Nokea
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
- A. A 2-cm nontender supraclavicular node
- B. A 1-cm mobile and nontender axillary node
- C. An inability to palpate any superficial lymph nodes
- D. Firm inguinal nodes in a patient with an infected foot
Correct Answer: A
Rationale: The correct answer is A. A 2-cm nontender supraclavicular node is of most concern as supraclavicular nodes are not normally palpable, and their enlargement can indicate underlying malignancy, such as metastatic cancer.
B: A 1-cm mobile and nontender axillary node is within normal limits.
C: Inability to palpate superficial lymph nodes may be due to factors like obesity or normal variation.
D: Firm inguinal nodes in a patient with an infected foot are expected as a local response to infection.
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A nurse is reviewing the medication record of a client who is receiving alteplase following an acute myocardial infarction (MI). Which of the following medications should the nurse expect the client to be taking in addition to the alteplase?
- A. Protamine
- B. Desmopressin
- C. Ferrous sulfate
- D. Heparin
Correct Answer: D
Rationale: The correct answer is D: Heparin. Following an acute MI, a client receiving alteplase may also be prescribed heparin to prevent re-thrombosis and further clot formation. Alteplase is a thrombolytic agent that works by breaking down clots, while heparin is an anticoagulant that helps prevent new clots from forming. Protamine (choice A) is used to reverse the effects of heparin, not typically administered alongside alteplase. Desmopressin (choice B) is used for conditions like diabetes insipidus, unrelated to MI treatment. Ferrous sulfate (choice C) is an iron supplement, not indicated in this scenario.
You are seeing a 13-year-old boy with fatigue, weight loss, night sweats, and splenomegaly. Peripheral blood shows anemia, thrombocytosis, and leukocytosis (300,000/mm3). What is this patient's most likely diagnosis?
- A. Leukemoid reaction
- B. Acute lymphoblastic leukemia (ALL)
- C. Chronic myeloid leukemia (CML)
- D. Juvenile myelomonocytic leukemia (JMML)
Correct Answer: C
Rationale: The correct answer is C: Chronic myeloid leukemia (CML). This is a likely diagnosis due to the presence of fatigue, weight loss, night sweats, splenomegaly, anemia, thrombocytosis, and leukocytosis with an elevated white blood cell count. CML is characterized by the Philadelphia chromosome, resulting in the BCR-ABL fusion gene. This gene leads to uncontrolled proliferation of myeloid cells, causing the symptoms seen in this patient. Leukemoid reaction (A) is a reactive increase in white blood cells, usually in response to an infection. Acute lymphoblastic leukemia (B) typically presents with symptoms in children but is more commonly associated with lymphoblasts in the peripheral blood. JMML (D) is a rare myelodysplastic disorder in children characterized by monocytosis and a specific genetic mutation.
The nurse is reviewing the results of a patient's arterial blood gas analysis. What should the nurse recognize as being a normal blood pH?
- A. 7.29
- B. 7.31
- C. 7.38
- D. 7.48
Correct Answer: C
Rationale: The normal blood pH range is 7.35-7.45. Choice C (7.38) falls within this range, indicating a normal pH level. Choices A (7.29) and D (7.48) are outside the normal range, indicating acidosis and alkalosis, respectively. Choice B (7.31) is slightly below the normal range, indicating mild acidosis. Therefore, the correct answer is C as it represents a normal blood pH level within the appropriate range.
Artemisinin and its derivatives are used in the treatment of severe forms of chloroquine-resistant falciparum because they have:
- A. Rapid gametocidal activity
- B. The ability to prevent further development of hypnozoites
- C. Rapid sporontocidal activity
- D. Rapid schizonticidal activity
Correct Answer: D
Rationale: The correct answer is D: Rapid schizonticidal activity. Artemisinin and its derivatives target the asexual stage of the malaria parasite's life cycle, specifically the schizont stage. By quickly destroying the schizonts, they effectively kill the parasites in the blood, leading to a rapid reduction in parasite load and alleviating symptoms. The other choices are incorrect because A (Rapid gametocidal activity) targets sexual stage parasites, B (Ability to prevent further development of hypnozoites) refers to relapse prevention in Plasmodium vivax and Plasmodium ovale infections, and C (Rapid sporontocidal activity) targets the mosquito stage of the parasite's life cycle.
Half life of plat. Is:
- A. 1-2days
- B. 3-4days
- C. 5-6days
- D. 7-8days
Correct Answer: B
Rationale: The correct answer is B (3-4 days) because the half-life of platinum is known to be around 3-4 days based on scientific research and studies. This means that within this time frame, half of the amount of platinum will decay or disintegrate. The other choices (A, C, D) are incorrect because they do not align with the established half-life value of platinum. Option A (1-2 days), C (5-6 days), and D (7-8 days) do not fall within the typical range of platinum's half-life duration as determined by scientific data and experimentation. Therefore, option B is the most accurate and scientifically supported choice for the half-life of platinum.