Nokea
Which of the ff. does the nurse understand usually precedes rheumatic fever?
- A. A viral infection
- B. A beta-hemolytic streptococcal
- C. A fungal infection infection c.A staphylococcal infection
Correct Answer: B
Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated infections caused by group A beta-hemolytic streptococci. These bacterial infections are usually in the form of strep throat or scarlet fever. Rheumatic fever typically occurs 2-4 weeks after a streptococcal infection. The body's immune response to the streptococcal infection can lead to an autoimmune reaction, resulting in rheumatic fever. It is important to promptly diagnose and treat streptococcal infections to prevent the development of rheumatic fever.
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A client with supraglottic cancer undergoes a partial laryngectomy. Postoperatively, a cuffed tracheostomy tube is in place. When removing secretions that pool above the cuff, the nurse should instruct the client to:
- A. Cough as the cuff is being deflated
- B. Hold the breath as the cuff is being re-inflated
- C. Take a deep breath as the nurse deflates the
- D. Exhale deeply as the nurse re-inflates the cuff cuff
Correct Answer: D
Rationale: The correct instruction for the client when removing secretions above the cuff of a tracheostomy tube is to exhale deeply as the nurse re-inflates the cuff. By having the client exhale deeply during cuff inflation, it helps to prevent aspiration of secretions or air into the lungs. This action also helps in securing an airtight seal around the tracheostomy tube before the normal breathing is resumed. It is crucial to promote the safety and prevent complications in clients with a tracheostomy tube, especially post partial laryngectomy.
Although most relapses in children with Wilms tumor occur early (within 2 yr of diagnosis) and have a favorable outcome, about 15% suffer relapse. Relapse includes all the following EXCEPT
- A. low stage (I/II) at diagnosis
- B. no prior radiotherapy
- C. anaplastic histology
- D. more than 12 mo from nephrectomy
Correct Answer: C
Rationale: Anaplastic histology is associated with a poorer prognosis and is not typically associated with favorable relapse outcomes.
A client is being returned to the room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?
- A. Indwelling urinary catheter kit
- B. Cardiac monitor
- C. Tracheostomy set
- D. Humidifier
Correct Answer: C
Rationale: Following a subtotal thyroidectomy, there is a risk of airway compromise and difficulty breathing due to the close proximity of the surgical site to the trachea. In case of swelling or other complications leading to airway obstruction, having a tracheostomy set readily available at the client's bedside is crucial for quick and efficient management of any respiratory distress. This equipment allows the healthcare team to establish a secure airway if needed, ensuring the client's safety and minimizing the risk of respiratory compromise post-operatively. The other equipment choices are important but having a tracheostomy set is the most critical for this particular situation to address potential airway issues promptly.
Which of the ff is a nursing intervention to ensure that the client is free from injury caused by falls?
- A. Nurse monitors for chest pain and elevated low-density lipoprotein levels
- B. Nurse monitors for swelling and heaviness of legs
- C. Nurse monitors postural changes in BP
- D. Nurse monitors temperature for mild fever
Correct Answer: B
Rationale: Monitoring for swelling and heaviness of legs is a nursing intervention that can help prevent falls. Swelling and heaviness of legs could indicate conditions such as edema or circulation problems, which may increase the risk of falls due to impaired mobility and stability. By identifying these signs early on, the nurse can intervene promptly to address the underlying issues and prevent potential falls. This proactive approach aligns with the goal of ensuring the client is free from injury caused by falls. Monitoring for chest pain and elevated low-density lipoprotein levels, postural changes in BP, or mild fever may be important for overall client care but are not directly related to fall prevention.
Which of the ff are the most significant symptoms of Hodgkin's disease category B? Choose all that apply
- A. Fever
- B. Anemia
- C. Night sweats
- D. Thrombocytopenia
Correct Answer: C
Rationale: The most significant symptoms of Hodgkin's disease with category B classification are fever, weight loss, and night sweats. Night sweats are particularly characteristic of Hodgkin's disease and are considered one of the B symptoms along with fever and weight loss. Anemia and thrombocytopenia are not typically classified as specific symptoms of Hodgkin's disease category B.