Nokea
The nurse is reviewing the results of a patient's arterial blood gas analysis. What should the nurse recognize as being a normal blood pH?
- A. 7.29
- B. 7.31
- C. 7.38
- D. 7.48
Correct Answer: C
Rationale: The correct answer is C: 7.38. Normal blood pH ranges from 7.35 to 7.45. A pH of 7.38 falls within this range, indicating a slightly alkaline (basic) pH, which is considered normal. Choices A, B, and D are all outside the normal range, indicating acidosis (A and B) or alkalosis (D). Therefore, C is the correct answer as it falls within the normal blood pH range.
You may also like to solve these questions
A 12-year-old patient has been referred to you following complete resection with clean margins of a high-grade malignant peripheral nerve sheath tumor of the shoulder region. The tumor measured approximately 4 cm in greatest dimension. A CT scan of the chest and a bone scan were within normal limits. The patient does not have evidence of neurofibromatosis type 1 (NF1). Which of the following treatment approaches would you recommend?
- A. Chemotherapy with doxorubicin and ifosfamide
- B. Radiotherapy
- C. Chemotherapy with doxorubicin and ifosfamide plus radiotherapy
- D. Observation
Correct Answer: D
Rationale: The correct answer is D: Observation. Given the complete resection with clean margins, normal chest CT, bone scan, and absence of NF1, observation is appropriate. Chemotherapy or radiotherapy may be considered in the presence of residual disease, positive margins, or metastasis. Chemotherapy with doxorubicin and ifosfamide may cause unnecessary toxicity without clear benefit in this scenario. Radiotherapy may be reserved for cases with high-risk features. Combining chemotherapy and radiotherapy may lead to increased toxicity without proven benefit. Observation allows monitoring for disease recurrence while minimizing unnecessary treatment side effects.
A 2-year-old girl has a diagnosis of overall stage IV favorable histology Wilms' tumor with pulmonary metastases and local stage III disease due to finding positive lymph nodes. After she completes 6 weeks of vincristine/dactinomycin/doxorubicin (DD4A) chemotherapy, restaging shows complete resolution of some but not all lung nodules. Tumor genetic testing reveals combined loss of heterozygosity for 1p and 16q. Which of the following would be the most appropriate treatment plan?
- A. Continue chemotherapy with vincristine, doxorubicin, and dactinomycin to complete 25 weeks of therapy. Administer radiation to lungs and flank.
- B. Continue chemotherapy with vincristine, doxorubicin and dactinomycin to complete 25 weeks of therapy. Radiation to flank only. No lung radiation.
- C. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to flank only. No lung radiation.
- D. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to lungs and flank.
Correct Answer: D
Rationale: The correct answer is D because the addition of cyclophosphamide and etoposide to the chemotherapy regimen is indicated for patients with combined loss of heterozygosity for 1p and 16q in Wilms' tumor. This genetic abnormality is associated with a higher risk of relapse and poorer outcomes. The extended duration of chemotherapy (33 weeks) is necessary to target any remaining tumor cells and reduce the risk of recurrence. Additionally, the decision to administer radiation to both the lungs and flank is appropriate given the incomplete resolution of some lung nodules after initial chemotherapy. Lung radiation helps to target any remaining metastatic lesions, while flank radiation targets the primary tumor site and positive lymph nodes. This comprehensive treatment approach aims to maximize the chances of long-term disease control and survival for the patient.
Choice A is incorrect because it lacks the addition of cyclophosphamide and etoposide, which are needed for Wilms' tumor with the specific genetic abnormality mentioned.
What are the six dimensions of quality care according to the Institute of Medicine?
- A. Safe, timely, effective, efficient, equitable, and person-centered
- B. Safe, transparent, effective, efficient, equitable, and person-centered
- C. Safe, timely, effective, low-cost, equitable, and person-centered
- D. Safe, timely, effective, efficient, cutting-edge, and person-centered
Correct Answer: A
Rationale: The correct answer is A: Safe, timely, effective, efficient, equitable, and person-centered. This aligns with the six dimensions of quality care outlined by the Institute of Medicine. Safety ensures patient well-being, timeliness reduces delays, effectiveness means providing evidence-based care, efficiency minimizes waste, equity ensures fair access, and person-centered care considers individual preferences.
Choice B is incorrect because transparency is not included in the Institute of Medicine's six dimensions. Choice C is incorrect as "low-cost" is not a recognized dimension of quality care. Choice D is incorrect because "cutting-edge" is not part of the established dimensions of quality care.
A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient's condition?
- A. Hemophilia A
- B. Thrombocytopenia
- C. Von Willebrand factor disease
- D. Vitamin K deficiency
Correct Answer: D
Rationale: The correct answer is D: Vitamin K deficiency. Prolonged prothrombin time and activated partial thromboplastin time indicate impaired blood clotting, which is characteristic of vitamin K deficiency. Vitamin K is essential for synthesizing clotting factors II, VII, IX, and X. Hemophilia A (choice A) is a genetic disorder resulting in deficiency of clotting factor VIII, not vitamin K-dependent factors. Thrombocytopenia (choice B) is a condition characterized by low platelet count, not affecting clotting factor synthesis. Von Willebrand factor disease (choice C) involves a deficiency or dysfunction of von Willebrand factor, not related to vitamin K deficiency.
A laboratory finding of granulocytosis
- A. Complete absence of peripheral blood granulocytes and their precursors in the bone marrow
- B. Acute bacterial infections
- C. Myeloproliferative disorders
- D. Increased numbers of granulocytes in blood and bone marrow
Correct Answer: D
Rationale: The correct answer is D because granulocytosis refers to an increased number of granulocytes in both blood and bone marrow. This finding is commonly associated with conditions such as infections, inflammation, and certain hematologic disorders. Other choices are incorrect because A describes a condition of granulocytopenia, B is associated with acute bacterial infections but not specific to granulocytosis, and C refers to myeloproliferative disorders which may involve other cell types besides granulocytes.