Nokea
The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
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A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate?
- A. Avoid getting salt water on the radiation site.
- B. Do not expose the radiation area to direct sunlight.
- C. Have a wonderful time and enjoy your vacation!
- D. Remember you should not drink alcohol for a year.
Correct Answer: B
Rationale: Post-radiation skin at the treatment site remains highly sensitive to ultraviolet (UV) rays due to damage to the epidermal layer, increasing the risk of burns, irritation, or delayed healing. The nurse's most appropriate response is to advise against exposing the radiation area to direct sunlight, a precaution that persists for at least a year after treatment to protect skin integrity. Avoiding saltwater isn't a standard concern unless the skin is broken, which isn't indicated here. Simply wishing the client well ignores the teaching opportunity and potential risk. The alcohol restriction isn't a universal post-radiation rule unless tied to specific treatments or conditions not mentioned. Educating about sun exposure empowers the client to enjoy the vacation safely, aligning with nursing's preventive care focus and ensuring the celebration isn't marred by avoidable complications.
The single most effective intervention to reduce the risk of developing COPD and stop its progression is
- A. Increased physical activity
- B. Prompt intervention for chest infection
- C. Smoking Cessation
- D. Avoidance of indoor and outdoor pollutants
Correct Answer: C
Rationale: COPD's king fix quit smoking slashes risk and stalls damage, trumping exercise, infection zaps, or pollution dodges. It's the top toxin, 80% of cases, a chronic killer nurses chase down hard.
The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?
- A. Adjust the dose to the patient's present symptoms
- B. Wash hands with an alcohol-based cleanser following administration
- C. Use gloves and a lab coat when preparing the medication
- D. Dispose of the antineoplastic wastes in the hazardous waste receptacle
Correct Answer: D
Rationale: Antineoplastics are hazardous proper disposal in designated receptacles is critical to protect staff, patients, and the environment from toxic exposure. Gloves and gowns are standard for prep, but the question stresses one action, and disposal trumps as a universal safety net. Dosing's fixed by protocol, not symptoms tweaking's dangerous. Alcohol-based cleansers don't cut it post-exposure; soap and water are needed pre- and post-handling to remove residue. Emphasizing disposal aligns with OSHA and oncology nursing standards, ensuring chemo waste (e.g., IV bags, syringes) doesn't leak into regular trash, a key lesson for newbies in this high-stakes field.
Toxic shock syndrome:
- A. will often manifest without fever
- B. is a misnomer because BP is often maintained
- C. is caused by pseudomonas species
- D. often produces elevated creatinine kinase
Correct Answer: D
Rationale: TSS fever burns, BP drops, staph rules, CK jumps, rash spreads. Nurses clock this chronic toxin surge.
Early Goal Directed Therapy in severe sepsis and septic shock (Rivers et al) does NOT recommend:
- A. hydrocortisone 100 mg QID
- B. maintaining mixed venous oxygen saturation measurement >70%
- C. maintaining CVP between 8-12 mmHg
- D. using inotropes to keep MAP >65 mmHg<90 mmHg
Correct Answer: A
Rationale: Rivers' sepsis hydrocortisone's out, SvO2, CVP, MAP, dobutamine hold. Nurses skip this chronic steroid sidestep.