Nokea
Which of the following BP changes alerts the nurse to increasing ICP, and should be reported immediately?
- A. Gradual increase
- B. Widening pulse pressure
- C. Rapid drop followed by gradual increase
- D. Rapid fluctuations
Correct Answer: B
Rationale: Widening pulse pressure is indicative of increasing intracranial pressure (ICP) and must be reported immediately. Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure. An increasing pulse pressure can suggest a rise in ICP due to factors like cerebral edema or hemorrhage. This change indicates increased pressure exerted on blood vessels within the brain, potentially leading to serious consequences like brain herniation. Thus, recognizing and promptly reporting a widening pulse pressure is crucial to prevent further complications and enable appropriate interventions for the patient.
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Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely "asleep" during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: C
Rationale: For a preschool child, the appropriate explanation about cardiac catheterization would be that the test is short, usually taking less than 1 hour. This explanation is suitable for a preschool child because it provides a simple and clear understanding of what to expect during the procedure. Preschool-aged children have limited attention spans and may become anxious about medical procedures, so providing a concise and reassuring explanation can help alleviate their fears. Additionally, knowing that the test will not take a long time can help the child feel more at ease about the procedure.
A healthy 20-day-old male examination reveals a palpable liver margin below the right costal margin; lab findings: white blood count, 18700/mm3; hemoglobin, 8.8 g/dl; blast cells, 10%; the BEST approach for the management is consistent with acute myeloproliferative disorder
- A. intensive chemotherapy
- B. low dose chemotherapy pulses
- C. bone marrow transplantation
- D. close follow up
Correct Answer: A
Rationale: Intensive chemotherapy is the standard approach for managing acute myeloproliferative disorders.
all the following are major signs of DM except :
- A. polydipsia
- B. hypernatremia
- C. polyphagia
- D. hyporeflexia and bradycardia
Correct Answer: D
Rationale: Hyporeflexia (reduced deep tendon reflexes) and bradycardia (slow heart rate) are not typical signs of diabetes mellitus (DM). The major signs of DM are the classic "3 Ps": polydipsia (excessive thirst), polyuria (excessive urination), and polyphagia (excessive hunger). These symptoms are usually due to elevated blood glucose levels leading to increased thirst, frequent urination, and hunger. Additionally, unexplained weight loss can also be a common symptom of DM. Other complications related to DM, such as neuropathy, can lead to issues like hyporeflexia, but they are not considered major signs of DM itself.
The adrenal cortex is responsible for producing which substances?
- A. Glucocortocoids and androgens
- B. Mineralocortiroids and
- C. Catecholamines and epinephrine catecholamines
- D. Norepinephine and epinephrine
Correct Answer: A
Rationale: The adrenal cortex is the outer portion of the adrenal glands and is responsible for producing hormones known as corticosteroids. Within the corticosteroids, the adrenal cortex produces glucocorticoids (such as cortisol) which are involved in regulating metabolism and the immune response. Additionally, the adrenal cortex produces androgens which are male sex hormones, although they are present in both males and females. Therefore, the correct substances produced by the adrenal cortex are glucocorticoids and androgens (Choice A).
A client is receiving the cell cycle-nonspecific alkylating agent thiotepa (thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?
- A. It interferes with deoxyribonucleic acid (DNA) replication only.
- B. It interferes with ribonucleic acid (RNA) transcription only.
- C. It interferes with DNA replication and RNA transcription.
- D. It destroys the cell membrane, causing lysis.
Correct Answer: C
Rationale: Thiotepa is a cell cycle-nonspecific alkylating agent that exerts its therapeutic effects by interfering with both DNA replication and RNA transcription. The alkylating properties of thiotepa lead to the cross-linking of DNA strands, ultimately inhibiting DNA replication. Additionally, thiotepa can also disrupt RNA synthesis, further affecting protein production and cell function. This combined action on DNA replication and RNA transcription contributes to the cytotoxic effects of thiotepa on rapidly dividing cancer cells.