Nokea
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for?
- A. Actinic
- B. Asymmetry
- C. Arcus
- D. Assessment
Correct Answer: B
Rationale: The correct answer is B: Asymmetry. In the ABCD method for assessing skin lesions, A stands for asymmetry, which refers to whether one half of the lesion looks different from the other half. This is important because asymmetrical lesions are more likely to be cancerous. Actinic (choice A) refers to sun damage, Arcus (choice C) refers to a condition affecting the eyes, and Assessment (choice D) is a general term that does not specifically relate to the characteristics of skin lesions.
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The nurse is aware that multiple sclerosis is a progressive disease of the central nervous system characterized by:
- A. Axon degeneration
- B. Sclerosed patches of nervous system
- C. Demyelination of the brain and spinal cord
- D. All of the above
Correct Answer: D
Rationale: Step 1: Multiple sclerosis (MS) is a progressive disease affecting the central nervous system.
Step 2: Axon degeneration occurs in MS, leading to impaired nerve signal transmission.
Step 3: MS is characterized by sclerosed patches, or plaques, in the nervous system.
Step 4: Demyelination of the brain and spinal cord is a hallmark feature of MS.
Step 5: Therefore, all of the above choices are correct as they accurately describe key features of MS.
Inhalation of carbogen for short period is recommended:
- A. To stimulate respiration
- B. To dilate blood vessels
- C. To dislodge the blood clot
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D. Carbogen is a gas mixture of carbon dioxide and oxygen. Inhaling carbogen can stimulate respiration due to increased oxygen levels and carbon dioxide acting as a respiratory stimulant. It can also dilate blood vessels, enhancing oxygen delivery to tissues. Additionally, carbogen can help dislodge blood clots by improving blood flow and oxygenation. Therefore, all the choices (A, B, and C) are correct as inhaling carbogen can have multiple beneficial effects on respiration, blood vessels, and blood clot dislodging.
A client with Hashimoto’s thyroiditis and a history of two myocardial infarctions and coronary artery disease is to receive levothyroxine (Synthroid). Because of the client’s cardiac history, the nurse would expect that the client’s initial dose for the thyroid replacement would be which of the following?
- A. 25 g/day, initially
- B. Delayed until after thyroid surgery
- C. 100 g/day, initially
- D. Initiated before thyroid surgery
Correct Answer: A
Rationale: The correct answer is A: 25 g/day, initially. In this scenario, the client with Hashimoto's thyroiditis and a history of cardiac issues requires a cautious approach due to the risk of exacerbating cardiac conditions with thyroid hormone replacement. Starting with a low dose of 25 µg/day allows for careful monitoring of the client's response and prevents potential adverse effects on the cardiovascular system.
Summary:
B: Delayed until after thyroid surgery - Not appropriate as the client requires thyroid replacement therapy for Hashimoto's thyroiditis.
C: 100 µg/day, initially - Too high of an initial dose and may lead to adverse cardiovascular effects.
D: Initiated before thyroid surgery - Not relevant to the client's situation as there is no indication for thyroid surgery mentioned in the question.
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands?
- A. Adrenal cortex
- B. Adrenal medulla
- C. Pancreas
- D. none of the above
Correct Answer: A
Rationale: The correct answer is A: Adrenal cortex. Primary hyperaldosteronism is a condition where the adrenal cortex produces too much aldosterone hormone, leading to hypertension. The adrenal medulla secretes adrenaline and noradrenaline, not aldosterone, making option B incorrect. The pancreas secretes insulin and glucagon, not aldosterone, making option C incorrect. Option D is incorrect because the adrenal cortex is responsible for aldosterone secretion in primary hyperaldosteronism.
Three days after admission Ms. CC continued to have frequent stools. Her oral intake of both fluids and solids are poor. Her physician ordered parenteral hyperalimentation. Hyperalimentation solutions are:
- A. Hypotonic solutions used primarily to increase osmotic pressure of blood plasma
- B. Hypertonic solutions used primarily for hydration when hemoconcentration is present
- C. Alkalizing solutions used to treat metabolic acidosis thus reducing cellular sweating
- D. Hyperosmolar solutions used primarily to reverse negative nitrogen balance
Correct Answer: D
Rationale: The correct answer is D: Hyperosmolar solutions used primarily to reverse negative nitrogen balance.
Rationale:
1. Hyperalimentation solutions are designed to provide essential nutrients intravenously.
2. Hyperosmolar solutions have a higher osmolarity compared to body fluids, providing concentrated nutrition.
3. Negative nitrogen balance occurs when the body breaks down more protein than it synthesizes, requiring additional protein intake.
4. Hyperosmolar solutions can provide adequate protein and nutrients to reverse negative nitrogen balance.
Summary:
A: Hypotonic solutions do not increase osmotic pressure, but rather decrease it.
B: Hypertonic solutions are not primarily used for hydration in this context.
C: Alkalizing solutions are not the primary purpose of hyperalimentation and do not directly address cellular sweating.