Nokea
Which of the following lab value profiles should the nurse know to be consistent with hemolytic anemia?
- A. Increased RBC, decreased bilirubin, decreased Hgb and Hct, increased reticulocytes
- B. Decreased RBC, increased bilirubin, decreased Hgb and Hct, increased reticulocytes
- C. Decreased RBC, decreased bilirubin, increased Hgb and Hct, decreased reticulocytes
- D. Increased RBC, increased bilirubin, increased Hgb and Hct, decreased reticulocytes
Correct Answer: B
Rationale: Hemolytic anemias are characterized by the premature destruction of red blood cells. As a result, the lab values typically seen in hemolytic anemia include decreased red blood cell counts (RBC), increased bilirubin (due to the breakdown of red blood cells), decreased hemoglobin (Hgb) and hematocrit (Hct) levels, and increased reticulocytes (immature red blood cells released from the bone marrow in response to the increased demand for red blood cell production). Therefore, profile B aligns with the expected lab values consistent with hemolytic anemia.
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A patient has end-stage dilated cardiomyopathy. He comes to the emergency department with dyspnea. He says he went to bed and awoke with a feeling of suffocation. He says it was frightening. Which of the ff. responses by the nurse is most appropriate?
- A. "You must have been dreaming."
- B. "Reclining decreases the heart's ability to pump blood." c."Sleeping increases heart rate, which increases the body's need for oxygen."
- C. "Reclining increases fluid returning to the heart, which builds up fluid in the lungs."
Correct Answer: C
Rationale: The most appropriate response by the nurse is option C, "Reclining increases fluid returning to the heart, which builds up fluid in the lungs." In a patient with end-stage dilated cardiomyopathy, reclining position can lead to increased fluid return to the heart due to the failing pump function. This can result in fluid backing up in the lungs, causing symptoms such as dyspnea or feeling of suffocation. By explaining this mechanism to the patient, the nurse can provide valuable information about the condition and the reason for the distressing symptoms experienced by the patient. It also highlights the importance of proper positioning to alleviate symptoms and improve the patient's comfort.
The child who can transfers object from hand to hand and babbles has achieved the developmental age of
- A. 4 months
- B. 6 months
- C. 8 months
- D. 10 months
Correct Answer: B
Rationale: Transferring objects and babbling typically occur around 6 months.
Which of the ff interventions is implemented for a client with empyema?
- A. Teach the client breathing exercises
- B. Offer assurance that empyema takes less time to resolve
- C. Recommend that the client eat a balanced but light diet
- D. Emphasize the completion of the entire course of drug therapy
Correct Answer: D
Rationale: Empyema is a serious infection that requires aggressive treatment with antibiotics. The client must complete the entire course of drug therapy as prescribed by the healthcare provider to ensure that the infection is completely eradicated. Failure to complete the full course of antibiotics can lead to antibiotic resistance and recurrence of the infection. It is crucial to emphasize to the client the importance of adhering to the prescribed treatment regimen to achieve a full recovery and prevent complications.
You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is
- A. vincristine
- B. cyclophosphamide
- C. cisplatin
- D. methotrexate
Correct Answer: C
Rationale: Cisplatin is a cornerstone in the treatment of germ cell tumors.
Niklaus was born with hypospadias; which of the following should be avoided when a child has such condition?
- A. Surgery
- B. Circumcision
- C. Intravenous pyelography (IVP)
- D. Catheterization
Correct Answer: B
Rationale: Hypospadias is a congenital condition where the opening of the urethra is located on the underside of the penis instead of the tip. If a child is born with hypospadias, circumcision should be avoided. Circumcision involves removing part of the foreskin, which can cause complications for children with hypospadias, such as affecting future surgical repair procedures or worsening the hypospadias itself. Therefore, it is recommended to avoid circumcision in children with hypospadias.