Nokea
The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take?
- A. Infuse the medication over a short period of time.
- B. Stop the infusion if swelling is observed at the site.
- C. Administer the chemotherapy through a small-bore catheter.
- D. Hold the medication unless a central venous line is available.
Correct Answer: B
Rationale: Vesicants (e.g., vincristine) burn tissue if they leak swelling at the site yells extravasation; stopping the IV stat limits necrosis. Fast infusion ups vein stress; small-bore risks rupture running IVs dilute it. Central lines are gold but not mandatory. Nurses in oncology prioritize this catching leaks early saves skin, a critical save in chemo land.
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A 4 week old baby is due for her second Hepatitis B vaccine dose. However, you note that the baby is mildly jaundiced. What would be the most appropriate step to take next?
- A. Screen for the Hepatitis B virus and only proceed with immunisation if the results are negative
- B. Immunisation is not required as the baby may already have hepatitis
- C. Give the hepatitis B vaccine and arrange for investigation for the jaundice
- D. Proceed with the vaccination but also give the Hepatitis B immunoglobulin at another site
Correct Answer: C
Rationale: Mild jaundice at 4 weeks likely physiologic or breast milk, not hep B vaccine's safe, so jab and probe cause. Screening delays, skipping's wrong, deferring's cautious overkill, immunoglobulin's for exposure. Nurses roll this, a chronic vax-plus-check play.
For a patient with osteogenic sarcoma, you would be particularly vigilant for elevations in which laboratory value?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Hematocrit
Correct Answer: B
Rationale: Osteogenic sarcoma, a bone cancer, often triggers hypercalcemia bone destruction releases calcium into blood, risking arrhythmias or kidney damage, a life-threatening shift demanding close watch. Sodium and potassium imbalances aren't bone-specific, more tied to general metabolism or treatment side effects. Hematocrit reflects anemia, common in cancer but not osteogenic sarcoma's hallmark. Calcium's spike, linked to osteolysis, makes it the nurse's focus elevations signal tumor activity or progression, prompting urgent interventions like fluids or bisphosphonates, a vigilance rooted in this cancer's skeletal impact and metabolic havoc.
Which of the following appropriately describes diastolic dysfunction?
- A. The rate of filling of the ventricles during diastole is slowed
- B. The left ventricle is dilated
- C. The preload (end ventricular diastolic volume) is increased
- D. The left ventricular ejection fraction is decreased
Correct Answer: A
Rationale: Diastolic dysfunction stiffens ventricles slowed filling in diastole nails it, as relaxation flops, hiking pressure. Dilated LV or high preload fits systolic; low EF's not here preserved in HFpEF. Dyssynchrony's another beast. Clinicians peg this slow fill, a chronic heart kink distinct from pump fail.
At what pressure goal can we optimally slow CKD progression in diabetic nephropathy?
- A. Less than 125/70 mmHg
- B. Less than 125/80 mmHg
- C. Less than 130/80 mmHg
- D. Less than 135/80 mmHg
Correct Answer: C
Rationale: Diabetic CKD <130/80 slows scarring best; tighter risks flow, looser misses. Nurses lock this chronic renal pace.
The nursing considerations that should be applied when assisting diabetics in management of their condition does not include:
- A. BGL monitoring, medications and compliance with treatment and medication
- B. Recognition and early intervention of potential complications
- C. Skin and foot care, including pressure area care when hospitalised
- D. Minimising exercise to prevent fatigue and foot ulcers
Correct Answer: D
Rationale: Diabetes nursing BGLs, meds, complication spots, skin/foot TLC all key. No exercise? Flops movement cuts sugar, boosts health, not ulcers. Nurses nix this, a chronic active push.