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The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical-surgical unit. Which client should the nurse see first?
- A. A client with pain that is two days post-operative from a prostatectomy
- B. A client ready for discharge education after treatment of an acute kidney injury
- C. A client with hypertension with a blood pressure of 172/92 mm Hg
- D. A client with a history of asthma complaining of increased dyspnea
Correct Answer: D
Rationale: Asthma's increased dyspnea flags airway risk ABCs prioritize breathing, as bronchospasm could crash fast, needing nebulizers or oxygen. Post-op pain's manageable, discharge education waits, hypertension's high but stable. Nurses hit dyspnea first, ensuring airflow, a life-first call in this shift-start triage.
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Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient?
- A. IL-2 enhances the body's immunologic response to tumor cells.
- B. IL-2 prevents bone marrow depression caused by chemotherapy.
- C. IL-2 protects normal cells from harmful effects of chemotherapy.
- D. IL-2 stimulates malignant cells in the resting phase to enter mitosis.
Correct Answer: A
Rationale: IL-2, a BRM, revs up immunity T-cells and NK cells to hunt renal cell carcinoma, a tumor responsive to this kick. It doesn't shield marrow or normal cells chemo's still rough. It's not pushing cancer mitosis that's chemo's gig. Nurses in oncology clarify this IL-2's an immune booster, a lifeline when mets rage, not a chemo sidekick.
Which of the following statements is INCORRECT concerning gestational diabetes?
- A. Most commonly developed in the first trimester of pregnancy
- B. Affects 8% of pregnant women
- C. Maternal blood glucose levels will return to normal shortly after birth
- D. There is a high risk of developing type 2 diabetes by the mother within 20 years
Correct Answer: A
Rationale: Gestational diabetes hits late second or third trimester, not first insulin resistance peaks then, a pregnancy twist. Eight percent's close, glucose norms post-birth, type 2 risk looms 20 years fits. Nurses catch this timing, a chronic precursor's true window.
A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate?
- A. Have the patient eat large meals when nausea is not present.
- B. Offer dry crackers and carbonated fluids during chemotherapy.
- C. Administer prescribed antiemetics 1 hour before the treatments.
- D. Give the patient a glass of a citrus fruit beverage during treatments.
Correct Answer: C
Rationale: Chemo vomiting's a beast pre-dosing antiemetics (e.g., ondansetron) an hour before blocks the gut-brain puke loop, the gold standard. Big meals overload; crackers and soda or citrus during treatment spark nausea acidity and fizz don't help. Nurses in oncology time this right prevention trumps mopping up, keeping patients steady.
The hospice nurse is caring for a patient with cancer in her home. The nurse has explained to the patient and the family that the patient is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this patient and family to do to reduce the patient's risk of hypercalcemia?
- A. Stool softeners are contraindicated
- B. Laxatives should be taken daily
- C. Consume 2 to 4 L of fluid daily
- D. Restrict calcium intake
Correct Answer: C
Rationale: Hypercalcemia cancer's bone breakdown gift needs hydration (2-4 L/day) to flush calcium through kidneys, unless heart or renal issues say no. Stool softeners and laxatives fight constipation (a symptom), not the cause, and aren't contraindicated. Cutting calcium's pointless tumors, not diet, spike it. Nurses in hospice drill this, balancing fluid push with symptom watch (confusion, thirst), keeping comfort king in late-stage oncology care.
A 58-year-old woman with chronic gout is visiting the dietitian and the correct dietary advice given is:
- A. To stop fried food and eat fish for better gout control
- B. To increase fructose drinks as it removes uric acid from urine
- C. Avoid soybeans and plant proteins
- D. Stop alcohol and reduce animal protein
Correct Answer: D
Rationale: Gout diet cut booze, meat; fructose spikes uric, soy's fine, mushrooms hurt, cherries help. Nurses steer this chronic food fix.