Nokea
Which of the following is a possible treatment plan for a client diagnosed with leukemia?
- A. Dialysis
- B. Therapeutic phlebotomy
- C. Splenectomy
- D. Stem cell transplant
Correct Answer: D
Rationale: Leukemia's marrow takeover needs a reset stem cell transplant swaps diseased cells for healthy ones, a potential cure or remission shot. Dialysis aids kidneys, not blood. Phlebotomy drains polycythemia. Splenectomy's rare, symptom-based. Nurses prep for transplant, eyeing this radical fix, a game-changer in leukemia's brutal playbook.
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A client is receiving treatment for the diagnosis of hemophilia A. Which of the following is the most appropriate to include in the assessment of this client?
- A. Cranial nerves
- B. Appetite
- C. Joint pain and bruising
- D. Urine output
Correct Answer: C
Rationale: Hemophilia A, a factor VIII deficiency, impairs clotting joint pain and bruising from hemarthrosis and bleeds are hallmark signs, demanding assessment to gauge bleeding severity and guide factor replacement. Cranial nerves check neurologic status, irrelevant unless bleeds hit the brain. Appetite or urine output offers general insight, not hemophilia-specific. Nurses zero in on joints and skin, tracking this genetic disorder's impact, critical for managing acute episodes and preventing long-term damage in this bleeding-prone client.
People with poorly controlled type 2 diabetes often show increased fasting blood glucose levels. Question: What causes these increased fasting blood glucose levels?
- A. Disturbed glucose uptake in adipose tissue due to insulin resistance
- B. Disturbed hepatic glucose uptake due to insulin resistance
- C. Disturbed suppression of hepatic glucose production by insulin
- D. Disturbed hepatic glucose uptake due to reduced insulin levels in portal blood
Correct Answer: C
Rationale: Type 2's fasting high liver pumps glucose, insulin can't hush it, resistance rules. Fat uptake's small, liver uptake's not key production's the leak nurses target this, a chronic dawn gush.
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching?
- A. The patient ambulates several times a day in the room
- B. The patient's visitors bring in some fresh peaches from home
- C. The patient cleans with a warm washcloth after having a stool
- D. The patient uses soap and shampoo to shower every other day
Correct Answer: B
Rationale: Neutropenia post-chemo low neutrophils craves germ-free zones; fresh peaches from home carry bacteria, a teaching gap as raw produce risks infection in this immune-wrecked state. Ambulation's safe, hygiene's spot-on washcloths and showers cut germs. Nurses reteach, banning unwashed fruit, a vital shield in leukemia's neutropenic peril, ensuring clients grasp this microbial minefield.
Hyperglycaemia is involved in cardiovascular complications in diabetes. There are several mechanisms through which high glucose levels in endothelial cells can lead to complications. Question: Which mechanism is NOT directly associated with cardiovascular complications in diabetes?
- A. Activation of PKC
- B. AGE pathway
- C. Sorbitol pathway
- D. Fatty acid oxidation
Correct Answer: D
Rationale: High glucose trashes vessels PKC, AGEs, sorbitol clog the works, but fatty acid burn's metabolic, not direct CV. Nurses spot this, a chronic heart sidestep.
For a patient who is experiencing side effects of radiation therapy, which task would be the most appropriate to delegate to the nursing assistant?
- A. Assist the patient to identify patterns of fatigue
- B. Recommend participation in a walking program
- C. Report the amount and type of food consumed from the tray
- D. Check the skin for redness and irritation after the treatment
Correct Answer: C
Rationale: Radiation side effects like fatigue and anorexia benefit from team care. Reporting food consumed from the tray suits nursing assistants observing and relaying intake data supports nutrition monitoring without requiring clinical judgment. Identifying fatigue patterns demands analysis, a nurse's role to adjust care plans. Recommending exercise exceeds assistants' scope physicians or RNs initiate such advice. Checking skin for redness post-treatment needs assessment skills to detect burns or infection, RN territory. Food reporting leverages assistants' observational role, aiding nurses in tracking radiation's impact on appetite, ensuring basic needs are flagged efficiently in a collaborative approach.