Which of the following is a priority nursing intervention for a client in atrial fibrillation with a rate of 180 beats per minute?
- A. Apply compression stockings
- B. Administer medications to slow the rate
- C. Administer anticoagulants
- D. Monitor urine output
Correct Answer: B
Rationale: AF at 180 bpm tanks output meds like beta-blockers or amiodarone slow it, restoring flow, a priority per ABCs over stockings' vein aid. Anticoagulants curb clots later; urine's secondary. Nurses push rate control, steadying this wild heart, a critical fix in this tachycardic storm.
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When assignments are being made for clients with alterations related to gastrointestinal (GI) cancer, which client would be the most appropriate to delegate to an LPN/LVN?
- A. A client with severe anemia secondary to GI bleeding
- B. A client who needs enemas and antibiotics to control GI bacteria
- C. A client who needs preoperative teaching for bowel resection surgery
- D. A client who needs central line insertion for chemotherapy
Correct Answer: B
Rationale: Delegating in GI cancer care hinges on scope LPN/LVNs handle routine tasks like administering enemas and antibiotics, a straightforward intervention to curb bacteria, fitting their training under RN oversight. Severe anemia from bleeding demands RN assessment for stability or transfusion, beyond LPN scope. Preoperative teaching requires detailed education and evaluation, an RN's domain. Central line insertion involves advanced skills and risks, reserved for RNs or specialists. Enemas and antibiotics align with LPN/LVN capabilities, optimizing team roles while keeping complex care with RNs, a practical choice in managing GI cancer's multifaceted needs safely and efficiently.
Which of the following statements on NAFLD is false?
- A. Weight loss is the prime way of management
- B. Long-term management is needed
- C. Patients should be referred to specialists for further evaluation
- D. Metformin should be used as first-line treatment in patients with NAFLD and diabetes mellitus
Correct Answer: D
Rationale: Weight loss (5-10%) is prime for NAFLD, long-term care is essential, and specialist referral aids complex cases all true. Statins manage dyslipidemia safely in NAFLD. Metformin, though first-line for diabetes, isn't for NAFLD itself lacking evidence for steatosis reversal making this false. Physicians must clarify this in chronic care planning.
A 66 year old man has recently been diagnosed with hypertension. He has no history of heart disease and diabetes mellitus. His average blood pressure is recorded as 154/82 mmHg. What is the MOST appropriate first line pharmacological therapy?
- A. Angiotensin converting enzyme-inhibitors
- B. Angiotensin receptor blockers
- C. Thiazide diuretics
- D. Calcium channel blockers
Correct Answer: C
Rationale: New hypertension at 66, 154/82 no heart or sugar issues thiazide diuretics kick off gentle, effective control, especially in older adults. ACE inhibitors or ARBs fit if kidneys or diabetes pop up; calcium blockers work but aren't first; beta blockers lag unless heart history. Nurses lean on thiazides cheap, proven for this chronic pressure nudge, keeping it simple and safe.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?
- A. Periodically apply ice to the area
- B. Keep the area cleanly shaven
- C. Apply petroleum jelly to the affected area
- D. Avoid using soap on the treatment area
Correct Answer: D
Rationale: Radiation erythema red, raw skin needs gentle care to dodge worsening. Soap dries and irritates, stripping fragile skin and upping infection risk, so skipping it's key. Ice or heat can burn or blister radiated tissue, already thin and sensitive. Shaving scrapes it raw; petroleum jelly traps moisture, breeding bacteria. Nurses teach this to protect the site, pushing mild cleansers (if needed) and air exposure, standard in oncology to heal radiation burns without sparking new problems.
For a patient on the chemotherapeutic drug vincristine (Oncovin), which of the following side effects should be reported to the physician?
- A. Fatigue
- B. Nausea and vomiting
- C. Paresthesia
- D. Anorexia
Correct Answer: C
Rationale: Vincristine, a vinca alkaloid, disrupts nerve function, making paresthesia tingling or numbness a critical side effect signaling neurotoxicity, warranting physician review for dose adjustment or cessation. Fatigue, nausea, and anorexia, while common in chemotherapy, are manageable with nursing interventions rest, antiemetics, small meals unless severe. Paresthesia's specificity to vincristine's mechanism, targeting microtubules, elevates its urgency; unchecked, it risks permanent nerve damage, impacting mobility and quality of life. Reporting it ensures timely intervention, distinguishing it from routine effects, a key nursing responsibility in monitoring chemotherapy's narrow therapeutic window.