Nokea
When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic stenosis (PS), Nurse Alex would keep in mind that this disorder involves which of the following?
- A. A single vessel arising from both ventricles
- B. Obstruction of blood flow from the left ventricle
- C. Obstruction of blood flow from the right ventricle
- D. Return of blood to the heart without entry to the left atrium
Correct Answer: C
Rationale: Pulmonic stenosis (PS) is a heart condition where there is obstruction or narrowing of the pulmonary valve, which is responsible for allowing blood to flow out of the right ventricle to the lungs for oxygenation. This obstruction leads to decreased blood flow from the right side of the heart to the lungs, causing increased pressure in the right ventricle. This can result in symptoms such as fatigue, shortness of breath, and possible heart murmurs. It is essential for Nurse Alex to educate Jessica's parents about the impact of this obstruction in the right ventricle and the importance of monitoring Jessica's symptoms and seeking appropriate medical care when needed.
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Which type of neuron transmits impulses from the central nervous system to the muscles and glands?
- A. Afferent
- B. Efferent
- C. Affective
- D. Effective
Correct Answer: B
Rationale: Efferent neurons, also known as motor neurons, transmit impulses from the central nervous system (brain and spinal cord) to the muscles and glands in the body. These neurons are responsible for inducing muscle contraction or glandular secretion in response to signals from the brain or spinal cord. In contrast, afferent neurons transmit impulses from sensory receptors to the central nervous system to convey sensory information. Thus, the correct answer is efferent neurons.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should highest priority to which intervention?
- A. Serving small portions bland food
- B. Encouraging rhythmic breathing exercises
- C. Administering metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed
- D. Withholding fluids for the first 4 to 6 hours after chemotherapy administration
Correct Answer: C
Rationale: Administering metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed should be the highest priority intervention for a client experiencing nausea and vomiting after cancer chemotherapy. Metoclopramide is a commonly used antiemetic medication that helps to reduce nausea and vomiting by enhancing gastric emptying and decreasing nausea. Dexamethasone, a corticosteroid, can also help alleviate inflammation that may contribute to the nausea and vomiting. By administering these medications as prescribed, the nurse can effectively address the client's symptoms and improve their comfort level. The other options, such as serving small portions bland food, encouraging rhythmic breathing exercises, and withholding fluids, are important interventions but should not take precedence over providing the prescribed antiemetic medications to manage the client's post-chemotherapy symptoms.
During chemotherapy for lymphocytic leukemia, a client develops abdominal pain, fever, and "horse barn" smelling diarrhea. It would be most important for the nurse to advise the physician to order:
- A. Enzyme-linked immunosuppressant assay
- B. Stool for Clostridium difficile test
- C. Flat palate X-ray of the abdomen
- D. Electrolyte panel and hemogram
Correct Answer: B
Rationale: The client's symptoms of abdominal pain, fever, and "horse barn" smelling diarrhea are concerning for Clostridium difficile infection, especially in the setting of receiving chemotherapy which can weaken the immune system. Clostridium difficile is a bacteria that can cause severe diarrhea and inflammation of the colon. Testing for Clostridium difficile in the stool is crucial for diagnosing the infection and guiding appropriate treatment. Therefore, advising the physician to order a stool test for Clostridium difficile would be the most important in this scenario to confirm the diagnosis and initiate appropriate management.
The nurse is presenting an in-service session on assessing gestational age in newborns. Which information should be included?
- A. The newborn's length and weight are the most accurate indicators of gestational age.
- B. The newborn's Apgar score and the mother's estimated date of confinement (EDC) are combined to determine gestational age.
- C. The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age.
- D. The newborn's chest circumference compared to the head circumference is the determinant for gestational age.
Correct Answer: C
Rationale: The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age. Assessment of posture at rest involves observing the newborn's flexed or extended posture when lying flat on their back. Premature infants tend to have more flexed postures due to their immature muscular tone. Arm recoil refers to the ability of the newborn to return their extended arm flexes to the flexed position. This reflex is typically present in more mature infants. These physical signs, along with other factors such as skin texture, breast development, and ear formation, are used by healthcare providers to estimate the gestational age of newborns. While length, weight, and head circumference are also important measurements, the posture at rest and arm recoil are specifically used in determining gestational age.
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 drug should be resumed when the WBC (white blood cell) count falls to 5,000/mm3. This is the appropriate indicator to monitor as a low WBC count may indicate the need for the medication to be restarted to support the immune system. It is important to closely monitor the WBC count as it is a crucial factor in gauging the body's ability to fight infections effectively. Resuming treatment at this point helps ensure that the client's immune system remains stable and can continue to function properly.