Nokea
The physician prescribes didanosone (ddl [Videx]), 200mg PO every 12 hours, for a client with acquired immunodeficiency syndrome (AIDS) who is intolerant to zidovudine (azidothymidine ,AZT [Retrovir]). Which condition in the client's history warrants cautious of this drug?
- A. Peripheral neuropathy
- B. Hypertension
- C. Diabetes mellitus
- D. Asthma
Correct Answer: A
Rationale: Didanosine (ddl or Videx) is an antiretroviral medication used in the treatment of HIV/AIDS. However, one of the notable side effects of didanosine is peripheral neuropathy, which can manifest as tingling, numbness, or pain in the hands and feet. Since the client already has a history of peripheral neuropathy, prescribing didanosine may exacerbate this condition, making it important for the healthcare provider to exercise caution. Monitoring for any signs or symptoms of worsening peripheral neuropathy is essential in this case.
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During thoracentesis, which of the following nursing intervention will be most crucial?
- A. Place patient in a quiet and cool room
- B. Maintain strict aseptic technique
- C. Advice patient to sit perfectly still during needle insertion until it has been withdrawn from the chest
- D. Apply pressure over the puncture site as soon as the needle is withdrawn
Correct Answer: B
Rationale: Maintaining strict aseptic technique during thoracentesis is the most crucial nursing intervention. Thoracentesis is a procedure where a needle is inserted into the pleural space to obtain a sample of fluid for diagnostic purposes or to drain excess fluid for therapeutic relief. It is essential to prevent the introduction of pathogens or contaminants into the pleural space, as this can lead to serious complications such as infection. By following strict aseptic technique, the risk of complications can be minimized, ensuring the safety and well-being of the patient undergoing the procedure.
Kasabach-Merritt syndrome is characterized by all the following EXCEPT
- A. thrombocytopenia
- B. microangiopathic hemolytic anemia
- C. coagulopathy
- D. association with infantile hemangiomas
Correct Answer: D
Rationale: Kasabach-Merritt syndrome is not typically associated with hemangiomas.
Small round blue cell tumors refer to all the following EXCEPT
- A. non-Hodgkin lymphoma
- B. osteosarcoma
- C. Ewing sarcoma
- D. rhabdomyosarcoma
Correct Answer: B
Rationale: Osteosarcoma does not typically fall under the category of small round blue cell tumors.
A patient with a history of haemophilia A arrives in the emergency department complaining of a "funny feeling" in his elbow. The patient states that he thinks he is bleeding into the joint. Which response by the nurse is correct?
- A. Palpate the patient's elbow to assess for swelling.
- B. Notify the physician immediately and expect an order for factor VIII.
- C. Prepare the patient for an x-ray examination to determine whether bleeding is occurring.
- D. Apply heat to the patient's elbow and wait for the physician to examine the patient.
Correct Answer: B
Rationale: For a patient with a history of hemophilia A complaining of a "funny feeling" in the elbow, suspecting bleeding into the joint, the correct response by the nurse is to notify the physician immediately and expect an order for factor VIII. Hemophilia A is a genetic disorder characterized by a deficiency in clotting factor VIII, leading to prolonged bleeding. In this case, immediate medical intervention in the form of factor VIII replacement therapy is crucial to control and manage the bleeding episode. Urgent treatment aims to prevent complications such as joint damage and to promote hemostasis in patients with hemophilia. Palpating the elbow, preparing for an x-ray, or applying heat are not the appropriate initial actions when managing a suspected bleeding episode in a patient with hemophilia.
A newborn is being discharged at age 48 hours. The parents ask how the newborn should be bathed this first week home. How should the nurse recommend to bathe the newborn?
- A. Daily with mild soap
- B. Daily with an alkaline soap
- C. Two or three times this week with plain water
- D. Two or three times this week with mild soap
Correct Answer: C
Rationale: It is recommended to bathe a newborn only a few times during the first week with plain water to avoid drying out the baby's delicate skin. Newborns do not need to be bathed daily, as excessive bathing can strip their skin of natural oils and lead to dryness or irritation. Plain water is gentle and sufficient for cleaning a newborn's skin without causing any harm. After the first week, parents can gradually introduce mild soap if needed for cleaning, but it is still not necessary to bathe the baby daily.