Nokea
The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?
- A. The UAP flushes the toilet once after emptying the patient's bedpan.
- B. The UAP stands by the patient's bed for 30 minutes talking with the patient.
- C. The UAP places the patient's bedding in the laundry container in the hallway.
- D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.
Correct Answer: B
Rationale: Cervical implant's radioactive 30 minutes bedside overshoots exposure limits (under 30's safe); flushing , laundry , and mouthwash don't radiate. Nurses in oncology intervene UAP need time caps to dodge radiation, a safety must.
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The nurse is working in the emergency department and has four clients arrive at the same time. Which client should the nurse see first?
- A. A client requesting antibiotics for a cough
- B. A client who has a facial fracture with severe facial and oral swelling
- C. A client who states she has not urinated in 8 hours
- D. A client with a history of chronic obstructive pulmonary disease reporting increased dyspnea
Correct Answer: B
Rationale: Facial fracture with severe swelling risks airway ABCs dictate first look, as edema could choke breathing fast. Cough's stable, anuria's concerning but not immediate, COPD dyspnea's chronic unless crashing. Nurses triage swelling, anticipating intubation, a split-second save in this ED rush.
In a patient with COPD, the risk of postoperative pulmonary complications increases with:
- A. Wheezing on preoperative examination.
- B. A history of preoperative cough.
- C. Low body mass index (BMI).
- D. A serum albumin concentration less than 35 mg litreâ»Â¹.
Correct Answer: A
Rationale: Postoperative pulmonary complications in COPD patients are influenced by disease severity and patient condition. Wheezing indicates active airway obstruction and inflammation, directly increasing the risk of complications like atelectasis or pneumonia due to impaired ventilation and secretion clearance. A preoperative cough may suggest irritation or infection but is less specific than wheezing as a risk predictor. Low BMI reflects malnutrition, a known risk factor, but its impact is less immediate than active respiratory symptoms. Low serum albumin (<35 g/L, not mg/L as stated) also indicates poor nutritional status and healing capacity, elevating risk, but wheezing is more directly tied to airway dynamics. Regional anesthesia may reduce complications compared to general anesthesia, but the question focuses on risk factors. Wheezing's presence signals acute respiratory compromise, making it the strongest preoperative indicator of postoperative issues.
A child is seen in the pediatrician's office for complaints of bone and joint pain. Which other assessment finding may indicate leukemia?
- A. Abdominal pain
- B. Increased activity level
- C. Increased appetite
- D. Petechiae
Correct Answer: D
Rationale: Leukemia often presents with bone and joint pain due to marrow infiltration by leukemic cells, but petechiae small red or purple spots from minor bleeds under the skin are a key additional sign of bleeding tendencies from thrombocytopenia, a common leukemia consequence. This reflects bone marrow failure to produce adequate platelets, making it a critical finding for nurses to note during assessment. Abdominal pain might occur from organ enlargement (e.g., splenomegaly), but it's less specific and not a primary complaint here. Increased activity level and appetite contradict leukemia's typical fatigue and anorexia due to metabolic demands of proliferating cells and anemia. Recognizing petechiae prompts urgent blood work and referral, aligning with nursing's role in early detection of pediatric leukemia, ensuring timely intervention to manage this life-threatening condition effectively.
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled 'Cancer: The Risks and What You Can Do About Them.' Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?
- A. Disease prophylaxis
- B. Risk reduction
- C. Secondary prevention
- D. Tertiary prevention
Correct Answer: C
Rationale: Screening's the game here secondary prevention spots cancer early in symptom-free folks, like mammograms or colonoscopies, boosting survival odds. Prophylaxis (primary) stops it cold think vaccines or sunscreen. Risk reduction's broader, overlapping primary efforts (e.g., quit smoking). Tertiary's post-diagnosis care, minimizing damage. This program's focus on early catch aligns with secondary's core, a public health win in oncology to shift outcomes before symptoms scream.
Risk factors for developing COPD include:
- A. Seasonal respiratory conditions and family history of emphysema
- B. Age, high fat diet and sedentary lifestyle
- C. History of cardiovascular and autoimmune conditions
- D. Indoor and outdoor air pollution
Correct Answer: D
Rationale: COPD risk factors center on chronic airway damage. Seasonal respiratory conditions may exacerbate, not cause, COPD, though family history of emphysema suggests genetic risk (e.g., alpha-1 antitrypsin deficiency), but it's less primary than exposure. Age is a factor as lung function declines naturally, but high fat diet and sedentary lifestyle are more linked to obesity or cardiovascular disease, not directly COPD. Cardiovascular and autoimmune histories don't drive COPD etiology smoking and pollution do. Indoor (e.g., biomass smoke) and outdoor air pollution (e.g., particulates) are major irritants, causing inflammation and irreversible airflow limitation, per Deravin and Anderson (2019). Pollution's role is critical globally, especially in occupational or urban settings, outweighing secondary factors by directly triggering the chronic inflammatory cascade defining COPD pathogenesis.