Nokea
The nurse is providing preoperative care for a 7-year-old patient with a brain tumor. Which of the following is the priority intervention?
- A. Assessing the child's level of consciousness
- B. Providing a tour of the intensive care unit for the child and parents
- C. Educating the child and parents about shunts
- D. Having the child talk to another child who has had this surgery
Correct Answer: A
Rationale: For a child with a brain tumor preoperatively, assessing level of consciousness (LOC) is the priority, as it monitors for increased intracranial pressure (ICP) from tumor mass effect vital signs like alertness or confusion shift rapidly and signal deterioration needing immediate action. No baseline data exists here, making LOC the first step in the nursing process to guide care. An ICU tour reduces anxiety but delays critical assessment. Shunt education applies post-diagnosis of hydrocephalus, not universally pre-op, and lacks urgency without LOC context. Peer support is psychosocial, not physiological, and secondary. LOC assessment aligns with ABCs (circulation includes cerebral perfusion), ensuring the nurse detects neurological decline early, a cornerstone of pediatric neuro-oncology care before surgery.
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The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?
- A. The UAP flushes the toilet once after emptying the patient's bedpan.
- B. The UAP stands by the patient's bed for 30 minutes talking with the patient.
- C. The UAP places the patient's bedding in the laundry container in the hallway.
- D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.
Correct Answer: B
Rationale: Cervical implant's radioactive 30 minutes bedside overshoots exposure limits (under 30's safe); flushing , laundry , and mouthwash don't radiate. Nurses in oncology intervene UAP need time caps to dodge radiation, a safety must.
With regards to adverse effects of first-line antihypertensive medications, angioedema has been associated with which ONE of the following classes of antihypertensives?
- A. Angiotensin receptor blockers
- B. Angiotensin-converting enzyme inhibitors
- C. Calcium channel blockers (dihydropyridine)
- D. Thiazide diuretics
Correct Answer: B
Rationale: Angioedema, a potentially life-threatening swelling of deep skin layers or mucous membranes, is a well-documented adverse effect of angiotensin-converting enzyme (ACE) inhibitors, occurring in about 0.1-0.7% of patients due to bradykinin accumulation from enzyme inhibition. This distinguishes ACE inhibitors from other first-line antihypertensives. Angiotensin receptor blockers (ARBs) rarely cause angioedema, as they don't affect bradykinin levels. Calcium channel blockers (e.g., dihydropyridines like amlodipine) may cause peripheral edema but not angioedema. Thiazide diuretics are linked to electrolyte imbalances or rashes, not angioedema. Family physicians must recognize this ACE inhibitor risk, ensuring prompt discontinuation and airway management if it occurs, critical for safe chronic disease management.
A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement. Which of the following statements by the client indicates the clients correct understanding of the discharge teaching regarding warfarin anticoagulant therapy?
- A. I may need to modify my diet while on this medication
- B. I do not need to take my prescribed medication for the rest of my life
- C. Additional monitoring is not required while on the anticoagulant
- D. I can lead a normal life while on anticoagulants; no restrictions are required
Correct Answer: A
Rationale: Mechanical valves demand warfarin forever diet tweaks, like steady vitamin K, keep INR stable, a sign the client gets it. Lifelong meds, monitoring, and restrictions (e.g., bleeding risk) are non-negotiable. Nurses cheer this dietary nod, ensuring warfarin's tightrope walk succeeds, a smart grasp in this valve swap life.
The genetic profile determines the prevalence of diabetic nephropathy in a population group. Question: Which population group has the LOWEST risk to develop endstage renal disease as a consequence of diabetes?
- A. Afro-Americans
- B. Iberians (Spanish origin)
- C. Caucasians
- D. Native Americans
Correct Answer: C
Rationale: Caucasians dodge worst kidney doom Afro-Americans, Native Americans soar high, Iberians mid-tier. Genes and diabetes hit lighter here, a chronic renal risk low nurses screen this gradient.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.