Nokea
Which of the following is not a criterion for a valid informed consent that a nurse should identify?
- A. freely given
- B. with coercion
- C. has an explanation of procedures
- D. describes the alternatives
Correct Answer: B
Rationale: Coercion should not be involved in obtaining informed consent as it undermines the voluntary nature of the decision-making process. Informed consent should be freely given by the patient without any form of pressure or manipulation. The other criteria for valid informed consent that a nurse should identify include that it is freely given, includes an explanation of procedures, and describes the alternatives available to the patient.
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Which of the following malignant tumors is least likely to occur in adults in comparison with children?
- A. acute Lymphoblastic Leukemia (ALL)
- B. osteosarcoma
- C. medulloblastoma
- D. retinoblastoma
Correct Answer: D
Rationale: Retinoblastoma predominantly occurs in children under 5 years of age, making it the least likely to occur in adults.
An adult is to receive narcotic analgesics via patient controlled analgesia. The nurse is evaluating client's understanding of the procedure. Which of the following statements by the client indicates that she understand PCA?
- A. When I press this button the machine will always give me more medicine
- B. I will press the button whenever I feel pain
- C. I should press this button every hour so the pain doesn't come back
- D. With this machine I will experience no more pain
Correct Answer: B
Rationale: Statement B, "I will press the button whenever I feel pain," indicates that the client understands how to use the patient-controlled analgesia (PCA). PCA systems are designed to allow patients to self-administer a predetermined dose of pain medication when needed. This statement demonstrates the client's comprehension that it is appropriate to use the PCA when pain is experienced, navigating the misunderstanding that pressing the button will always give more medicine (A), that it should be pressed on a scheduled basis regardless of pain (C), or that it will completely eliminate pain (D).
The physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in situ in several bladder regions. To treat bladder cancer, the client will have a series of intravesical instillations of bacillus Calmette-Guerin (BCG), administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes:
- A. Renal calculi
- B. Delayed ejaculation
- C. Hematuria
- D. Impotence
Correct Answer: C
Rationale: Bacillus Calmette-Guerin (BCG) is a form of immunotherapy used to treat bladder cancer by stimulating the immune system to attack cancer cells in the bladder. One of the common side effects of BCG therapy is hematuria, which is the presence of blood in the urine. This can be expected due to the irritation caused by the BCG instillations in the bladder lining. Hematuria is usually mild to moderate and can resolve on its own without specific treatment.
Which of the following statements is true regarding Joel's disorder? a.Hemophilia is an autosomal dominant disorder in which the woman carries the trait
- A. Hemophilia follows regular laws of Mendelian inherited disorders such as sickle ceil anemia
- B. This disorder can be carried by either male or female but occurs in the sex opposite that of the carrier
- C. Hemophilia is an X-linked disorder in which the mother is usually the carrier of the illness but is not affected by it
Correct Answer: C
Rationale: Hemophilia is an X-linked disorder, meaning the gene responsible for hemophilia is carried on the X chromosome. Typically, hemophilia is passed down from a carrier mother to her male offspring who then express the disorder. This is because males have only one X chromosome (inherited from their mother), making them more vulnerable to X-linked disorders. Females have two X chromosomes, which means that even if one carries the hemophilia gene, the other X chromosome may carry a normal gene that can compensate, making females less likely to exhibit symptoms of hemophilia. In this case, Joel's disorder aligns with the typical pattern of inheritance for hemophilia as described in statement C.
A seizure characterized by loss of consciousness and tonic spasms of the trunk and extremities rapidly followed by repetitive generalized clonic jerking is classified as:
- A. Focal seizure
- B. Jacksonian seizure
- C. Generalized seizure
- D. Partial seizure
Correct Answer: C
Rationale: The description provided aligns with the characteristics of a generalized seizure. Generalized seizures involve abnormal electrical activity in the entire brain, leading to loss of consciousness and widespread motor symptoms, such as tonic (stiffening) and clonic (jerking) movements affecting both sides of the body. Examples of generalized seizures include tonic-clonic seizures (formerly known as grand mal seizures) where there is a sequence of tonic stiffness followed by clonic jerking. In contrast, focal (partial) seizures originate in a specific area of the brain and may result in localized symptoms before possibly spreading to involve both sides of the brain. Jacksonian seizures specifically refer to focal seizures with motor symptoms that spread in a stepwise fashion, starting from one part of the body.