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Prescription of long term oxygen therapy has some very strict guidelines. In order to qualify for this treatment, the patient has to:
- A. Be admitted to hospital 3 times within a 12 month time frame with acute exacerbation of COPD
- B. Demonstrate a significant impairment of QOL because of dyspnoea and decreased exercise capacity
- C. Have very high levels of anxiety which impact on their ability to self-manage and increase stress on carer
- D. Have a diagnosis of severe COPD with PaO2 of >55 mmHg, or evidence of tissue hypoxia and end organ damage
Correct Answer: D
Rationale: O2's lifeline demands proof severe COPD with PaO2 ≤55 mmHg or hypoxia's organ bite, a strict cut. Admissions, QOL dips, anxiety don't seal it hypoxemia does. Nurses gatekeep this, a chronic oxygen rule.
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The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient?
- A. Fatigue related to altered metabolic processes
- B. Altered nutrition: less than body requirements related to anorexia
- C. Risk for infection related to altered immunologic response
- D. Body image disturbance related to weight loss and anorexia
Correct Answer: C
Rationale: HSCT obliterates marrow, tanking immunity risk for infection soars as neutrophils vanish, making it the top nursing diagnosis pre-transplant. Sepsis can kill fast in this window, unlike fatigue or nutrition issues, which matter but aren't immediate threats. Body image might nag later with hair loss or weight shifts, but infection's the killer to watch. Nurses lock in on this, driving strict isolation and monitoring, knowing a stray germ could derail everything in oncology's high-stakes transplant game.
The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider?
- A. Generalized muscle aches
- B. Crackles heard at the lung bases
- C. Complaints of nausea and anorexia
- D. Oral temperature of 100.6°F (38.1°C)
Correct Answer: B
Rationale: IL-2 can spark capillary leak crackles at lung bases signal pulmonary edema, an emergency needing fast action over aches , nausea , or low fever , all common. Nurses in oncology flag this fluid in lungs kills quick, demanding stat calls.
Which of the following models view disability as directly caused by disease or trauma?
- A. Social
- B. Nursing
- C. Medical
- D. Collaborative
Correct Answer: C
Rationale: The medical model pins disability on disease or injury fix the body, fix the problem a view nurses use for acute hits. Social blames society's gaps; nursing, collaborative blend care angles, not cause. It's a chronic lens shift, body-first.
A nurse is performing discharge teaching for a client who was recently diagnosed with heart failure. Which of the following should be included in the client and family teaching?
- A. Low sodium diet
- B. Weekly weights
- C. Symptoms to report to the provider
- D. Fluid restriction
Correct Answer: A
Rationale: Heart failure management hinges on education to prevent exacerbations. A low sodium diet reduces fluid retention, easing cardiac workload crucial teaching for clients and families to grasp, as salt drives edema and hypertension, common pitfalls in heart failure. Weekly weights track fluid shifts daily is ideal, but weekly still aids while reporting symptoms like dyspnea flags worsening. Medication teaching ensures adherence, and fluid restriction may apply, but sodium's broader impact makes it foundational. Focusing on diet empowers lifestyle change, tackling a root cause over monitoring or restrictions alone, aligning with nursing's role in empowering self-care to stabilize this chronic condition long-term.
A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient's cancer cells spread?
- A. Hematologic spread
- B. Lymphatic circulation
- C. Invasion
- D. Angiogenesis
Correct Answer: B
Rationale: Lung cancer loves lymphatics its cells hitch rides via nodes, the most common metastasis route, hitting bones and liver downstream. Blood (hematologic) spread happens too, but lymph's king for lung primaries. Invasion's local creep, not distant jumps. Angiogenesis feeds tumors, not moves them. Nurses track this pattern, knowing lymph drainage from lungs seeds those far-off sites, a grim oncology reality shaping staging and prognosis.