Nokea
The following statements regarding retinoblastoma are correct:
- A. It is usually fatal even if diagnosis is made early
- B. The tumour is heritable
- C. They may occur bilaterally
- D. The finding of leucorrhoea suggests the diagnosis
Correct Answer: B
Rationale: Retinoblastoma is heritable and can occur bilaterally. Early diagnosis improves prognosis, and leucorrhoea is not associated with retinoblastoma.
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A client with cancer is receiving chemotherapy with a known vesicant. The client's IV has been in place for 72 hours. The nurse determines that a new IV site cannot be obtained, and leaves the present IV in place. What is the greatest clinical risk related to this situation?
- A. Impaired skin integrity
- B. Fluid volume excess
- C. Acute pain and anxiety
- D. Peripheral neurovascular dysfunction
Correct Answer: A
Rationale: Vesicants can cause severe tissue damage if they extravasate, leading to impaired skin integrity.
For the child with hypoplastic left heart syndrome, which medication may be given to keep the patent ductus arteriosus (PDA) open until surgery can be done?
- A. Prostaglandin E
- B. Indomethicin
- C. Ibuprofen
- D. Digoxin
Correct Answer: A
Rationale: Prostaglandin E is used to keep the PDA open in infants with hypoplastic left heart syndrome, allowing for adequate blood flow until surgical intervention can be performed.
Contributing features to renal osteodystrophy include:
- A. Hypophosphataemia
- B. Hyperparathyroidism
- C. Increased loss of calcium in the kidney
- D. Hypoalbuminaemia
Correct Answer: B
Rationale: Hyperparathyroidism is a key contributor to renal osteodystrophy due to secondary hyperparathyroidism in chronic kidney disease.
A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?
- A. Document the finding in the chart.
- B. Initiate external pacing.
- C. Assess the client’s medications.
- D. Administer 1 mg of atropine.
Correct Answer: C
Rationale: A heart rate of 48 beats/min (bradycardia) in an older adult with multiple chronic diseases may be due to medication side effects. Assessing the client’s medications is the first step to determine if any drugs are contributing to the bradycardia.
An adolescent who sustained a tibia fracture in a motor vehicle accident has a cast. What should the nurse do to help relieve the itching?
- A. Apply cool air under the cast with a blow-dryer
- B. Use sterile applicators to scratch the itch
- C. Apply cool water under the cast
- D. Apply hydrocortisone cream under the cast using sterile applicator
Correct Answer: A
Rationale: Cool air helps relieve itching without damaging the cast or introducing moisture, which can lead to skin breakdown.