Nokea
Which of the following nursing interventions would be appropriate for a client with sickle cell disease?
- A. Prepare the client for surgery
- B. Encourage fluid intake
- C. Provide a warm environment
- D. Keep the client strictly NPO
Correct Answer: B
Rationale: Sickle cell's sticky cells crave hydration fluids thin blood, easing vaso-occlusion, a top intervention to cut crisis. Surgery's rare, warmth helps pain, NPO starves. Nurses push intake, preventing sickling, a hydration win in this hemoglobin war.
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All of the following are true about erysipelas EXCEPT
- A. facial and scalp manifestations occur in infants and the elderly
- B. it progresses to skin desquamation
- C. bacteremia common in the lower extremity manifestations
- D. fever
Correct Answer: C
Rationale: Erysipelas face, scalp, peeling, fever, sharp edge fit; bacteremia's rare, not common. Nurses mark this chronic skin truth.
A 56-year-old patient comes to the walk-in clinic for scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history for colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?
- A. Diarrhea/Constipation related to altered bowel patterns
- B. Knowledge Deficit related to disease process and diagnostic procedure
- C. Risk for Fluid Volume Deficit related to rectal bleeding and diarrhea
- D. Anxiety related to unknown outcomes and perceived threat to body integrity
Correct Answer: D
Rationale: The patient's anger and threat to leave during colonoscopy teaching signal emotional distress overriding physical symptoms. Anxiety stemming from uncertain outcomes and perceived bodily threat fits, as colorectal cancer risk tied to polyps and family history heightens fear, blocking education uptake. Diarrhea/constipation reflects symptoms but isn't immediately urgent with scant bleeding. Knowledge deficit exists but is secondary fear drives the refusal, not just ignorance. Fluid volume risk is plausible with bleeding, yet no data suggests acute loss; stability allows focus on emotions. Addressing anxiety first calms the patient, enabling teaching and care, a priority in this tense encounter where psychological barriers could delay critical colorectal screening and intervention.
A nurse sets an infusion pump to infuse 1 L of D5NS at the rate of $100 \mathrm{~mL} / \mathrm{hr}$. How many hours will it take to complete the infusion?
- A. 8
- B. 10
- C. 12
- D. 14
Correct Answer: B
Rationale: Math rules IV timing 1 L (1000 mL) at 100 mL/hr divides to 10 hours, a straightforward calc nurses nail for fluid planning. Missteps like 8 or 12 flub the rate; 14's way off. Precision here ensures hydration or med delivery hits the mark, a basic skill keeping care on track.
In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.
A nurse is caring for a client recently diagnosed with hypertension. Which of the following should be included in the discharge teaching?
- A. Decrease physical activity to avoid spikes in blood pressure
- B. Diet changes are not recommended
- C. Only check blood pressure at a clinic or pharmacy
- D. Adherence to sodium restrictions
Correct Answer: D
Rationale: Hypertension bows to sodium cutting it shrinks fluid, easing BP, a discharge must-teach as salt drives pressure up. Activity lowers BP, diet's key, home checks empower. Nurses push sodium limits, like 2.3 g daily, a lifestyle linchpin to tame this silent killer, grounding clients in control.