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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 caring for oncology clients knows that which form of metastasis is the most common?
- A. Bloodborne
- B. Direct invasion
- C. Lymphatic spread
- D. Via bone marrow
Correct Answer: A
Rationale: Metastasis is the process by which cancer spreads from its original site to distant parts of the body, a critical concern in oncology nursing. Among the various mechanisms, bloodborne metastasis is the most common, as cancer cells often enter the bloodstream and travel to organs like the lungs, liver, or brain. This occurs because the circulatory system provides an efficient pathway for tumor cells to disseminate widely, especially in cancers like breast or lung cancer. Lymphatic spread is also frequent, particularly in carcinomas, where cells travel via lymph nodes, but it is less dominant than bloodborne spread across all cancer types. Direct invasion involves cancer growing into adjacent tissues, which is a local process rather than true metastasis. Bone marrow is not a medium for metastasis but a potential site where cancer can settle, such as in leukemia or multiple myeloma. Understanding that bloodborne metastasis predominates helps nurses prioritize monitoring for systemic symptoms and complications, such as organ dysfunction, in clients with advanced cancer.
Cholesterol contributes to the pathogenesis and progression of NASH via which mechanism?
- A. Reduction of steatosis
- B. Increase of steatosis
- C. Increase of inflammation
- D. Increase of the feeling of satiety
Correct Answer: C
Rationale: Cholesterol stokes NASH inflammation rises, not steatosis alone or satiety shifts. A chronic fire feeder nurses link this to liver woes.
In which of these do you see clue cells?
- A. trichomonas vaginalis
- B. bacterial vaginosis
- C. candida
- D. HSV 2
Correct Answer: B
Rationale: Clue cells BV's fishy flag, not trich's swim, candida's yeast, HSV's sores, or syphilis' chancre. Nurses scope this chronic hint.
The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical-surgical unit. Which client should the nurse see first?
- A. A client with pain that is two days post-operative from a prostatectomy
- B. A client ready for discharge education after treatment of an acute kidney injury
- C. A client with hypertension with a blood pressure of 172/92 mm Hg
- D. A client with a history of asthma complaining of increased dyspnea
Correct Answer: D
Rationale: Asthma's increased dyspnea flags airway risk ABCs prioritize breathing, as bronchospasm could crash fast, needing nebulizers or oxygen. Post-op pain's manageable, discharge education waits, hypertension's high but stable. Nurses hit dyspnea first, ensuring airflow, a life-first call in this shift-start triage.
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.