Which blood product replaces missing clotting factors in the patient who has a bleeding disorder?
- A. Platelets
- B. Albumin
- C. Packed RBC
- D. Cryoprecipitate
Correct Answer: D
Rationale: Cryoprecipitate is a blood product that contains concentrated amounts of clotting factors, including fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor. These clotting factors are essential for the formation of blood clots, and when a patient has a bleeding disorder such as hemophilia or von Willebrand disease, cryoprecipitate is used to replace the missing or deficient clotting factors. Platelets are used to help with clot formation in cases of thrombocytopenia, albumin is used to treat low albumin levels in conditions like liver disease, and packed RBCs are used to treat anemia by providing oxygen-carrying red blood cells. However, for a patient with a bleeding disorder needing replacement of missing clotting factors, cryoprecipitate is the most appropriate blood product.
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The nurse is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?
- A. Testicular cancer is a highly curable type of cancer.
- B. Testicular cancer is very difficult to diagnose
- C. Testicular cancer is the number one cause of cancer deaths in males.
- D. testicular cancer is more common in older men.
Correct Answer: A
Rationale: It is appropriate to inform the male client that testicular cancer is a highly curable type of cancer. Testicular cancer has a high cure rate, especially when detected early through self-examinations. By emphasizing the curability of this cancer, the nurse can empower the client to perform regular self-exams and seek prompt medical attention if any abnormalities are detected. This information can help alleviate fears and encourage proactive health behaviors.
The nurse is aware that in communicating with an elderly client, the nurse will
- A. Lean and shout at the ear of the client
- B. Use a low-pitched voice
- C. Open mouth wide while talking to the client
- D. Use a medium-pitched voice
Correct Answer: B
Rationale: When communicating with an elderly client, it is important to use a low-pitched voice because high frequencies can be difficult for older individuals to hear. A low-pitched voice is easier for them to understand and can help enhance communication. Speaking clearly and directly in a calm manner with a lower pitch can make it easier for the elderly client to hear and comprehend what is being said. Additionally, it is important to speak at a moderate pace and volume to ensure effective communication with elderly clients.
When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. What is the best explanation for this?
- A. Some form of cancer
- B. Local scalp infection common in children
- C. Infection or inflammation distal to the site
- D. Infection or inflammation close to the site
Correct Answer: D
Rationale: In this case, the tenderness, enlargement, and warmth of the child's cervical lymph nodes are likely due to an infection or inflammation that is close to the site. When lymph nodes are palpated and found to be tender, enlarged, and warm, it often indicates that the lymphatic system is responding to an infection or inflammation in the nearby area. The lymph nodes are part of the body's immune system and can become enlarged and tender as they work to fight off the infection. In this scenario, the most likely explanation is an infection or inflammation located near the cervical lymph nodes.
The client with rheumatoid arthritis reports GI irritation after taking piroxicam (Feldene). To prevent GI upset, the nurse should provide which instruction?
- A. Space the administration every 4 hours.
- B. Use the drug for a short time only
- C. Take piroxicam with food or oral antacid
- D. Decrease the piroxicam dosage
Correct Answer: C
Rationale: Piroxicam is a nonselective NSAID (nonsteroidal anti-inflammatory drug) that can irritate the gastrointestinal (GI) tract, leading to symptoms such as heartburn, indigestion, and stomach pain. Taking piroxicam with food or an oral antacid can help reduce GI irritation by providing a protective barrier and reducing acid production within the stomach. Encouraging the client to take piroxicam with a meal or antacid can help prevent or minimize GI upset associated with the medication. Additionally, using a proton pump inhibitor (PPI) or histamine-2 receptor antagonist (H2 blocker) along with piroxicam may further protect the stomach lining from irritation.
A newborn with hypospadias: The parents ask if circumcision is an option. Which is the best response?
- A. Circumcision is a fading practice and is now contraindicated.
- B. Circumcision is recommended to prevent infection.
- C. Circumcision is an option but should be delayed, as the foreskin may be needed for surgical repair.
- D. Circumcision can never be performed in a child with hypospadias.
Correct Answer: C
Rationale: In hypospadias, preserving the foreskin may be beneficial for repair, so circumcision is usually delayed.