Nokea
The nurse should include in the patient's teaching plan that if the patient does not take the vitamin B12, which one of the following will develop?
- A. Iron deficiency anemia
- B. Sickle cell anemia
- C. Pernicious anemia
- D. Acquired haemolytic anemia
Correct Answer: C
Rationale: Pernicious anemia is a condition caused by a deficiency in vitamin B12 absorption due to the lack of intrinsic factor, a protein necessary for B12 absorption in the gastrointestinal tract. If a patient does not take vitamin B12, they can develop pernicious anemia. This condition leads to the inability to produce enough healthy red blood cells, resulting in anemia. Symptoms of pernicious anemia include fatigue, weakness, shortness of breath, and pale or yellowish skin. It is important for patients to take vitamin B12 supplements or receive injections if they are unable to absorb the vitamin properly in order to prevent or treat pernicious anemia.
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The nurse will monitor J.E. for the following signs and symptoms:
- A. Change in the levei of consciousness, tachypnea, tachycardia, petechiae
- B. Onset of chest pain, tachycardia, diaphoresis, nausea and vomiting
- C. Loss of consciousness, bradycardia, petechiae, and severe leg pain
- D. Change in leve! of consciousness, bradycardia, chest pain and oliguria
Correct Answer: A
Rationale: The signs and symptoms mentioned in option A are indicative of potential complications that may occur in a patient being monitored by a nurse.
Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture?
- A. Negative scarf sign
- B. Asymmetric Moro reflex
- C. Swelling of fingers on affected side
- D. Paralysis of affected extremity and muscles
Correct Answer: C
Rationale: A newborn with a clavicle fracture may present with swelling of the fingers on the affected side. This is due to the injury disrupting the nerves and blood vessels that supply the arm, leading to edema and swelling in the fingers. The other signs mentioned in the options are not typically associated with a clavicle fracture. A negative scarf sign relates to positioning of the arm and is not specific to a clavicle fracture. Asymmetric Moro reflex can be a normal finding in newborns and not indicative of a fracture. Paralysis of the affected extremity and muscles would be more suggestive of a nerve injury rather than a clavicle fracture.
In fetal period, all are true EXCEPT
- A. returns of midgut to abdomen by 10 weeks
- B. recognizable external genitalia formed by 12 weeks
- C. surfactant production begins by 24 weeks
- D. tripling of weight occurs during the third trimester
Correct Answer: B
Rationale: Recognizable external genitalia are formed by 14 weeks, not 12 weeks.
The nurse knows which of the following statements about TPN and peripheral parenteral nutrition is true?
- A. TPN is usually indicated for clients needing short term (less than 3 weeks) nutritional support, whereas PPN is for long term maintenance
- B. A client needing more than 3000 calories would receive PPN, whereas TPN is given to those requiring less than 3000 calories
- C. TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake
- D. TPN is given to those who need to augment oral feeding, whereas PPN is used for those who are nothing by mouth
Correct Answer: C
Rationale: The statement that is true about TPN and peripheral parenteral nutrition (PPN) is that TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake. This is because TPN is a hypertonic solution that can cause fluid overload if given in large volumes, so it's typically reserved for patients who have fluid restrictions. On the other hand, PPN is a less concentrated solution that can be safely administered to patients without fluid restrictions.
A 9-year-old boy develops acute myelogenous leukemia (AML) one year after completion of therapy for soft tissue sarcoma at his right thigh. Which of the following chemotherapeutic agents is MOST likely the cause of secondary acute myelogenous leukemia AML in this boy?
- A. cyclophosphamide
- B. vincristine
- C. etoposide
- D. doxorubicin
Correct Answer: C
Rationale: Etoposide is known to be associated with secondary AML due to its potential to induce chromosomal abnormalities.