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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A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching?
- A. Foods high in vitamin A and vitamin C are important.
- B. I'll have to cut down on the amount of bacon I eat.
- C. I'm so glad I don't have to give up my juicy steaks.
- D. Vegetables, fruit, and high-fiber grains are important.
Correct Answer: C
Rationale: Diet plays a significant role in cancer prevention, and nurses often educate clients on evidence-based dietary adjustments. Foods rich in vitamins A and C, such as carrots and citrus fruits, are known to have antioxidant properties that may reduce cancer risk by neutralizing free radicals. Reducing processed meats like bacon is advised due to their association with colorectal cancer, linked to nitrates and high fat content. Similarly, high vegetable, fruit, and fiber intake is recommended for their protective effects against various cancers, including colon cancer. However, excessive red meat consumption, such as steaks, is a known risk factor for cancers like colorectal and prostate cancer due to saturated fats and carcinogenic compounds formed during cooking. The client's statement about not giving up steaks suggests a misunderstanding, indicating the nurse must clarify that limiting red meat, not just processed meat, is part of a cancer-preventive diet. This additional teaching is essential to ensure the client adopts a comprehensive approach to reducing cancer risk.
The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment?
- A. I have frequent muscle aches and pains.'
- B. I rarely have the energy to get out of bed.'
- C. I experience chills after I inject the interferon.'
- D. I take acetaminophen (Tylenol) every 4 hours.'
Correct Answer: B
Rationale: Interferon's flu-like hell aches , chills , and Tylenol use are par but crushing fatigue flags dose-limiting toxicity, hinting at overdose or depression. Nurses in oncology dig deeper here rarely out of bed' could mean more than side effects, needing med tweaks or psych consult, critical for home care balance.
Choose the CORRECT statement Babies born from mothers with gestational diabetes:
- A. Are at a high risk of being born with diabetes
- B. Are usually hypoglycaemic due to maternal insulin drug therapy
- C. Are usually of higher birth weight
- D. Are always given a glucose challenge test
Correct Answer: C
Rationale: Gestational diabetes fattens babies high maternal sugar pumps fetal growth, a hefty birth norm. They don't inherit diabetes at birth, hypo's rare unless mom's on insulin, tests aren't routine. Nurses track this, a chronic womb echo.
A client has a platelet count of 9800/mm^3. What action by the nurse is most appropriate?
- A. Assess the client for calf pain, warmth, and redness.
- B. Instruct the client to call for help to get out of bed.
- C. Obtain cultures as per the facility's standing policy.
- D. Place the client on protective isolation precautions.
Correct Answer: B
Rationale: A platelet count of 9800/mm^3 is severely low (normal is 150,000-450,000/mm^3), indicating thrombocytopenia, a common chemotherapy side effect that heightens bleeding risk. The most appropriate action is instructing the client to call for help before getting out of bed to prevent falls or injuries that could trigger uncontrolled bleeding, such as intracranial hemorrhage. Assessing for calf pain, warmth, and redness checks for thrombosis, which is unrelated to low platelets thrombosis risk rises with high counts. Obtaining cultures relates to infection, tied to low white cells, not platelets. Protective isolation is for neutropenia, not thrombocytopenia. This safety-focused intervention minimizes physical risk, crucial in oncology where low platelets demand proactive prevention to avoid life-threatening bleeds, empowering the client while ensuring nurse oversight.
The immediate nursing care to be provided to a patient presenting with a suspected ischaemic stroke include:
- A. Position on left lateral side, insert nasogastric tube, conduct an ECG and insert an IV line
- B. Primary/Secondary survey, give analgesia, 4th hourly neuro obs and vital signs, maintain oral intake
- C. Primary/Secondary survey, 4th hourly neuro obs and vital signs, monitor BGL and maintain nil by mouth
- D. 4th hourly neuro obs and vital signs, monitor BGL, insert an IV line and reduce intracranial pressure by positioning and reduced stimulation
Correct Answer: C
Rationale: Stroke hits fast surveys spot deficits, neuro obs track brain, vitals catch crashes, BGL rules out mimics, and nil by mouth preps for scans or clots, a tight first step. Lateral's for airways, not here; analgesia's late; IVs and ICP control follow. Nurses nail this, racing for tPA windows, a chronic precursor's acute kickoff.