Nokea
The nurse observes flaring of nares in a newborn. This should be interpreted as:
- A. nasal occlusion.
- B. sign of respiratory distress.
- C. common response to sneezing.
- D. snuffles of congenital syphilis.
Correct Answer: B
Rationale: Flaring of nares in a newborn is typically interpreted as a sign of respiratory distress. When a baby is having trouble breathing or is not getting enough oxygen, the body compensates by increasing the size of the nasal passages to allow for easier airflow. This response helps the baby to breathe more effectively during times of respiratory distress. It is important for healthcare providers to recognize this sign as it may indicate the need for prompt intervention and support to help the baby breathe more comfortably.
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Which of the following types of translocation of childhood AML that typically associated with granulocytic sarcoma mass?
- A. inv(16)
- B. t(8;21)
- C. t(6;9)
- D. inv(3)
Correct Answer: A
Rationale: The inv(16) translocation is strongly associated with granulocytic sarcoma in AML.
During the physical examination of a client for a possible neurologic disorder, how can the nurse examine the client for stiffness and rigidity of the neck?
- A. By positioning the client flat on bed for at least 3 hrs
- B. By moving the head and chin of the client toward the chest
- C. By asking the client to bend and pick up small and large objects on the floor
- D. By introducing a painful stimulus on the neck
Correct Answer: B
Rationale: The nurse can examine the client for stiffness and rigidity of the neck by moving the head and chin of the client toward the chest. This maneuver, known as neck flexion, assesses the resistance and presence of stiffness in the neck muscles. Stiffness and rigidity of the neck muscles may suggest conditions such as meningitis, cervical dystonia, or other neurologic disorders. It is important for the nurse to perform this examination maneuver carefully to avoid causing discomfort or injury to the client.
A client with advanced liver cancer is scheduled for chemotherapy. As part of the chemotherapy regimen, the nurse expects the physician to prescribe:
- A. Fluoxymesterone (Halotestin)
- B. Fluorouracil (5-fluorouracil, 5 FU
- C. Tamoxifen (Nolvadex) [Fluoroplex])
- D. Megestrol (Megace)
Correct Answer: B
Rationale: Fluorouracil (5-FU) is a commonly used chemotherapy drug for various cancers, including of the liver. It is often used to treat advanced liver cancer as part of a chemotherapy regimen. 5-FU works by interfering with the synthesis of DNA and RNA in cancer cells, leading to their death.
In children with asthma, which of the following preoperative preparations is LEAST likely to be necessary?
- A. Increase in beta-agonist dosage
- B. Addition of systemic steroids
- C. Bronchodilator therapy
- D. None of the above
Correct Answer: D
Rationale: In stable asthmatic patients, additional interventions like systemic steroids or increased beta-agonist doses are not always necessary unless there are signs of exacerbation.
A client tells the nurse that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
- A. Urine glucose level
- B. Serum fructosamine level
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct Answer: D
Rationale: Checking the glycosylated hemoglobin (HbA1c) level is the most appropriate way to determine the effectiveness of the client's efforts to control type 2 diabetes mellitus over the past few months. HbA1c provides an average of the blood glucose levels over the past 2-3 months, reflecting how well the client has been managing their diabetes. This test is not affected by recent food intake or physical activity, making it a reliable indicator of long-term glucose control. Unlike fasting blood glucose levels or urine glucose levels, which can fluctuate throughout the day, HbA1c gives a more comprehensive view of glucose control and helps guide treatment decisions.