Nokea
Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.
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For a patient who is experiencing side effects of radiation therapy, which task would be the most appropriate to delegate to the nursing assistant?
- A. Assist the patient to identify patterns of fatigue
- B. Recommend participation in a walking program
- C. Report the amount and type of food consumed from the tray
- D. Check the skin for redness and irritation after the treatment
Correct Answer: C
Rationale: Radiation side effects like fatigue and anorexia benefit from team care. Reporting food consumed from the tray suits nursing assistants observing and relaying intake data supports nutrition monitoring without requiring clinical judgment. Identifying fatigue patterns demands analysis, a nurse's role to adjust care plans. Recommending exercise exceeds assistants' scope physicians or RNs initiate such advice. Checking skin for redness post-treatment needs assessment skills to detect burns or infection, RN territory. Food reporting leverages assistants' observational role, aiding nurses in tracking radiation's impact on appetite, ensuring basic needs are flagged efficiently in a collaborative approach.
Glycaemic profiles of people with diabetes varies with all EXCEPT:
- A. Diet
- B. Exercise
- C. Stress
- D. Monitoring of blood glucose
Correct Answer: C
Rationale: Sugar swings food, sweat, drugs, checks shift it; dress' is a typo for stress, but stress fits, not fabric. Nurses track this chronic dance, not wardrobe.
A client is admitted with superior vena cava syndrome. What action by the nurse is most appropriate?
- A. Administer a dose of allopurinol (Aloprim).
- B. Assess the client's serum potassium level.
- C. Gently inquire about advance directives.
- D. Prepare the client for emergency surgery.
Correct Answer: C
Rationale: Superior vena cava syndrome (SVCS) occurs when cancer (often lung or lymphoma) obstructs the superior vena cava, impairing venous return from the head and upper body. It's often a late-stage manifestation with a poor prognosis, though treatable with radiation or stenting. After stabilizing the client (e.g., with oxygen, positioning), gently inquiring about advance directives is most appropriate, as it opens a compassionate discussion about goals of care amid a potentially terminal condition. Allopurinol and potassium levels relate to tumor lysis syndrome, not SVCS. Surgery is rare for SVCS, with non-invasive options preferred. This action respects the client's autonomy and prepares for realistic outcomes, aligning with oncology nursing's holistic approach to end-of-life care in advanced disease.
A nurse is caring for a client who has recently diagnosed with left ventricular heart failure. What is an early sign the client is most likely to report?
- A. Dyspnea on exertion
- B. Abdominal distention
- C. Swollen legs
- D. Weight gain
Correct Answer: A
Rationale: Left ventricular failure backs blood into lungs dyspnea on exertion hits early as fluid seeps, taxing breathing during activity, a telltale sign before systemic effects. Abdominal distention or leg swelling marks right-sided or late failure. Weight gain tracks fluid, not initial. Nurses catch dyspnea, educating clients to report it, key to early management in this progressive pump failure.
After receiving the hand-off report, which client should the oncology nurse see first?
- A. Client who is afebrile with a heart rate of 108 beats/min
- B. Older client on chemotherapy with mental status changes
- C. Client who is neutropenic and in protective isolation
- D. Client scheduled for radiation therapy today
Correct Answer: B
Rationale: In oncology nursing, prioritizing care is critical due to the complexity of cancer patients' conditions. An older client on chemotherapy with mental status changes is the priority because this could signal sepsis or infection, especially since chemotherapy-induced neutropenia often masks typical signs like fever in the elderly. Mental confusion might be the only early clue, and delayed assessment could lead to rapid deterioration or death. A heart rate of 108 beats/min without fever suggests tachycardia, possibly from dehydration or anxiety, but it's less urgent without other red flags. A neutropenic client in isolation needs monitoring, but no acute change is noted. The client scheduled for radiation has a planned treatment, not an immediate crisis. Assessing the older client first allows the nurse to rule out or address a life-threatening issue, aligning with the principle of prioritizing unstable patients in acute care settings.