Which of the following cancer patients could potentially be placed together as roommates?
- A. A patient with a neutrophil count of 1000/mm³
- B. A patient who underwent debulking of a tumor to relieve pressure
- C. A patient receiving high-dose chemotherapy after a bone marrow harvest
- D. A patient who is post-op laminectomy for spinal cord compression
Correct Answer: B
Rationale: Roommate pairing hinges on infection risk and care needs. The debulking patient tumor reduced for symptom relief and post-laminectomy patient spinal decompression both underwent palliative surgeries, not inherently immunocompromised, making them compatible. A neutrophil count of 1000/mm³ signals moderate neutropenia, needing isolation to dodge infections. High-dose chemotherapy post-bone marrow harvest obliterates immunity, demanding strict protection. The surgical pair's stability, lacking acute immune suppression, allows safe cohabitation, a nurse's practical call to optimize space and reduce cross-infection risks in cancer care settings.
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The followings are risk factors associated with non-alcoholic fatty liver disease (NAFLD) except:
- A. Elevated uric acid
- B. Elevated blood pressure
- C. Diabetes mellitus
- D. Elevated LDL-cholesterol
Correct Answer: A
Rationale: NAFLD ties to metabolic mess hypertension, diabetes, high LDL, and triglycerides fuel fat's liver pile-up, all in. Uric acid links to gout, not NAFLD's core, despite metabolic overlap. Clinicians eye this quartet, not urate, in chronic liver fat's risk map, a key split.
You are monitoring your client who is at risk for spinal cord compression related to tumor growth. Which client statement is most likely to suggest early manifestation?
- A. Last night my back really hurt, and I had trouble sleeping
- B. My leg has been giving out when I try to stand
- C. My bowels are just not moving like they usually do
- D. When I try to pass my urine, I have difficulty starting the stream
Correct Answer: A
Rationale: Spinal cord compression from tumors strikes early with back pain reported in 95% of cases as vertebral pressure or nerve irritation flares, a red flag needing urgent imaging to prevent paralysis. Leg weakness signals motor loss, a later sign as compression worsens. Bowel or bladder issues like constipation or hesitancy mark advanced nerve involvement, not initial hints. Nurses prioritize this pain statement, recognizing its prevalence and timing, prompting swift action like steroids or surgery to halt progression, critical in cancer clients where spinal integrity dictates mobility and survival.
The best way to prevent chronic complications of diabetes is to:
- A. Take medications as prescribed and remove sugar from the diet completely.
- B. Check feet daily for cuts, long toe nails and infections between the toes.
- C. Maintain a BGL that is as close to normal as possible.
- D. Undertake daily exercise to burn up the excess glucose in the system.
Correct Answer: C
Rationale: Preventing diabetes complications (e.g., neuropathy, retinopathy) hinges on glycemic control. Medications and sugar elimination help, but total sugar removal is impractical carbohydrates are broader, and control, not absence, matters. Daily foot checks prevent ulcers but address consequences, not root causes. Maintaining blood glucose levels (BGL) near normal (e.g., HbA1c <7%) via diet, exercise, and drugs prevents microvascular (kidney, eye) and macrovascular (heart) damage, per ADA guidelines. Exercise burns glucose, aiding control, but isn't singularly best' it's part of a triad. Tight BGL management reduces oxidative stress, glycation, and vascular injury, evidenced by trials (e.g., DCCT), making it the cornerstone strategy over isolated tactics, ensuring long-term organ protection.
Cardiac catheterisation (angiography) is performed to assess blood flow through the coronary arteries through use of a contrast agent and radiographic imaging. The nursing responsibilities in caring for the patient post angiography do not include:
- A. Applying pressure and observing the insertion site for bleeding or haematoma formation
- B. Informing the patient of the findings of the angiogram to allay fear and provide reassurance
- C. Monitor for arrhythmias by both cardiac monitoring and assessing apical or peripheral pulses
- D. Encourage fluids to increase urinary output and flush out the dye
Correct Answer: B
Rationale: Post-angio, nurses press sites, watch rhythms, flush dye hands-on musts. Telling results? Docs' turf nurses soothe, don't spill, a chronic care line.
A 56-year-old patient comes to the walk-in clinic for scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history for colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?
- A. Diarrhea/Constipation related to altered bowel patterns
- B. Knowledge Deficit related to disease process and diagnostic procedure
- C. Risk for Fluid Volume Deficit related to rectal bleeding and diarrhea
- D. Anxiety related to unknown outcomes and perceived threat to body integrity
Correct Answer: D
Rationale: The patient's anger and threat to leave during colonoscopy teaching signal emotional distress overriding physical symptoms. Anxiety stemming from uncertain outcomes and perceived bodily threat fits, as colorectal cancer risk tied to polyps and family history heightens fear, blocking education uptake. Diarrhea/constipation reflects symptoms but isn't immediately urgent with scant bleeding. Knowledge deficit exists but is secondary fear drives the refusal, not just ignorance. Fluid volume risk is plausible with bleeding, yet no data suggests acute loss; stability allows focus on emotions. Addressing anxiety first calms the patient, enabling teaching and care, a priority in this tense encounter where psychological barriers could delay critical colorectal screening and intervention.