Nokea
The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse?
- A. Shortness of breath
- B. Shivering and chills
- C. Muscle aches and pains
- D. Temperature of 100.2°F (37.9°C)
Correct Answer: A
Rationale: Rituximab, a monoclonal antibody, can trigger anaphylaxis shortness of breath yells airway trouble, needing stat infusion halt over chills , aches , or mild fever . Nurses in oncology jump breathing trumps flu-like norms, a life-or-death call.
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A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
- A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
- B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
- C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
- D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.
Correct Answer: C
Rationale: Terminal pancreatic cancer pain's relentless around-the-clock opioids with breakthrough doses keep it tamed, per hospice norms. Waiting for 5/10 lags; IV isn't inherently better oral's fine. Nonopioids at max opioid miss the mark escalation's the play. Nurses in oncology teach this steady dosing plus rescues nails chronic cancer pain, a win if families get it.
The nurse is reviewing laboratory values for a client. Which of the following lab values should the nurse address immediately?
- A. Potassium 5.9 mmol/L
- B. Phosphorus 5.1 mg/dL
- C. Creatinine 6.2 mg/dL
- D. Sodium 147 mEq/L
Correct Answer: A
Rationale: Potassium 5.9 mmol/L above 5.5 sparks hyperkalemia, risking arrhythmias, a now-or-never fix over phosphorus's mild bump (3.0-4.5 normal). Creatinine's renal cry waits; sodium's high but tolerable. Nurses jump on potassium, anticipating ECG or kayexalate, a heart-stopping lab in this urgent sweep.
Which agent is the usually choice for moderate to severe travelers diarrhea?
- A. metronidazole
- B. doxycycline
- C. norfloxacin
- D. penicillin
Correct Answer: C
Rationale: Norfloxacin fluoroquinolone zaps travelers' E. coli, not metro, doxy, pen, or cotrim's fade. Nurses pick this chronic gut punch.
Your junior trainee has been in theatre for 5 h with a patient undergoing a femorodistal bypass procedure. He is yawning and seems withdrawn. The trainee's fatigue is likely to be improved by:
- A. Imbibing one 60 ml shot of espresso coffee.
- B. Taking a 1-h nap.
- C. Increasing the brightness of the theatre lighting.
- D. Walking around and chatting to other members of staff.
Correct Answer: B
Rationale: Fatigue during long procedures impairs performance. A 60 ml espresso shot (50-100 mg caffeine) boosts alertness temporarily (20-30 minutes onset), but its effect wanes after 5 hours of sustained effort. A 1-hour nap restores cognitive function and vigilance significantly, countering sleep pressure per sleep research (e.g., NASA nap studies), with benefits lasting hours. Bright lighting enhances alertness via circadian stimulation but is less effective mid-fatigue. Walking and chatting provide a break, mildly boosting arousal, but lack restorative depth. Microsleeps signal severe fatigue, worsening performance. A nap's superiority lies in addressing accumulated sleep debt, critical in high-stakes settings like surgery, offering sustained recovery over stimulants or environmental tweaks.
During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next?
- A. Obtain more information about the family history.
- B. Schedule a sigmoidoscopy to provide baseline data.
- C. Teach the patient about the need for a colonoscopy at age 50.
- D. Teach the patient how to do home testing for fecal occult blood.
Correct Answer: A
Rationale: Family history of colon cancer flags risk first step's digging deeper: who, when, how many cases? That shapes if it's sporadic or hereditary (e.g., Lynch syndrome), guiding screening timing. Jumping to sigmoidoscopy or fecal tests skips assessment too soon without details. Colonoscopy at 50's standard, but family history might bump it earlier (e.g., 40 or 10 years before kin's diagnosis). Nurses in oncology start here, gathering intel to tailor prevention, not rushing tools that might miss the mark without context.