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Question: Which statement applies to glucose measurement in a central laboratory? Statement 1: Glucose values are normally determined in venous blood. Statement 2: Glucose values are given in plasma values. Which answer is correct?
- A. Both statements are correct
- B. Both statements are incorrect
- C. Statement 1 is correct; statement 2 is incorrect
- D. Statement 1 is incorrect; statement 2 is correct
Correct Answer: A
Rationale: Lab glucose venous blood, plasma read, both true, a chronic standard nurses trust.
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The nurse is caring for a client with mitral regurgitation. Which of the following would the nurse anticipate the client to develop if left untreated?
- A. Left-sided heart failure
- B. Right-sided heart failure
- C. Renal failure
- D. Myocardial ischemia
Correct Answer: A
Rationale: Mitral regurgitation backflows blood into the left atrium, hiking pressure and volume untreated, it overburdens the left ventricle, leading to left-sided heart failure. Pulmonary congestion follows, with dyspnea and edema, a direct consequence of this valve flaw. Right-sided failure stems from downstream effects or separate causes, not primary here. Renal failure or ischemia might complicate advanced disease, but left-sided failure's progression is the immediate risk, rooted in mitral dysfunction's mechanics. Nurses anticipate this, monitoring for early signs like crackles, ensuring timely intervention to halt this predictable cardiac cascade.
A 56-year-old patient comes to the walk-in clinic for scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history for colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?
- A. Diarrhea/Constipation related to altered bowel patterns
- B. Knowledge Deficit related to disease process and diagnostic procedure
- C. Risk for Fluid Volume Deficit related to rectal bleeding and diarrhea
- D. Anxiety related to unknown outcomes and perceived threat to body integrity
Correct Answer: D
Rationale: The patient's anger and threat to leave during colonoscopy teaching signal emotional distress overriding physical symptoms. Anxiety stemming from uncertain outcomes and perceived bodily threat fits, as colorectal cancer risk tied to polyps and family history heightens fear, blocking education uptake. Diarrhea/constipation reflects symptoms but isn't immediately urgent with scant bleeding. Knowledge deficit exists but is secondary fear drives the refusal, not just ignorance. Fluid volume risk is plausible with bleeding, yet no data suggests acute loss; stability allows focus on emotions. Addressing anxiety first calms the patient, enabling teaching and care, a priority in this tense encounter where psychological barriers could delay critical colorectal screening and intervention.
The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective?
- A. After cancer has not recurred for 5 years, it is considered cured.
- B. The cancer will be cured if the entire tumor is surgically removed.
- C. I will need follow-up examinations for many years after treatment before I can be considered cured.
- D. Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation.
Correct Answer: C
Rationale: Stage III breast cancer's advanced local spread means long-term vigilance, not a quick cured' label. Five years recurrence-free is a milestone, but not universal some hit sooner, others never. Surgery alone won't cut it; chemo and radiation tag-team it. Never cured' overstates control's the goal, but cure's possible. Nurses in oncology drill this: years of follow-ups track sneaky recurrence, key for stage III's tricky prognosis.
While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
- A. Stopping the administration of the drug immediately
- B. Notifying the patient's physician
- C. Continuing the infusion but decreasing the rate
- D. Applying a warm compress to the infusion site
Correct Answer: A
Rationale: Doxorubicin's a vesicant swelling and pain scream extravasation, where it leaks into tissue, risking severe necrosis. Stopping the IV stat is priority to limit damage; delaying could worsen injury. Notifying the physician follows, but action comes first. Slowing the infusion keeps pumping toxin into the site disastrous. Warm compresses might spread the drug, unlike ice, which can help post-stoppage per protocol. Nurses must act fast, knowing vesicants like doxorubicin (an anthracycline) demand immediate cessation and often antidotes (e.g., dexrazoxane), critical in oncology to prevent permanent harm from chemo mishaps.
In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.