Nokea
Which is not a differential diagnosis for tetanus?
- A. strychnine poisoning
- B. dystonic reactions
- C. quinsy
- D. rabies
Correct Answer: C
Rationale: Tetanus mimics strychnine, dystonia, rabies flex muscles; cyanide gasps, quinsy's throat, not spasms. Nurses sift this chronic stiffness list.
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The physician tells the patient that there will be an initial course of treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a prolonged period of time. You can help the patient by reinforcing that the primary goal for this type of treatment is:
- A. Cure
- B. Control
- C. Palliation
- D. Permanent remission
Correct Answer: B
Rationale: The physician's plan initial treatment, maintenance, and long-term monitoring suggests a chronic cancer unamenable to cure, aiming instead to control growth and spread. Control stabilizes disease, extending life and quality, unlike cure, which eradicates cancer, or permanent remission, implying no recurrence both unfeasible here. Palliation focuses on symptom relief, not longevity, misaligning with ongoing treatments. Reinforcing control clarifies expectations, reducing anxiety by framing therapy as proactive management, not defeat. Nurses bolster this by explaining observation's role in adjusting care, aligning patient understanding with realistic goals, vital for adherence and emotional resilience in prolonged cancer battles.
A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most appropriate?
- A. Assess the client's gait and balance.
- B. Ask the client about the ease of urine flow.
- C. Document the report completely.
- D. Inquire about the client's job risks.
Correct Answer: A
Rationale: Prostate cancer commonly metastasizes to bones, especially the spine, causing spinal cord compression a medical emergency that can lead to paralysis if untreated. New, severe low back pain in this context suggests possible metastasis, making gait and balance assessment the most appropriate action to check for neurological deficits (e.g., weakness, unsteady gait) indicating compression. This prioritizes client safety, as falls or worsening paralysis could result without intervention. Asking about urine flow relates to prostate obstruction, less urgent here given the pain's prominence. Documentation is essential but passive without assessment. Job risks might contribute to back pain but are secondary to cancer history. Assessing gait and balance first ensures rapid escalation if needed, reflecting oncology nursing's focus on detecting metastatic complications early.
A client with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate?
- A. Have the patient eat large meals when nausea is not present
- B. Offer dry crackers and carbonated fluids during chemotherapy
- C. Administer prescribed antiemetics 1 hour before the treatments
- D. Give the patient two ounces of a citrus fruit beverage during treatments
Correct Answer: C
Rationale: Chemo's gut punch severe vomiting bows to preemptive antiemetics, given 1 hour before, blunting nausea's peak, the most effective move per oncology standards. Big meals overload; crackers help post-, not during; citrus risks acid reflux. Nurses time antiemetics, syncing with chemo's onslaught, a proactive strike to ease this metastatic misery, trumping reactive nibbles or sips.
During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next?
- A. Obtain more information about the family history.
- B. Schedule a sigmoidoscopy to provide baseline data.
- C. Teach the patient about the need for a colonoscopy at age 50.
- D. Teach the patient how to do home testing for fecal occult blood.
Correct Answer: A
Rationale: Family history of colon cancer flags risk first step's digging deeper: who, when, how many cases? That shapes if it's sporadic or hereditary (e.g., Lynch syndrome), guiding screening timing. Jumping to sigmoidoscopy or fecal tests skips assessment too soon without details. Colonoscopy at 50's standard, but family history might bump it earlier (e.g., 40 or 10 years before kin's diagnosis). Nurses in oncology start here, gathering intel to tailor prevention, not rushing tools that might miss the mark without context.
A 75-year-old female presented to the emergency department with shortness of breath. The client's daughter is at the bedside and shares that the client has a history of heart failure. The nurse places the client on the cardiac monitor and finds that the client is in atrial fibrillation at a rate of 180 beats per minute. Which is a likely finding?
- A. Bounding pulses
- B. Lethargy
- C. Hypotension
- D. Edema
Correct Answer: C
Rationale: Atrial fibrillation at 180 beats/minute in heart failure loses atrial kick, slashing output hypotension follows as rapid, erratic beats fail to fill ventricles, a likely finding with this tachycardic chaos. Bounding pulses need strong ejection, not here. Lethargy or edema might emerge, but BP drop's immediate, tied to poor perfusion. Nurses expect this, anticipating rate control or fluids, a critical catch in this acute decompensation.