Nokea
The first thing to do for a nurse when an accident occurs is to find out if patient is conscious so that she could:
- A. Reassure the patient
- B. Call relatives
- C. Bring patient immediately to the hospital
- D. Call a doctor
Correct Answer: A
Rationale: The correct answer is A: Reassure the patient. The first priority in any accident scenario is to ensure the patient's safety and well-being. By checking if the patient is conscious, the nurse can assess their immediate condition and provide reassurance to alleviate any distress or anxiety. This step establishes communication and trust, allowing for further assessment and appropriate actions to be taken. Calling relatives (B) may be important but not the immediate first step. Bringing the patient immediately to the hospital (C) is premature without assessing the patient first. Calling a doctor (D) can be done after assessing the patient's condition.
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Which drug class is used to reduce symptoms of muscle weakness from myasthenia gravis?
- A. Anticholinesterase drugs
- B. Adrenergic drugs
- C. Anticholinergic drugs
- D. Beta-blocker drugs
Correct Answer: A
Rationale: The correct answer is A: Anticholinesterase drugs. These drugs increase acetylcholine levels at neuromuscular junctions, helping improve muscle strength in myasthenia gravis. Adrenergic drugs (B) and beta-blocker drugs (D) are not typically used to treat muscle weakness in myasthenia gravis. Anticholinergic drugs (C) can worsen symptoms by blocking acetylcholine receptors, making them an inappropriate choice for this condition.
Which of the following guidelines should a nursing instructor provide to nursing students who are now responsible for assessing their clients?
- A. Assessment data should be collected continuously.
- B. Assess your client after receiving the nursing report and again before giving a report to the next shift.
- C. Assess your client at least hourly if vital signs are unstable, and every two hours if stable.
- D. Assessment data should be collected prior to the physician rounding on the unit.
Correct Answer: A
Rationale: The correct answer is A because assessment data should be collected continuously to ensure timely detection of any changes in the client's condition. This allows for prompt interventions and prevents complications. Choice B is incorrect as assessment should be ongoing and not limited to specific times. Choice C is incorrect as the frequency of assessment should be based on client needs, not a fixed schedule. Choice D is incorrect as assessments should not be limited to certain times but should be ongoing to provide comprehensive care.
Which of the following is the most important assessment during the acute stage of an unconscious patient like Mr. Franco?
- A. Level of awareness and response to pain
- B. Papillary reflexes and response to sensory stimuli
- C. Coherence and sense of hearing
- D. Patency of airway and adequacy of respiration
Correct Answer: D
Rationale: The correct answer is D - Patency of airway and adequacy of respiration. This is the most important assessment during the acute stage of an unconscious patient like Mr. Franco because maintaining a clear airway and ensuring proper breathing are crucial for sustaining life. Without a patent airway and adequate respiration, the patient's oxygen supply could be compromised, leading to serious complications such as hypoxia or respiratory failure. Monitoring the airway and respiratory status takes precedence over other assessments in this scenario.
A: Level of awareness and response to pain - While important, assessing level of awareness and response to pain is secondary to ensuring a patent airway and adequate respiration in an unconscious patient.
B: Papillary reflexes and response to sensory stimuli - While these assessments provide valuable information about neurological function, they are not as critical as maintaining a clear airway and proper breathing in an unconscious patient.
C: Coherence and sense of hearing - Coherence and sense of hearing are not as vital as
Major treatment modalities for breast cancer are:
- A. Surgery, remove the primary tumor
- B. Radiotherapy, destroy microscopic diseases
- C. Chemotherapy, systematically destroys cancer cells
- D. All of these
Correct Answer: D
Rationale: The correct answer is D because all the treatment modalities listed - surgery, radiotherapy, and chemotherapy - play essential roles in managing breast cancer. Surgery removes the primary tumor, radiotherapy targets any remaining microscopic disease, and chemotherapy systematically destroys cancer cells throughout the body. Each modality addresses a different aspect of the disease, making a comprehensive treatment approach necessary for the best outcomes. Choices A, B, and C alone do not cover all necessary aspects of breast cancer treatment, hence D is the correct choice.
The client is taking phenyton (Dilantin) for seizure control. A sample is drawn to determine the serum drug level, and the nurse reviews the results. Which of the following would indicate a therapeutic serum drug range?
- A. 5 to 10 mcg/ml.
- B. 20 to 30 mcg/ml.
- C. 10 to 20 mcg/ml.
- D. 30 to 40 mcg/ml.
Correct Answer: A
Rationale: The correct answer is A (5 to 10 mcg/ml) because this range is typically considered therapeutic for phenytoin (Dilantin) for seizure control. Levels below 5 mcg/ml may be subtherapeutic, leading to inadequate seizure control. Levels above 10 mcg/ml can increase the risk of toxicity. Choices B, C, and D are incorrect because they are outside the optimal therapeutic range, leading to either ineffective treatment (B, C) or an increased risk of adverse effects (D). Monitoring drug levels helps ensure the medication's effectiveness while minimizing side effects.