Nokea
Prenatal screening is recommended for all pregnant women to detect neural tube defect. If a neural tube defect is present, one of the following is often elevated
- A. human chorionic gonadotropin
- B. a-fetoprotein
- C. estriol
- D. inhibin
Correct Answer: B
Rationale: Alpha-fetoprotein (AFP) levels are elevated in maternal serum when a neural tube defect is present due to fetal leakage of AFP into the amniotic fluid and maternal circulation.
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The initial neurological symptom of Guilain-Barre Syndrome is:
- A. Absent tendon reflex
- B. Paresthesia of the legs
- C. Dysrhythmias
- D. Transient hypertension
Correct Answer: B
Rationale: The initial neurological symptom of Guillain-Barre Syndrome (GBS) is typically paresthesia, which is a tingling or numbness sensation in the legs. GBS is an autoimmune disorder that affects the peripheral nervous system, leading to muscle weakness and paralysis. As the condition progresses, symptoms may worsen and may include absent tendon reflexes, weakness in the arms and legs, and difficulty breathing. However, paresthesia is often one of the earliest and most common symptoms of GBS.
The nurse is caring for a newborn whose mother is diabetic. Which clinical manifestations should the nurse expect to see?
- A. Hypoglycemic, large for gestational age
- B. Hyperglycemic, large for gestational age
- C. Hypoglycemic, small for gestational age
- D. Hyperglycemic, small for gestational age
Correct Answer: C
Rationale: Infants born to mothers with diabetes, especially uncontrolled diabetes, are at risk for hypoglycemia due to exposure to high glucose levels in utero. The infant's pancreas may have been producing high levels of insulin in response to the mother's high blood glucose levels, leading to hypoglycemia after birth. Additionally, these infants are typically smaller for gestational age (SGA) due to the effects of high blood sugar levels on fetal growth. Therefore, the nurse should expect the newborn of a mother with diabetes to exhibit signs of hypoglycemia and be small for gestational age.
Baby Melody is a neonate who has a very low-birth-weight. Nurse Josie carefully monitors inspiratory pressure and oxygen (O ) concentration to prevent which of the following?
- A. Meconium aspiration syndrome
- B. Bronchopulmonary dysplasia (BPD)
- C. Respiratory syncytial virus (RSV)
- D. Respiratory distress syndrome (RDS)
Correct Answer: D
Rationale: A neonate with very low birth weight is at risk of developing respiratory distress syndrome (RDS), which is a common breathing disorder in premature infants. RDS occurs due to a lack of a substance in the lungs called surfactant, which helps keep the air sacs open and prevents them from collapsing. In neonates with very low birth weight, the lungs may not have produced enough surfactant, leading to breathing difficulties and respiratory distress.
A client with advanced liver cancer is scheduled for chemotherapy. As part of the chemotherapy regimen, the nurse expects the physician to prescribe:
- A. Fluoxymesterone (Halotestin)
- B. Fluorouracil (5-fluorouracil, 5 FU
- C. Tamoxifen (Nolvadex) [Fluoroplex])
- D. Megestrol (Megace)
Correct Answer: B
Rationale: Fluorouracil (5-FU) is a commonly used chemotherapy drug for various cancers, including of the liver. It is often used to treat advanced liver cancer as part of a chemotherapy regimen. 5-FU works by interfering with the synthesis of DNA and RNA in cancer cells, leading to their death.
You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is
- A. vincristine
- B. cyclophosphamide
- C. cisplatin
- D. methotrexate
Correct Answer: C
Rationale: Cisplatin is a cornerstone in the treatment of germ cell tumors.