Nokea
Which of the following clients is most at risk for developing endocarditis?
- A. A client who recently had a valve replacement and had dental work recently performed
- B. A client who recently underwent a valve replacement
- C. A client with Marfan's syndrome
- D. A client recently diagnosed with mitral stenosis
Correct Answer: A
Rationale: Endocarditis loves damaged valves and bacteremia recent valve replacement plus dental work (a bacterial gateway) spikes risk, as prosthetic valves are prime targets post-procedure. Valve replacement alone risks less without a trigger. Marfan's or mitral stenosis predispose, but lack acute catalysts like dental work. Nurses flag this combo surgery and oral breach anticipating prophylaxis or monitoring, a top risk in endocarditis's infectious playbook.
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Rehabilitation utilises two types of rehabilitation interventions. The goal of the intervention support is to
- A. Maintaining existing abilities
- B. Restoring function
- C. Preventing deterioration and further disability
- D. Maintaining existing abilities while preventing new or further disabilities
Correct Answer: D
Rationale: Rehab's dual play hold steady, fend off worse blends maintenance and prevention, a chronic balance. Nurses aim here, a full guard.
When conventional routes of analgesia have been unsuccessful or are contraindicated for chronic pain syndromes, intrathecal drug delivery systems may be considered. Appropriate indications are likely to include:
- A. Patients with cancer-related pain in whom life expectancy is estimated to be >3 months.
- B. Chronic pancreatitis.
- C. Haematuria loin pain syndrome.
- D. Chronic low back pain.
Correct Answer: A
Rationale: Intrathecal drug delivery systems (IDDS) treat severe, refractory pain. Cancer pain with >3 months life expectancy justifies IDDS, balancing implantation risks with prolonged benefit shorter expectancy favors simpler methods. Chronic pancreatitis may respond, but evidence is weaker; it's not a primary indication. Haematuria loin pain syndrome (loin pain haematuria syndrome) is niche, rarely managed with IDDS due to limited data. Chronic low back pain often fails conservative treatment, but IDDS is reserved for extreme cases (e.g., failed back surgery syndrome), not routine. Chronic refractory angina is cardiac, not typically IDDS-eligible. Cancer pain's prevalence, severity, and responsiveness to intrathecal opioids/ziconotide make it the clearest indication, optimizing quality of life in palliative care.
An intra-venous drug user with endocarditis has a TOE and multiple blood cultures taken. He is most likely to have:
- A. tricuspid valve involvement and s.aureus on blood culture
- B. tricuspid valve involvement and enterococci on blood culture
- C. mitral valve involvement and mixed growth on blood culture
- D. tricuspid valve involvement and candida on blood culture
Correct Answer: A
Rationale: IVDU endocarditis tricuspid flops, Staph aureus spikes, not enterococci, mixed, candida, or blanks. Nurses hear this chronic junkie beat.
A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?
- A. Assessing the IV site every hour
- B. Educating the client on side effects
- C. Monitoring the client for nausea
- D. Providing warm packs for comfort
Correct Answer: A
Rationale: Chemotherapy drugs administered via peripheral IV can be vesicants, meaning they can cause severe tissue damage if they leak (extravasate) into surrounding tissues. Peripheral lines are more prone to this than central lines due to smaller vein size and less secure placement. Assessing the IV site hourly or per facility policy is the most important action to prevent extravasation, ensuring the line remains patent and no swelling, redness, or pain develops. Early detection allows prompt intervention, like stopping the infusion, to minimize harm. Educating about side effects and monitoring for nausea are key aspects of care but address systemic effects, not the immediate risk of local tissue injury. Warm packs might soothe discomfort but could worsen damage if extravasation occurs. Prioritizing IV site assessment reflects the nurse's role in safety and prevention, critical in oncology where chemotherapy's potency demands vigilant monitoring to protect the client from serious complications.
Which of the following options applies to the accumulation of macrophages in adipose tissue?
- A. This accumulation has been shown in mice but not in humans
- B. This accumulation is negatively correlated with the size of the adipose cells
- C. This accumulation cannot be influenced by weight reduction
- D. None of the options applies
Correct Answer: D
Rationale: Macrophages swarm fat in humans big cells pull them, weight loss shrinks the crowd, not mouse-only or stuck. Nurses see this, a chronic inflammation truth.