Nokea
Which of the following is a late symptom of polycythemia vera?
- A. Headache.
- B. Dizziness.
- C. Pruritus.
- D. Shortness of breath.
Correct Answer: C
Rationale: Pruritus, especially after warm baths, is a late symptom of polycythemia vera due to increased histamine release from elevated basophils. Headache, dizziness, and shortness of breath are earlier symptoms related to increased blood viscosity and hypermetabolism.
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The nurse has attended a staff education program about blood transfusion reactions. Which of the following statements by the nurse would indicate a correct understanding of how to prevent a febrile reaction?
- A. The blood product recipient should be thoroughly screened for any infectious diseases.
- B. Leukocyte-reduced blood products should be used.
- C. A prescribed antihistamine should be administered before a transfusion.
- D. ABO compatibility should be verified between the blood donor and recipient before transfusion.
Correct Answer: B
Rationale: Leukocyte-reduced blood products minimize febrile reactions caused by white blood cell antigens. Screening for infectious diseases prevents disease transmission, antihistamines prevent allergic reactions, and ABO compatibility prevents hemolytic reactions, not febrile reactions.
A client who is recovering from a subtotal gastrectomy experiences dumping syndrome. The client asks the nurse, 'When will I be able to eat three meals a day again like I used to?' Which of the following responses by the nurse is most appropriate?
- A. Eating six meals a day is time-consuming, isn't it?'
- B. You will have to eat six small meals a day for the rest of your life.'
- C. You will be able to tolerate three meals a day before you are discharged.'
- D. Most clients can resume their normal meal patterns in about 6 to 12 months.'
Correct Answer: D
Rationale: Most clients can gradually resume a normal meal pattern (three meals a day) within 6 to 12 months as the body adapts post-gastrectomy, making this the most accurate and supportive response.
Which of the following findings would suggest pneumothorax in a trauma victim?
- A. Pronounced crackles.
- B. Inspiratory wheezing.
- C. Dullness on percussion.
- D. Absent breath sounds.
Correct Answer: D
Rationale: Absent breath sounds on the affected side suggest pneumothorax due to air in the pleural space. Crackles, wheezing, and dullness are more indicative of other conditions.
The nurse is preparing to administer an intramuscular (IM) injection to a neonate. Which gauge and size needle should the nurse use to administer the medication?
- A. 19 gauge, 1 1/2" (3.8 cm) needle
- B. 18 gauge, 1" (2.5 cm) needle
- C. 20 gauge, 1" (2.5 cm) needle
- D. 25 gauge, 5/8" (1.6 cm) needle
Correct Answer: D
Rationale: A 25-gauge, 5/8" needle is appropriate for neonates due to their small muscle mass and thin subcutaneous tissue, minimizing trauma.
The nurse is caring for a client who has had a gastroscopy. Which of the following signs and symptoms may indicate that the client is developing a complication related to the procedure? Select all that apply.
- A. The client has a sore throat.
- B. The client appears drowsy following the procedure.
- C. The client has epigastric pain.
- D. The client experiences hematemesis.
Correct Answer: C,D
Rationale: Epigastric pain and hematemesis after a gastroscopy may indicate complications such as perforation or bleeding. A sore throat and drowsiness are expected post-procedure effects due to throat irritation and sedation.