Which finding requires immediate attention in a child with glomerulonephritis?
- A. Sleeping most of the day with BP 170/90.
- B. Urine output of 190 mL in 8 hours with Coca-Cola-colored urine.
- C. Severe headache and photophobia.
- D. Refusal to eat with poor appetite.
Correct Answer: C
Rationale: A severe headache with photophobia may indicate hypertensive encephalopathy; this requires prompt evaluation.
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To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?
- A. The client is maintained on strict bed rest
- B. The head of the bed is at 30-degree angle
- C. The client receives a complete bed bath each morning
- D. The nurse checks the applicator's position every 4 hours
Correct Answer: B
Rationale: Keeping the head of the bed at a 30-degree angle can dislodge the applicator of radioactive material placed in the vagina. When caring for a client with a radioactive applicator, it is important to ensure that the position of the applicator is maintained to prevent radiation exposure to staff and other clients. This can be achieved by keeping the head of the bed flat without elevation. The other options are appropriate measures in caring for a client with a radioactive applicator.
A client is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (sub-arachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia?
- A. To prevent confusion
- B. To prevent cerebrospinal fluid (CSF)
- C. To prevent seizures leakage
- D. To prevent cardiac arrhythmias
Correct Answer: B
Rationale: Special positioning is required for a spinal (sub-arachnoid) block to prevent cerebrospinal fluid (CSF) leakage. The client is usually positioned in either a sitting or lateral decubitus position to allow for easier access to the spinal canal and ensure proper administration of the anesthesia. Maintaining the correct positioning helps to minimize the risk of CSF leakage, which can result in headaches and potential complications postoperatively. By positioning the client appropriately during the procedure, healthcare providers can optimize the effectiveness of the spinal block while reducing the risk of adverse effects.
The pediatric nurse advises a parent how to best convey the circumstances surrounding the sudden death of an 18-month-old patient to a four-year-old sibling. The nurse anticipates that the sibling:
- A. may feel guilty about the patient's death.
- B. may mistrust the parent.
- C. understands the permanence of death.
- D. will role-play the patient's death.
Correct Answer: A
Rationale: Young children often struggle with understanding death and may internalize feelings of guilt, believing they had a role in the event.
The nurse administers chemotherapeutic drugs to a client with cancer. What adverse effects are most common?
- A. Painful mouth sores
- B. Nausea and vomiting
- C. Frequent diarrhea
- D. Constipation
Correct Answer: B
Rationale: Nausea and vomiting are common adverse effects experienced by clients undergoing chemotherapy. Chemotherapeutic drugs can irritate the lining of the digestive system, leading to these symptoms. Nausea and vomiting can significantly impact a client's quality of life and may also affect their ability to continue with treatment. Healthcare providers often prescribe anti-nausea medications to help manage these side effects and improve the client's comfort during chemotherapy treatment. It is essential for nurses to assess, monitor, and address nausea and vomiting promptly to provide optimal care for clients undergoing chemotherapy.
A client with advanced liver cancer is scheduled for chemotherapy. As part of the chemotherapy regimen, the nurse expects the physician to prescribe:
- A. Fluoxymesterone (Halotestin)
- B. Fluorouracil (5-fluorouracil, 5 FU
- C. Tamoxifen (Nolvadex) [Fluoroplex])
- D. Megestrol (Megace)
Correct Answer: B
Rationale: Fluorouracil (5-FU) is a commonly used chemotherapy drug for various cancers, including of the liver. It is often used to treat advanced liver cancer as part of a chemotherapy regimen. 5-FU works by interfering with the synthesis of DNA and RNA in cancer cells, leading to their death.