Nokea
Which combination of signs is commonly associated with glomerulonephritis?
- A. Mild proteinuria, hematuria, decreased urine output, and lethargy.
- B. Massive proteinuria, hematuria, increased output, and lethargy.
- C. Mild proteinuria, increased output, and lethargy.
- D. Massive proteinuria, decreased output, and hypotension.
Correct Answer: A
Rationale: Glomerulonephritis typically presents with mild to moderate proteinuria, hematuria, decreased urine output, and lethargy.
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The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.
The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30s and has two young children. Although she's worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping?
- A. Tell the client's spouse or partner to be supportive while she recovers.
- B. Encourage the client to proceed with the next phase of treatment.
- C. Recommend that the client remain cheerful for the sake of her children.
- D. Refer the client to the American Cancer Society's Reach for Recovery program or another support program.
Correct Answer: D
Rationale: Referring the client to the American Cancer Society's Reach for Recovery program or another support program is the best course of action to support her coping. This program can provide emotional support, practical assistance, and guidance to the client as she navigates through the challenges of coping with breast cancer and reconstruction surgery. Connecting with others who have gone through similar experiences can help her feel less isolated and provide her with valuable insights and resources to cope effectively. This approach acknowledges the importance of holistic support for the client during this difficult time, beyond what medical treatment alone can provide.
A 78 year old male has been working on his lawn for two days, although the temperature has been above 90 degree F. he has been on thiazide diuretics for hypertension. His lab values are K 3.7 mEq/L, Na 129 mEq/L, Ca 9 mg/dl, and Cl 95 mEq/L. What would be a priority action for this man?
- A. Make sure he drinks 8 glasses of water a day.
- B. Monitor for fatigue, muscle weakness, restlessness, and flushed skin
- C. Look for signs of hyperchloremia
- D. Observe for neurologic changes
Correct Answer: B
Rationale: The 78-year-old male in this scenario is at risk for electrolyte imbalances due to prolonged exposure to high temperatures while taking thiazide diuretics, commonly prescribed for hypertension. The low potassium level (K 3.7 mEq/L) and low sodium level (Na 129 mEq/L) in his lab results are indicative of potential electrolyte disturbances, especially considering his age and medication. These electrolyte imbalances can lead to symptoms like fatigue, muscle weakness, restlessness, and flushed skin, which are signs of hyponatremia and hypokalemia.
A baby that was born 5 minutes earlier is tachypneic, tachycardic, and markedly cyanotic. A STAT echocardiogram confirms the presence of a cyanotic congenital cardiac defect. Which of the following defects would be consistent with the assessment findings?
- A. Patent ductus arteriosus
- B. Transposition of the great vessels
- C. Atrial septal defect
- D. Ventricular septal defect
Correct Answer: B
Rationale: Transposition of the great vessels is a cyanotic congenital heart defect where the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This results in two separate circulatory systems - one for oxygenated blood and another for deoxygenated blood. Due to this abnormal circulation, babies with transposition of the great vessels may present with severe cyanosis soon after birth. They can also develop tachypnea and tachycardia as compensatory mechanisms to maintain oxygen delivery. A STAT echocardiogram would confirm the diagnosis by showing the abnormal connection of the great vessels.
A nurse makes the decision to apply a topical anesthetic to a child's skin before drawing blood. Which ethical principle is the nurse demonstrating?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Truthfulness
Correct Answer: B
Rationale: The nurse is demonstrating the ethical principle of beneficence by applying a topical anesthetic to the child's skin before drawing blood. Beneficence refers to the obligation to act in the best interest of the patient, promoting their well-being and preventing harm. In this case, the nurse is taking proactive steps to minimize the child's discomfort and potential pain during the blood draw procedure, thus upholding the principle of beneficence.