Nokea
Which of the following appropriately describes diastolic dysfunction?
- A. The rate of filling of the ventricles during diastole is slowed
- B. The left ventricle is dilated
- C. The preload (end ventricular diastolic volume) is increased
- D. The left ventricular ejection fraction is decreased
Correct Answer: A
Rationale: Diastolic dysfunction stiffens ventricles slowed filling in diastole nails it, as relaxation flops, hiking pressure. Dilated LV or high preload fits systolic; low EF's not here preserved in HFpEF. Dyssynchrony's another beast. Clinicians peg this slow fill, a chronic heart kink distinct from pump fail.
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The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?
- A. Tumor lysis syndrome (TLS)
- B. Syndrome of inappropriate antidiuretic hormone (SIADH)
- C. Disseminated intravascular coagulation (DIC)
- D. Hypercalcemia
Correct Answer: A
Rationale: Non-Hodgkin lymphoma's fast cell turnover, plus recent chemo, primes for TLS dead cells dump potassium, phosphorus, and uric acid, risking kidney failure days post-treatment. SIADH (low sodium) and hypercalcemia (bone mets) are less tied to this timeline. DIC's bleeding chaos isn't lymphoma's usual post-chemo hit. Nurses hunt TLS signs fatigue, nausea, arrhythmias knowing it's a fatal oncology curveball if missed early.
The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
- A. Poor oral intake
- B. Frequent loose stools
- C. Complaints of nausea and vomiting
- D. Increase in carcinoembryonic antigen (CEA)
Correct Answer: D
Rationale: Colorectal cancer's chemo tracks via CEA rising levels signal progression or resistance, a red flag for therapy tweak, needing provider input. Poor intake, diarrhea, and nausea are side effects, manageable with nursing care diet, fluids, antiemetics unless extreme. CEA's uptick, a tumor marker, trumps symptoms, hinting at disease outpacing treatment. Nurses flag this, pushing for scans or regimen shifts, a critical catch in this cancer's chemo dance.
The nurse is assessing a 14-year-old girl with a tumor. Which of the following findings would indicate Ewing sarcoma?
- A. Child complains of dull bone pain just above the knee.
- B. Palpation reveals non-tender swelling on the right ribs.
- C. Parents report a mass on the abdomen that crosses the midline.
- D. Palpation reveals asymptomatic mass on the upper back.
Correct Answer: B
Rationale: Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents, typically arising in flat bones like the pelvis, chest wall (e.g., ribs), or vertebrae, and the diaphysis of long bones. A hallmark is a palpable, non-tender mass, making non-tender swelling on the ribs a strong indicator, as it aligns with the tumor's common chest wall location and lack of initial pain sensitivity. Dull bone pain above the knee suggests a long bone issue, possibly osteosarcoma, which favors the metaphysis, not Ewing's typical diaphysis site. An abdominal mass crossing the midline is more characteristic of Wilms tumor or neuroblastoma, not Ewing sarcoma. An asymptomatic upper back mass could suggest various tumors, but lacks specificity for Ewing's flat bone preference. Nurses must recognize this presentation to facilitate prompt imaging and biopsy, critical for early diagnosis and treatment planning in pediatric oncology.
The nurse assesses a client and documents the following findings: edema 2+ bilateral ankles, brown pigmentation of lower extremity skin, aching pain of lower extremities when standing that resolves with elevation, and 2+ pedal pulses. What condition does the client likely have?
- A. Deep vein thrombosis
- B. Raynaud's disease
- C. Venous insufficiency
- D. Peripheral arterial disease
Correct Answer: C
Rationale: Venous insufficiency pools blood 2+ edema, brown pigmentation from hemosiderin, aching relieved by elevation, and decent pulses fit, as veins fail while arteries hold. DVT clots acutely, often unilateral. Raynaud's spasms, not pigments. PAD dims pulses, pains with walking. Nurses peg this chronic venous flop, suggesting hose or elevation, a textbook stasis tale.
The nursing considerations that should be applied when assisting diabetics in management of their condition does not include:
- A. BGL monitoring, medications and compliance with treatment and medication
- B. Recognition and early intervention of potential complications
- C. Skin and foot care, including pressure area care when hospitalised
- D. Minimising exercise to prevent fatigue and foot ulcers
Correct Answer: D
Rationale: Diabetes nursing BGLs, meds, complication spots, skin/foot TLC all key. No exercise? Flops movement cuts sugar, boosts health, not ulcers. Nurses nix this, a chronic active push.