Nokea
Which of the following factors has a major impact on the development of chronic illness?
- A. Poverty
- B. Social stability
- C. Urban dwelling
- D. High school diploma
Correct Answer: A
Rationale: Poverty slams chronic illness cash shortages spike stress, skimp care, and fuel risks like poor diet, a root driver nurses see in diabetes or heart woes. Stability's a buffer, urban life's neutral, education helps but lacks poverty's punch. Socioeconomic holes breed disease, a chronic trap clinicians fight.
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Damage control resuscitation:
- A. Is not indicated unless it is clear the patient's physiology has been deranged by severe injury.
- B. Is not indicated unless the patient is in the hospital.
- C. Is likely to involve restriction of fluid administration in a hypotensive, bleeding patient.
- D. Is likely is be assessed for adequacy by palpation of the radial pulse in patients with a head injury.
Correct Answer: C
Rationale: Damage control resuscitation (DCR) mitigates trauma's lethal triad (hypothermia, acidosis, coagulopathy). It's indicated preemptively in severe bleeding, not just post-derangement, to prevent physiologic collapse. It begins pre-hospital (e.g., paramedics), not only in-hospital, using blood products early. Fluid restriction in hypotensive bleeding limits dilutional coagulopathy, favoring permissive hypotension until haemostasis crucial in uncontrolled haemorrhage. Radial pulse palpation gauges perfusion broadly, but head injury patients need cerebral perfusion pressure prioritization, not DCR adequacy. ABC remains foundational. Fluid restriction's role balancing shock correction with bleeding exacerbation defines DCR's shift from crystalloid overload, improving survival in exsanguinating trauma.
The client is diagnosed with laryngeal cancer and is scheduled for a laryngectomy next week. Which intervention would be priority for the clinic nurse?
- A. Assess the client's ability to swallow
- B. Refer the client to a speech therapist
- C. Order the client's preoperative lab work
- D. Discuss the client's operative unit
Correct Answer: B
Rationale: Laryngectomy severs voice referring to a speech therapist pre-op sets up post-surgical communication, a priority as clients lose speech, facing isolation without aids like electrolarynx training. Swallowing matters, but airway and cancer trump function now. Labs are routine, delegated often; unit talk's secondary. Nurses push this referral, easing the mute transition, a proactive step in laryngeal cancer's life-altering prep, ensuring clients adapt to this voiceless future from day one.
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?
- A. I've had a backache for several days
- B. I feel nauseated and have no appetite
- C. I can walk a mile a day
- D. I am urinating more frequently
Correct Answer: B
Rationale: Digoxin's tightrope nausea and anorexia flag toxicity, a common adverse hit as levels climb, risking arrhythmias. Backache's vague, walking's a win, urination's unrelated. Nurses catch this, checking levels, a red light in this heart-boosting med's dance.
Which of the following statements applies best to the effect of fear appeals?
- A. Fear appeals motivate people to adopt healthier behaviour
- B. Fear appeals lead to avoidance and denial
- C. Fear appeals help to show the negative consequences of unhealthy behaviour
- D. Fear appeals make people avoid unhealthy behaviour
Correct Answer: B
Rationale: Fear appeals backfire denial trumps motivation, showing cons or dodging acts. Nurses see this, a chronic scare flop.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.