Nokea
The nurse specialist explains that chemotherapyis extremely toxic to the bone marrow and the patient may develop thrombocytopenia. What is the priority goal of the nurse? To take precautions to control _______.
- A. Bleeding
- B. Infection
- C. Hypotension
- D. diarrhea
Correct Answer: A
Rationale: The correct answer is A: Bleeding. Chemotherapy can lead to low platelet counts (thrombocytopenia), increasing the risk of bleeding. The priority goal of the nurse is to prevent bleeding by taking precautions such as avoiding invasive procedures, using soft toothbrushes, and monitoring for signs of bleeding. Infection (B) is important but not the priority as bleeding can be life-threatening. Hypotension (C) is not directly related to thrombocytopenia. Diarrhea (D) is a potential side effect of chemotherapy but is not the priority when considering thrombocytopenia.
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Which of the following structures is responsible for the production of digestive enzymes and bicarbonate-rich pancreatic juice?
- A. Liver
- B. Gallbladder
- C. Pancreas
- D. Spleen
Correct Answer: C
Rationale: The correct answer is C: Pancreas. The pancreas is responsible for producing digestive enzymes and bicarbonate-rich pancreatic juice. It secretes enzymes like amylase, lipase, and protease to break down carbohydrates, fats, and proteins in the small intestine. The bicarbonate-rich juice helps neutralize stomach acid. The liver (A) produces bile stored in the gallbladder (B), which aids in fat digestion. The spleen (D) is involved in immune function and blood filtration, not digestive enzyme production.
A woman in active labor is experiencing precipitous labor with rapid cervical dilation and descent of the fetal presenting part. What maternal complication should the nurse anticipate?
- A. Postpartum hemorrhage
- B. Uterine atony
- C. Shoulder dystocia
- D. Placental abruption
Correct Answer: A
Rationale: Precipitous labor is characterized by rapid cervical dilation and descent of the fetal presenting part, leading to a shortened labor duration of less than 3 hours. This rapid progression can increase the risk of maternal complications, such as postpartum hemorrhage. Postpartum hemorrhage is defined as excessive bleeding of more than 500 ml after vaginal delivery or more than 1000 ml after cesarean delivery. The rapid delivery in precipitous labor can result in inadequate uterine contractions after delivery, leading to poor uterine tone and potential postpartum hemorrhage due to uterine atony. Therefore, the nurse should anticipate postpartum hemorrhage as a potential maternal complication in a woman experiencing precipitous labor.
A patient presents with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip. Laboratory tests reveal oocysts in the stool sample. Which of the following parasites is most likely responsible for this infection?
- A. Giardia lamblia
- B. Entamoeba histolytica
- C. Cryptosporidium parvum
- D. Cyclospora cayetanensis
Correct Answer: C
Rationale: The correct answer is C: Cryptosporidium parvum. This parasite is the most likely cause of the infection due to its presentation with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Laboratory tests revealing oocysts in the stool sample further support this diagnosis as Cryptosporidium parvum is known to produce oocysts in the stool. Giardia lamblia (choice A) presents with similar symptoms but does not typically produce oocysts. Entamoeba histolytica (choice B) is more associated with bloody diarrhea and liver abscesses. Cyclospora cayetanensis (choice D) is also associated with watery diarrhea but is less common in this scenario. Thus, based on the symptoms and laboratory findings, Cryptosporidium parvum is the most likely culprit.
A patient with a history of chronic liver disease presents with ecchymoses, mucosal bleeding, and altered mental status. Laboratory tests reveal prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. Which of the following conditions is most likely to cause these findings?
- A. Liver cirrhosis
- B. Disseminated intravascular coagulation (DIC)
- C. Hemophilia A
- D. Vitamin K deficiency
Correct Answer: B
Rationale: The correct answer is B: Disseminated intravascular coagulation (DIC). In DIC, there is widespread activation of coagulation leading to consumption of clotting factors, resulting in prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. This pattern matches the laboratory findings in the patient. In liver cirrhosis (choice A), there is a decrease in clotting factors synthesis, leading to prolonged PT but not aPTT. Hemophilia A (choice C) is a genetic disorder that affects specific clotting factors, typically leading to prolonged aPTT but not PT. Vitamin K deficiency (choice D) impairs the synthesis of clotting factors, leading to prolonged PT but not aPTT and low levels of factors II, VII, IX, and X.
A patient presents with a palpable thyroid nodule and signs of hypothyroidism. Fine-needle aspiration biopsy reveals cystic degeneration and colloid-filled spaces. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid nodules
Correct Answer: A
Rationale: The correct answer is A: Hashimoto's thyroiditis. This autoimmune disorder results in chronic inflammation of the thyroid gland, leading to thyroid nodules and hypothyroidism. The colloid-filled spaces seen in the biopsy are characteristic of Hashimoto's.
Choice B: Graves' disease is an autoimmune disorder causing hyperthyroidism, not hypothyroidism. Choice C: Diabetes mellitus is a metabolic disorder unrelated to the thyroid. Choice D: Thyroid nodules is a general term and does not explain the presence of colloid-filled spaces.