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The following blood values are found in a patient: total cholesterol: 9.2 mmol/L (strongly elevated) and triglycerides: 1.7 mmol/L (normal). Question: Which lipid particle is most likely to cause this abnormal lipid spectrum?
- A. The chylomicron particle
- B. The IDL particle
- C. The LDL particle
- D. The VLDL particle
Correct Answer: C
Rationale: Sky-high cholesterol, normal triglycerides LDL's the cholesterol hog, not chylomicrons, IDL, or VLDL's triglyceride tilt. Nurses peg this, a chronic heart risk spike.
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The nurse understands that the physician would need to be notified regarding a chemotherapy dose if the client experiences:
- A. Fatigue
- B. Nausea and vomiting
- C. Stomatitis
- D. Bone marrow suppression
Correct Answer: D
Rationale: Chemotherapy's marrow hit bone marrow suppression drops counts like neutrophils or platelets, risking infection or bleeding, a dose-limiting toxicity needing physician review to adjust or pause treatment. Fatigue, nausea, and stomatitis are common, manageable with nursing care rest, antiemetics, mouth rinses unless extreme. Suppression's severity, tied to labs (e.g., ANC <500), halts therapy to protect the client, a critical threshold nurses monitor, distinguishing it from routine side effects, ensuring safety in this marrow-bashing regimen.
A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?
- A. A client with a swollen and painful left great toe
- B. Client who reports dyspnea
- C. Client with a blood pressure of 180/98 mm Hg
- D. Client who reports calf tenderness and swelling
Correct Answer: B
Rationale: Polycythemia vera thickens blood, risking clots dyspnea signals possible pulmonary embolism, a life-threatening emergency needing instant assessment per ABCs. Toe pain suggests gout, common but less acute. Hypertension, a chronic issue here, waits behind respiratory distress. Calf tenderness hints at DVT, urgent but not immediately fatal like embolism. Nurses triage dyspnea first, ensuring airway and oxygenation, a critical call in this hyperviscous condition prone to thrombotic crises.
A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- A. Helping clients adjust to their appearance
- B. Reassuring clients that this change is temporary
- C. Referring clients to a reputable wig shop
- D. Teaching measures to prevent scalp injury
Correct Answer: D
Rationale: Alopecia, or hair loss, is a common chemotherapy side effect due to drugs targeting rapidly dividing cells, including hair follicles. While emotional support is vital, the priority is client safety. Teaching measures to prevent scalp injury such as avoiding harsh brushing or sun exposure takes precedence because the scalp becomes vulnerable without hair's protective barrier, risking cuts, infections, or burns. Helping clients adjust to appearance and reassuring them about regrowth address psychosocial needs but don't mitigate physical risk. Referring to a wig shop is practical but secondary to safety. In oncology nursing, prioritizing physical protection aligns with the hierarchy of needs, ensuring the client avoids complications like infection, especially if immunocompromised, before addressing emotional impacts.
Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds
- D. The ratio of respiratory effort and respiratory rate
Correct Answer: A
Rationale: Spirometry sizes COPD FEV1/FVC ratio, air blasted in one second versus all-out capacity, pegs obstruction's depth, tracking decline. Residual's post-exhale, not this; 6-second's off; effort-rate's vague. Nurses lean on this, staging chronic airflow's fade.