Nokea
The nurse is caring for a school-age child with a tinea capitis (ringworm) infection. What should the nurse expect the therapeutic management of this child to include?
- A. Administering oral griseofulvin
- B. Administering topical or oral antibiotics
- C. Applying topical sulfonamides
- D. Applying Burow solution compresses to affected area
Correct Answer: A
Rationale: The nurse should expect the therapeutic management of a school-age child with tinea capitis to include administering oral griseofulvin. Griseofulvin is an antifungal medication commonly used to treat fungal infections like tinea capitis. Topical or oral antibiotics are not effective in treating fungal infections. Applying topical sulfonamides is also not a recommended treatment for tinea capitis. Burow solution compresses are used to provide relief for inflammatory skin conditions and are not specific treatments for fungal infections like tinea capitis.
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A 10-mo-old boy has a left suprarenal mass. Surgery is accomplished with complete removal of the mass as well as the non-adherent lymph nodes; surgical biopsies are taken during surgery. The histology reveals poorly differentiated neuroblastoma with microscopic ipsilateral lymph nodes involvement. The contralateral lymph nodes are negative. Of the following, the BEST therapeutic approach for this infant is
- A. chemotherapy
- B. radiotherapy
- C. concomitant chemo-radiotherapy
- D. chemotherapy followed by radiotherapy
Correct Answer: A
Rationale: Complete resection with microscopic residual disease typically warrants adjuvant chemotherapy.
If a patient has severe hyperkalemia, it is possible to administer calcium gluconate intravenously to:
- A. Immediately lower the potassium level by
- B. Prevent transient renal failure (TRF)
- C. Accomplish all of the above
- D. Antagonize the action of K on the heart
Correct Answer: D
Rationale: Calcium gluconate is administered intravenously in the setting of severe hyperkalemia to antagonize the effects of potassium on the heart. Hyperkalemia can lead to dangerous cardiac arrhythmias due to the changes in membrane potential of cardiac cells caused by increased extracellular potassium levels. Administration of calcium gluconate helps stabilize the cardiac cell membrane potential, protecting against the risk of life-threatening arrhythmias. It doesn't provide an immediate decrease in serum potassium levels (Choice A) or prevent transient renal failure (TRF) (Choice B). Therefore, the correct answer is D, as calcium gluconate primarily acts to counteract the effects of hyperkalemia on the heart.
Which is an important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns?
- A. Apply topical medication with clean hands.
- B. Wash hands and forearms before and after dressing change.
- C. If dressings adhere to the wound, soak in hot water before removal.
- D. Apply dressing so that movement is limited during the healing process.
Correct Answer: B
Rationale: Washing hands and forearms before and after a dressing change is crucial for maintaining proper hygiene and preventing the spread of infection. This practice helps to reduce the risk of introducing harmful microorganisms to the burn wounds, which could lead to complications. It is important for the nurse to wash their hands and forearms thoroughly using proper hand hygiene techniques before touching the child's wounds or applying topical medications. By following the principles of infection control, the nurse can help promote proper wound healing and prevent potential complications in the child's recovery process.
A client is receiving chemotherapy to treat breath cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
- A. A Urine output of 400 ml in 8 hours
- B. B. Serum potassium level of 3.6 mEq/L
- C. C. Blood pressure of 120/64 to 130/72 mm Hg
- D. D. Dry oral mucous membranes and cracked lips
Correct Answer: A
Rationale: Chemotherapy can cause fluid and electrolyte imbalances in the body, leading to potential kidney damage and altered urinary output. A low urine output of 400 ml in 8 hours could indicate dehydration or impaired renal function, both of which can be induced by chemotherapy. Monitoring urine output is crucial in assessing the patient's fluid balance and kidney function during chemotherapy. It is essential to identify and address such imbalances promptly to prevent complications.
A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, NO, MO. What does this classification mean?
- A. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis
- B. Carcinoma is situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
- C. Can't assess tumor or regional lymph nodes and no evidence of metastasis
- D. Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis
Correct Answer: B
Rationale: In the TNM staging system, "T" represents the extent of the primary tumor, "N" refers to the involvement of regional lymph nodes, and "M" indicates the presence of distant metastasis. In the given classification of TIS, N0, M0: