Nokea
The nurse is caring for a client who was recently diagnosed with hemophilia. Which of the following laboratory tests is consistent with that diagnosis?
- A. Prolonged activated partial thromboplastin time
- B. Prolonged prothrombin time
- C. Decreased platelet count
- D. Decreased bleeding time
Correct Answer: A
Rationale: Hemophilia factor VIII or IX lack stretches aPTT, as intrinsic clotting lags, a lab fit for this X-linked bleed fest. PT stays normal extrinsic path's fine. Platelets don't drop; bleeding time's off-base. Nurses spot prolonged aPTT, confirming hemophilia's clotting chaos, guiding factor therapy in this bloody diagnosis.
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A nurse is caring for a client diagnosed with atherosclerosis. Which of the following is considered a risk factor for the development of this disorder?
- A. Diet high in vitamin K
- B. Low HDL-C/High LDL-C
- C. High HDL-C/Low LDL-C
- D. Vegan diet
Correct Answer: B
Rationale: Atherosclerosis loves lipids low HDL (good cholesterol) and high LDL (bad cholesterol) pile plaque, a prime risk factor driving vessel narrowing. Vitamin K aids clotting, not plaque. High HDL/low LDL protects. Vegan diets cut fats, lowering risk. Nurses flag lipid imbalance, pushing statins or diet shifts, a cholesterol-fueled root of this vascular scourge.
A 3-year-old girl with a Wilms tumor is returning to the unit after a simple nephrectomy. Which of the following actions have the highest priority in caring for this child?
- A. Maintaining NPO.
- B. Monitoring the BP every 2 hours.
- C. Turning her every 2 hours.
- D. Administering pain medication every 4 hours.
Correct Answer: B
Rationale: After a nephrectomy for Wilms tumor, monitoring blood pressure (BP) every 2 hours is the highest priority because kidney removal disrupts renin-angiotensin regulation, risking hypo- or hypertension, especially in a young child with one remaining kidney. Using the ABCs (airway, breathing, circulation), BP falls under circulation, a critical postoperative focus to detect shock or fluid imbalance early. Maintaining NPO is temporary post-anesthesia but shifts to hydration once awake, less urgent than BP. Turning every 2 hours prevents pressure ulcers, but a mobile 3-year-old post-simple nephrectomy likely moves independently unless sedated, lowering its priority. Pain medication is key but ranks lower (e.g., G' in extended ABCs) than circulation. Frequent BP checks ensure stability, aligning with nursing's role in pediatric surgical care to prevent complications in a child adapting to single-kidney function.
Which enzyme is activated by oxidative stress in endothelial cells and plays a key role in the development of complications?
- A. GAPDH
- B. Glyoxalase-1
- C. PARP
- D. Transketolase
Correct Answer: C
Rationale: PARP wakes to oxidative hits repairs DNA, drives damage in diabetes vessels, not GAPDH's stall, glyoxalase's detox, or transketolase's shunt. Nurses clock this, a chronic complication cog.
Lymphoma is differentiated in stages to assisting classifications. Stage III is when there are
- A. Diffuse or disseminated involvement of one or more extra lymphatic organs
- B. Involvement limited to one side of the diaphragm with two or more lymph node regions
- C. Involvement of lymph node regions on both sides of the diaphragm
- D. Involvement of a single lymph node region or single extralymphatic organ or site
Correct Answer: C
Rationale: Lymphoma's Stage III nodes jump diaphragm's sides, not one-sided, organ-wide, or solo. Nurses stage this, a chronic spread mark.
Regarding oxygen consumption by the adult human body:
- A. It is approximately 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at rest in the awake adult patient.
- B. It rises to approximately 11 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at peak exercise in healthy young adults.
- C. Increases by approximately 5-fold after major surgery.
- D. Peak oxygen consumption is likely to be quantified accurately by cardiopulmonary exercise testing.
Correct Answer: A
Rationale: Oxygen consumption (VOâ‚‚) reflects metabolic demand. At rest, VOâ‚‚ is approximately 3-4 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ in awake adults, aligning with basal energy needs (250-300 ml/min total). During peak exercise, healthy young adults can reach 30-40 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹, far exceeding 11 ml, depending on fitness. Post-major surgery, VOâ‚‚ increases 50-100% (1.5-2-fold), not 5-fold, due to stress and healing, though critical illness may spike higher briefly. Cardiopulmonary exercise testing (CPET) accurately measures peak VOâ‚‚, unlike the Duke Activity Status Index, which estimates it via questionnaire. The resting value of 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ is a physiological constant, foundational to understanding perioperative oxygen delivery and demand.