Nokea
Total parenteral nutrition (TPN) is ordered for an adult client. Which nutrient is not likely to be in the solution?
- A. dextrose
- B. electrolytes
- C. trace minerals
- D. amino acids
Correct Answer: C
Rationale: Total parenteral nutrition (TPN) is a method of providing nutrition intravenously to individuals who are unable to obtain adequate nutrition through oral or enteral routes. The components of a TPN solution typically include dextrose (a source of carbohydrates for energy), amino acids (building blocks of proteins), electrolytes (such as sodium, potassium, and magnesium to maintain proper balance), vitamins, and trace elements (such as zinc and selenium). Trace minerals are essential for various metabolic functions in the body, and their inclusion in TPN solutions is crucial to prevent deficiencies. Therefore, trace minerals are likely to be present in TPN solutions, making them an essential component, unlike the other options provided in the question.
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For a client with an exacerbation of rheumatoid arthritis, the physician prescribes the corticosteroid prednisone (Deltasone). When caring for this client, the nurse should monitor for which adverse drug reactions?
- A. Increased weight, hypertension, and insomnia
- B. Vaginal bleeding, jaundice, and inflammation
- C. Stupor, breast lumps, and pain
- D. Dyspnea, numbness, and headache
Correct Answer: A
Rationale: Corticosteroids, like prednisone, are commonly associated with several adverse drug reactions. Increased weight is often observed due to fluid retention and increased appetite caused by corticosteroids. Hypertension can result from the sodium and water retention triggered by these medications. Insomnia is a common side effect of corticosteroids due to their stimulant effect on the central nervous system. It is important for the nurse to monitor the client for these adverse reactions and report any concerning symptoms to the healthcare provider for appropriate management.
A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify?
- A. Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels
- B. Low levels of urine constituents normally excreted in the urine
- C. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
- D. Electrolyte imbalance that could affect the blood's ability to coagulate properly
Correct Answer: C
Rationale: A complete blood count (CBC) is a common blood test that provides important information about the types and numbers of cells in the blood, such as red blood cells, white blood cells, and platelets. The primary purpose of performing a CBC before surgery is to identify any abnormalities in the blood that could affect the patient's ability to undergo the surgical procedure safely. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels indicated by a CBC may suggest anemia, which could impact the patient's ability to tolerate surgery and anesthesia. Anemia can result in decreased oxygen delivery to tissues and organs, leading to potential complications during surgery. Therefore, identifying low HCT and Hb levels through a CBC allows healthcare providers to take appropriate measures to address and manage the condition before proceeding with surgery.
What does the American Academy of Pediatrics recommend as the best form of newborn nutrition?
- A. Exclusive breastfeeding until age 2 months.
- B. Exclusive breastfeeding until age 6 months.
- C. Commercially prepared newborn formula for 1 year.
- D. Commercially prepared newborn formula until age 4 to 6 months.
Correct Answer: B
Rationale: The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first 6 months of a baby's life. Breast milk provides all the necessary nutrients and antibodies that a baby needs for healthy growth and development during this crucial period. Breastfeeding also offers long-term health benefits for both the baby and the mother. It is important for mothers to receive support and education to establish and maintain successful breastfeeding. After the first 6 months, the AAP recommends continuing breastfeeding while introducing appropriate solid foods until at least 12 months of age, or longer if both the mother and baby are willing and able.
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: C
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
- A. Social isolation
- B. Level of stress
- C. Degree of depression
- D. Desire to punish others
Correct Answer: D
Rationale: The most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats is the desire to punish others. Individuals who commit suicide often exhibit behaviors or thought patterns indicating a desire to cause harm or guilt to others. This desire to punish others may drive them to take their own lives as a way to make others feel responsible or suffer the consequences of their actions. On the other hand, individuals who make suicidal attempts or threats may not have the same level of intent to harm others through their actions, and their motivations may stem from different underlying issues such as social isolation, stress, or depression. Therefore, the desire to punish others is a crucial factor that sets those who commit suicide apart from those who make attempts or threats.