Nokea
The nurse is preparing an intravenous infusion of phenytoin (Dilantin) as prescribed by the physician for the client with seizures. Which of the following solutions will the nurse plan to use to dilute this medication?
- A. Dextrose 5%
- B. Lactated Ringer's solution
- C. Normal saline solution
- D. Dextrose 5% and half-normal saline (0.45%)
Correct Answer: C
Rationale: Phenytoin (Dilantin) is known to be incompatible with dextrose solutions (such as dextrose 5% or dextrose 5% and half-normal saline). Therefore, the nurse would plan to use normal saline solution to dilute phenytoin in order to ensure medication effectiveness and prevent any potential adverse reactions. Lactated Ringer's solution is not commonly used for diluting phenytoin as normal saline solution is the preferred choice due to compatibility considerations.
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Hepatoblastoma is a neoplasm of undifferentiated precursors of hepatocytes. It is of different histological classification; which type predict the MOST favorable outcome?
- A. mixed type of pure epithelial and mesenchymal elements
- B. type of pure epithelial histology
- C. type of mixed fetal and embryonal histology
- D. type of undifferentiated histology
Correct Answer: B
Rationale: Pure epithelial histology, particularly fetal type, is associated with the best prognosis.
Which of the ff factors predisposes a client to the development of TB?
- A. Exposure to toxic gases
- B. Congenital abnormalities
- C. Obstruction by tumor
- D. Malnutrition
Correct Answer: D
Rationale: Malnutrition predisposes a client to the development of Tuberculosis (TB) because a lack of proper nutrition weakens the immune system, making the individual more susceptible to infections such as TB. Adequate nutrition is essential for maintaining a healthy immune system that can effectively fight off pathogens. Malnourished individuals are less able to mount a strong immune response, thus increasing their vulnerability to contracting TB and experiencing more severe symptoms and complications from the disease.
During the physical assessment, the nurse recalls that the areas most frequently affected by multiple sclerosis are the:
- A. Lateral, 3rd and 4th ventricles
- B. Pons medulla and cerebral peduncles
- C. Optic nerve and chiasm
- D. Above areas
Correct Answer: C
Rationale: Multiple sclerosis (MS) is a disease that primarily affects the central nervous system (CNS) by causing inflammation, damage, and scarring in the myelin sheath that covers nerve fibers. The optic nerve and chiasm are common areas affected by MS, leading to symptoms such as blurred or double vision, loss of color vision, and pain with eye movement. This involvement is known as optic neuritis, a common early symptom of MS. While MS can affect various parts of the CNS, the optic nerve and chiasm are among the most frequently involved areas, making choice C the correct answer in this case.
A nurse is directed to administer a hypotonic intravenous solution. The nurse expects that compensatory mechanisms associated with hypovolemia would cause all of the following symptoms except:
- A. O.45% sodium chloride
- B. 5% dextrose in water
- C. O.90% sodium chloride
- D. 5% dextrose in normal saline solution
Correct Answer: C
Rationale: Hypotonic solutions have lower osmolarity compared to the intracellular fluid, causing water to move into the cells by osmosis. This can lead to further swelling of the cells in the body. In the case of hypovolemia, the body is already experiencing a deficit of fluid and electrolytes, so administering a hypotonic solution like 0.90% sodium chloride would further exacerbate cellular swelling and potentially lead to cellular damage. Therefore, using 0.90% sodium chloride as a compensatory mechanism for hypovolemia would not be appropriate.
Which is an important consideration when the nurse is discussing enuresis with the parents of a young child?
- A. Enuresis is more common in girls than in boys.
- B. Enuresis is neither inherited nor has a familial tendency.
- C. Organic causes that may be related to enuresis should be considered first.
- D. Psychogenic factors that cause enuresis persist into adulthood.
Correct Answer: C
Rationale: An important consideration when the nurse is discussing enuresis with the parents of a young child is that organic causes related to enuresis should be considered first. Enuresis, or bedwetting, can have various causes including physical issues like urinary tract infections, constipation, or structural abnormalities. It is essential to rule out any underlying medical conditions before addressing behavioral or psychological factors. By focusing on organic causes first, healthcare providers can ensure that the child receives appropriate evaluation and treatment, leading to better outcomes.