abdominal pressure and reduce the risk of further complications. Having the patient sit upright in a chair can increase intra-abdominal pressure, worsening the dehiscence. Slowing IV fluids may be necessary to prevent fluid overload in certain situations, but it is not the immediate action required when dehiscence occurs. Obtain a sterile suture set may eventually be needed, but the priority in this situation is to stabilize the patient by having them lie down.
An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: C
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
A client who was diagnosed with type I diabetes mellitus 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?
- A. Cool, moist skin
- B. Arm and leg trembling
- C. Rapid, thready pulse
- D. Slow, shallow respirations
Correct Answer: B
Rationale: A blood glucose level of 470 mg/dl indicates severe hyperglycemia in a client with type I diabetes mellitus. Arm and leg trembling, known as tremors, is a common symptom associated with high blood glucose levels. Tremors are often a result of the body's stress response to the extreme levels of glucose in the blood. Other common symptoms of hyperglycemia include increased thirst, frequent urination, blurred vision, and fatigue. Cool, moist skin, rapid, thready pulse, and slow, shallow respirations are not typically associated with hyperglycemia and are more indicative of other conditions or clinical situations.