Nokea
The nurse Questions which order for a client with thrombocytopenia?
- A. Apply ice to areas of trauma
- B. Administer intramuscular (IM) medication
- C. Test all urine and stool for the presence of occult blood
- D. Avoid enemas
Correct Answer: B
Rationale: Thrombocytopenia's bleed risk IM shots pierce muscle, risking hematomas, a questionable order nurses flag, as low platelets can't clot it. Ice curbs swelling, occult blood tests track bleeds, enemas avoid rectal tears all fit. Nurses challenge IM, pushing IV routes, a safety catch in this platelet-poor state.
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About the mineralocorticoid antagonists (MRAs) which of the following is correct?
- A. Patiromer is a new MRA
- B. Losartan is a MRA
- C. MRAs can cause hypokalemia
- D. Finerenone is a novel nonsteroidal MRA
Correct Answer: D
Rationale: MRAs finerenone's new, not patiromer, losartan; hyperkalemia, albumin cuts fit. Nurses tap this chronic kidney tweak.
A 65-year-old male client is brought via EMS to the emergency department with chest pain. He rates the pain as a 10 on a scale from 0-10; the pain is located mid-sternum and radiates to his left arm. His heart rate is 126 beats/minute and blood pressure are 96/60 mm Hg. A 12-lead electrocardiogram is performed and reveals ST-segment elevation. Which of the following interventions does the nurse anticipate performing immediately?
- A. Administer oxygen
- B. Administer morphine
- C. Administer a statin
- D. Administer nitroglycerin
Correct Answer: A
Rationale: ST-elevation MI (STEMI) signals acute coronary occlusion severe chest pain, tachycardia, and hypotension demand oxygen first to counter hypoxia, per ABCs, buying time for reperfusion. Morphine eases pain, nitroglycerin dilates (if BP allows), but oxygen's immediate. Statins aid long-term, not now. Nurses prioritize oxygen, anticipating cath lab prep, a critical step in this time-sensitive infarct emergency.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.
Why are endothelial cells in particular sensitive to the damage caused by high plasma glucose levels?
- A. Endothelial cells have a high metabolic activity
- B. Endothelial cells cannot regulate the glucose uptake
- C. Endothelial cells have a low level of antioxidants
- D. All statements provided above are correct
Correct Answer: B
Rationale: Endothelial cells drown in glucose no uptake brakes, high sugar slams them, not just metabolism or low shields. A chronic vessel weak spot nurses watch this sugar soak.
A primary nursing responsibility is the prevention of lung cancer by assisting patients in smoking/tobacco cessation. Which tasks would be appropriate to delegate to the LPN/LVN?
- A. Develop a quit plan
- B. Explain the application of a nicotine patch
- C. Discuss strategies to avoid relapse
- D. Suggest ways to deal with urges for a tobacco
Correct Answer: B
Rationale: LPN/LVNs shine in standardized teaching like explaining nicotine patch application, a medication-focused task within their scope, detailing placement and timing to aid cessation. Developing a quit plan requires RN-level planning and assessment of individual needs. Discussing relapse strategies involves behavioral counseling, an RN forte. Suggesting urge-coping methods needs tailored insight, beyond LPN/LVN training. Patch explanation leverages their skills, supporting lung cancer prevention through practical cessation aid, a delegated task enhancing team efforts while keeping complex planning with RNs.