Nokea
Then the drug is stopped. When should treatment resume?
- A. When the WBC falls to 5,000mm3
- B. When the WBC count rises to
- C. When lost hair begins to grow back 50,000/mm3
- D. When the client displays anemia
Correct Answer: A
Rationale: The correct answer is A because the drug should be resumed when the WBC count falls to 5,000mm3 to ensure the client's safety and efficacy of treatment. This criterion indicates that the client's immune system has recovered sufficiently to tolerate the drug. Choices B, C, and D are incorrect because they do not directly correlate with the client's immune system recovery, which is crucial for drug tolerance. Choice B focuses on the rise in WBC count, not the fall to a specific level. Choice C is related to a cosmetic side effect, not clinical readiness. Choice D is unrelated to immune system recovery.
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A client with serum glucose level of 618mg/dl is admitted to the facility. He’s awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6F (38.1C), heart rate of 116 beats/min, and blood pressure of 108/70mHg. Based on these assessment findings, which nursing diagnosis take highest priority?
- A. Deficient volume related to osmotic diuresis
- B. Decreased cardiac output related to elevated heart rate
- C. Imbalanced nutrition: Less than body requirements related to insulin deficiency
- D. Ineffective thermoregulation related to dehydration
Correct Answer: D
Rationale: The correct answer is D, "Ineffective thermoregulation related to dehydration." The client's high serum glucose level of 618mg/dl indicates severe hyperglycemia, leading to dehydration. The client's hot, dry skin and elevated temperature can be signs of dehydration, impacting the body's ability to regulate temperature. Dehydration can also affect other vital signs, contributing to the elevated heart rate and low blood pressure. Addressing ineffective thermoregulation is crucial as it can lead to further complications.
Choices A, B, and C are not the highest priority because addressing dehydration and ineffective thermoregulation takes precedence due to the immediate risk of complications such as heatstroke or hypothermia. Deficient volume, decreased cardiac output, and imbalanced nutrition are important but not as urgent in this scenario.
Which of the ff conditions are more likely to develop in a client who is relatively immobile for the rest of his or her life? Choose all that apply
- A. Bladder infection
- B. Constipation
- C. Calculus information
- D. Bladder inflammation
Correct Answer: A
Rationale: The correct answer is A: Bladder infection. Immobility can lead to urinary stasis, causing bacteria to multiply in the bladder, leading to a higher risk of bladder infections.
B: Constipation can also occur due to immobility, but it is not directly related to the urinary system.
C: Calculus formation is more related to factors like diet and hydration, not immobility.
D: Bladder inflammation can be a result of infection but is not as directly linked to immobility as bladder infections.
The nurse is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:
- A. Breast self-examination
- B. Fine needle aspiration
- C. Mammography
- D. Chest x-ray
Correct Answer: B
Rationale: The correct answer is B: Fine needle aspiration. This is because fine needle aspiration involves extracting cells from the lump in the breast for examination under a microscope to determine if they are cancerous. This procedure provides a definitive diagnosis of breast cancer. Breast self-examination (A) is a screening tool for detecting lumps but does not confirm a diagnosis. Mammography (C) is used for screening and detecting abnormalities but requires further testing for confirmation. Chest x-ray (D) is not useful for diagnosing breast cancer.
A client has had heavy menstrual bleeding for 6 months. Her gynecologist diagnoses microcytic hypochromic anemia and prescribes ferrous sulfate (Feosol), 300mg PO daily. Before initiating iron therapy, the nurse reviews the client’s medical history. Which condition would contraindicate the use of ferrous sulfate?
- A. Pregnancy
- B. Ulcerative colitis
- C. Asthma
- D. Severely impaired liver function
Correct Answer: B
Rationale: The correct answer is B: Ulcerative colitis. Iron therapy can exacerbate gastrointestinal issues, including ulcerative colitis due to its potential to cause irritation and inflammation in the digestive tract. This can lead to worsening symptoms and complications for the client.
A: Pregnancy is not a contraindication for iron therapy; in fact, it is commonly prescribed during pregnancy to prevent or treat anemia.
C: Asthma is not a contraindication for iron therapy as it does not directly interact with asthma or its treatment.
D: Severely impaired liver function is not a direct contraindication for iron therapy, although caution may be needed in such cases due to iron metabolism being affected by liver function.
A patient who has just had a TURP asks his nurse to explain why he has to have the bladder irrigation because it seems to increase his pain. Which of the following explanations by the nurse is best?
- A. “The bladder irrigation is needed to stop the bleeding in the bladder.”
- B. “Antibiotics are being administered into the bladder to prevent infection.”
- C. “The irrigation is needed to keep the catheter from becoming occluded by blood clots.”
- D. “Normal production of urine is maintained with the irrigations until healing can occur.”
Correct Answer: C
Rationale: Step 1: The nurse should explain that bladder irrigation is necessary to prevent blood clots from occluding the catheter after a TURP procedure.
Step 2: Without irrigation, blood clots could block the catheter, leading to urinary retention and potential complications.
Step 3: This explanation addresses the patient's concern about increased pain and highlights the importance of the irrigation in maintaining proper urine flow.
Step 4: Choice A is incorrect because the primary purpose of irrigation is not to stop bleeding but to prevent clot formation. Choice B is incorrect because the irrigation is not for administering antibiotics. Choice D is incorrect as it does not address the issue of clot formation.