Nokea
The most common and significant symptom associated with cancer and associated treatments, which has a long term impact on quality of life, as reported by patients, is:
- A. Anorexia
- B. Alopecia
- C. Pain
- D. Fatigue
Correct Answer: D
Rationale: Cancer's top drag fatigue saps QOL long-term, outlasting appetite, hair, or pain woes. Nurses hear this, a chronic weary king.
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The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
- A. Poor oral intake
- B. Frequent loose stools
- C. Complaints of nausea and vomiting
- D. Increase in carcinoembryonic antigen (CEA)
Correct Answer: D
Rationale: Colorectal cancer's chemo tracks via CEA rising levels signal progression or resistance, a red flag for therapy tweak, needing provider input. Poor intake, diarrhea, and nausea are side effects, manageable with nursing care diet, fluids, antiemetics unless extreme. CEA's uptick, a tumor marker, trumps symptoms, hinting at disease outpacing treatment. Nurses flag this, pushing for scans or regimen shifts, a critical catch in this cancer's chemo dance.
Which of the following client statements reflect an outcome expectancy statement?
- A. I am not able to exercise
- B. Exercise helps people lose weight
- C. Exercise is too hard on my arthritis
- D. Dietary restrictions work better than exercise to lose weight
Correct Answer: B
Rationale: Outcome expectancy ties behavior to results exercise shedding pounds nails it, a belief nurses tap for motivation. Can't-do's, pain gripes, or diet bets miss that link, just vent or compare. It's a chronic nudge, faith in action's payoff.
A client states that their legs have pain with walking that decreases with rest. The nurse observes absence of hair on the client's lower extremities and the client has a thread, weakened posterior tibial pulse. What would be the best position to have the client's legs?
- A. Elevated above the heart
- B. Slightly bent with three pillows under the knees
- C. Crossed at the knee
- D. Hanging down
Correct Answer: D
Rationale: PAD's claudication pain with walking, eased by rest plus hairless legs and weak pulses cry ischemia. Hanging legs down boosts gravity-fed flow, easing pain, the best position here. Elevation cuts supply, worsening it. Bending or crossing risks pressure. Nurses dangle limbs, enhancing perfusion, a practical fix in this arterial crunch.
Appropriate statements concerning intrathecal drug delivery systems include:
- A. In a patient with progressive cancer-related pain, a low-grade pelvic infection is an absolute contraindication for implanting either an intrathecal catheter or a pump, even under antibiotic cover.
- B. Intrathecally administered opioids circulate to the central neuraxis, including the brainstem, where they are likely to cause drowsiness and respiratory depression.
- C. In difficult cases, ziconotide can be administered with either an opioid or clonidine, or both.
- D. As a mixture of opioid and clonidine is expected to distribute throughout the cerebrospinal fluid, the level of the catheter in the intrathecal space is unlikely to be important.
Correct Answer: B
Rationale: Intrathecal drug delivery systems (IDDS) manage severe pain with nuances. A low-grade pelvic infection isn't an absolute contraindication; implantation may proceed with antibiotics if benefits outweigh risks (e.g., cancer palliation). Intrathecal opioids do reach the brainstem via cerebrospinal fluid, causing drowsiness and respiratory depression, though less than systemic routes due to lower doses still a key risk requiring monitoring. Ziconotide combines with opioids or clonidine for synergy in refractory pain, per clinical practice. Catheter tip position matters; drug distribution isn't uniform higher placement enhances rostral spread, affecting efficacy and side effects. MRI compatibility exists with most modern pumps. The brainstem effect of opioids underscores IDDS's potency and danger, necessitating careful titration and patient selection.
A 66 year old man has recently been diagnosed with hypertension. He has no history of heart disease and diabetes mellitus. His average blood pressure is recorded as 154/82 mmHg. What is the MOST appropriate first line pharmacological therapy?
- A. Angiotensin converting enzyme-inhibitors
- B. Angiotensin receptor blockers
- C. Thiazide diuretics
- D. Calcium channel blockers
Correct Answer: C
Rationale: New hypertension at 66, 154/82 no heart or sugar issues thiazide diuretics kick off gentle, effective control, especially in older adults. ACE inhibitors or ARBs fit if kidneys or diabetes pop up; calcium blockers work but aren't first; beta blockers lag unless heart history. Nurses lean on thiazides cheap, proven for this chronic pressure nudge, keeping it simple and safe.