Nokea
Which of the following is a treatment option for a client with infective endocarditis?
- A. Bedrest
- B. Antimicrobials
- C. Diet modification
- D. Antihypertensive
Correct Answer: B
Rationale: Infective endocarditis bacterial valve infection needs antimicrobials to kill pathogens like *Streptococcus*, the root cause, halting damage and sepsis. Bedrest aids recovery but doesn't treat. Diet tweaks support health, not infection. Antihypertensives manage pressure, irrelevant to endocarditis's microbial core. Nurses anticipate antibiotics, often IV for weeks, targeting the source, a priority to save valves and lives in this high-mortality condition, aligning with infectious disease protocols.
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For a patient with osteogenic sarcoma, you would be particularly vigilant for elevations in which laboratory value?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Hematocrit
Correct Answer: B
Rationale: Osteogenic sarcoma, a bone cancer, often triggers hypercalcemia bone destruction releases calcium into blood, risking arrhythmias or kidney damage, a life-threatening shift demanding close watch. Sodium and potassium imbalances aren't bone-specific, more tied to general metabolism or treatment side effects. Hematocrit reflects anemia, common in cancer but not osteogenic sarcoma's hallmark. Calcium's spike, linked to osteolysis, makes it the nurse's focus elevations signal tumor activity or progression, prompting urgent interventions like fluids or bisphosphonates, a vigilance rooted in this cancer's skeletal impact and metabolic havoc.
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?
- A. Impaired nutritional status
- B. Cognitive changes
- C. Diarrhea
- D. Alopecia
Correct Answer: A
Rationale: Neck radiation hits the oral mucosa, salivary glands, and throat, causing mucositis, taste loss, pain, and dysphagia leading to impaired nutrition. Patients struggle to eat, risking weight loss and weakness, a top concern in head-and-neck cases. Cognitive changes tie to brain radiation, not neck. Diarrhea aligns with abdominal radiation, not this site. Alopecia occurs with whole-brain radiation, not localized neck treatment, where hair loss is minimal unless the scalp's in the field. Nurses must prep patients for these site-specific effects, ensuring dietary support (e.g., soft foods, supplements) to maintain strength through therapy, a key part of oncology 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.
The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take?
- A. Infuse the medication over a short period of time.
- B. Stop the infusion if swelling is observed at the site.
- C. Administer the chemotherapy through a small-bore catheter.
- D. Hold the medication unless a central venous line is available.
Correct Answer: B
Rationale: Vesicants (e.g., vincristine) burn tissue if they leak swelling at the site yells extravasation; stopping the IV stat limits necrosis. Fast infusion ups vein stress; small-bore risks rupture running IVs dilute it. Central lines are gold but not mandatory. Nurses in oncology prioritize this catching leaks early saves skin, a critical save in chemo land.
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.