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Then the drug is stopped. When should treatment resume?
- A. When the WBC falls to 5,000mm3
- B. When lost hair begins to grow back
- C. When the WBC count rises to 50,000/mm3
- D. When the client displays anemia
Correct Answer: A
Rationale: The correct answer is A: When the WBC falls to 5,000mm3. This is because a low WBC count indicates potential bone marrow suppression from the drug. Resuming treatment at this point ensures the bone marrow has recovered enough to handle the drug's effects.
Summary:
- Choice B: Hair regrowth is not a reliable indicator of bone marrow recovery.
- Choice C: A high WBC count suggests potential toxicity, not readiness for treatment.
- Choice D: Anemia is a late sign of bone marrow suppression, not an appropriate indicator to resume treatment.
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During the physical assessment, the nurse recalls that the areas most frequently affected by multiple sclerosis are the:
- A. Lateral, 3rd and 4th ventricles
- B. Pons medulla and cerebral peduncles
- C. Optic nerve and chiasm
- D. Above areas
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer):
1. Multiple sclerosis (MS) commonly affects the optic nerve and chiasm.
2. MS is characterized by demyelination of nerves, leading to visual disturbances.
3. Optic nerve involvement results in vision problems, such as blurred vision.
4. Chiasm involvement can cause visual field deficits and color perception changes.
Summary of Other Choices:
A: Lateral, 3rd, and 4th ventricles - Incorrect. MS primarily affects the central nervous system, not ventricles.
B: Pons, medulla, and cerebral peduncles - Incorrect. While these areas are part of the brainstem, they are not commonly affected in MS.
D: Above areas - Incorrect. This choice is vague and does not specify any specific areas affected by MS.
The nurse observes the client as he walks into the room. What information will this provide the nurse?
- A. Information regarding the client’s gait
- B. Information regarding the client’s personality
- C. Information regarding the client’s psychosocial status
- D. Information on the rate of recovery from surgery
Correct Answer: A
Rationale: The correct answer is A because observing the client's gait while walking can provide valuable information about their physical mobility, balance, coordination, and any potential musculoskeletal issues. This assessment helps the nurse determine if the client requires any assistance, mobility aids, or further evaluation by a healthcare provider. Choices B and C are incorrect as observing gait does not directly provide information on personality or psychosocial status. Choice D is incorrect as gait observation is not specifically related to the rate of recovery from surgery. In summary, observing the client's gait is important for assessing physical mobility and identifying potential issues, making it the most relevant choice in this context.
Hypernatremia is associated with a:
- A. Serum osmolality of 245mOsm/kg
- B. Urine specific gravity below 1.003
- C. Serum sodium of 150mEq/L
- D. Combination of all of the above
Correct Answer: D
Rationale: Step 1: Hypernatremia is defined by elevated serum sodium levels (>145mEq/L).
Step 2: Serum osmolality of 245mOsm/kg is high, consistent with hypernatremia.
Step 3: Urine specific gravity below 1.003 indicates dilute urine, a common finding in hypernatremia.
Step 4: The combination of elevated serum sodium, high serum osmolality, and low urine specific gravity confirms hypernatremia.
Summary:
A: Incorrect, as high serum osmolality (not 245mOsm/kg) is associated with hypernatremia.
B: Incorrect, as low urine specific gravity (not below 1.003) is seen in hypernatremia.
C: Incorrect, as serum sodium needs to be >145mEq/L to indicate hypernatremia.
Hyperparathyroidism is caused by increased levels of thyroxine in blood plasma. A client with this endocrine dysfunction would experience:
- A. Heat intolerance and systolic
- B. Diastolic hypertension and widened hypertension pulse pressure
- C. Weight gain and heat intolerance
- D. Anorexia and hyper-excitability
Correct Answer: A
Rationale: The correct answer is A because hyperparathyroidism is not caused by increased levels of thyroxine but by overactivity of the parathyroid glands. This would lead to symptoms of heat intolerance due to increased metabolism and systolic hypertension due to the effects of excess parathyroid hormone on calcium levels.
Choice B is incorrect because diastolic hypertension and widened pulse pressure are not typical symptoms of hyperparathyroidism. Choice C is incorrect because weight gain is not a common symptom of hyperparathyroidism. Choice D is incorrect because anorexia and hyper-excitability are not typical symptoms of hyperparathyroidism.
Which of the following is the most important assessment during the acute stage of an unconscious patient like Mr. Franco?
- A. Level of awareness and response to pain
- B. Papillary reflexes and response to sensory stimuli
- C. Coherence and sense of hearing
- D. Patency of airway and adequacy of respiration
Correct Answer: D
Rationale: The correct answer is D: Patency of airway and adequacy of respiration. During the acute stage of an unconscious patient like Mr. Franco, ensuring the airway is open and that breathing is adequate is the top priority to maintain oxygenation and prevent complications like hypoxia. This assessment is crucial for immediate intervention and can be life-saving.
A: Level of awareness and response to pain may provide important information but is secondary to ensuring a patent airway and adequate breathing in an unconscious patient.
B: Pupillary reflexes and response to sensory stimuli are important neurological assessments, but airway and breathing take precedence in the acute stage to maintain vital functions.
C: Coherence and sense of hearing are not as critical as assessing and maintaining the airway and breathing in an unconscious patient.