Which of these causes of gastroenteritis usually requires treatment with antibiotics?
- A. shigella
- B. salmonella
- C. e-coli
- D. giardia
Correct Answer: D
Rationale: Giardia flagellate needs metronidazole, not shigella, salmonella, E. coli, campy's self-run. Nurses dose this chronic gut bug.
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Which of the following medications are appropriate for the treatment of heart failure?
- A. Digoxin
- B. Bronchodilators
- C. Antibiotics
- D. Diuretics
Correct Answer: D
Rationale: Heart failure's fluid overload and pump inefficiency need diuretics they offload excess volume, easing dyspnea and edema, a cornerstone of treatment. Digoxin boosts contractility, useful in some cases, but diuretics directly tackle the hallmark issue. Bronchodilators aid breathing in lung disease, not heart failure's core. Antibiotics fight infection, irrelevant here. Diuretics' rapid impact on preload makes them essential, aligning with guideline-directed therapy, a nurse's focus for symptom relief and stability in heart failure management, outranking adjuncts like digoxin in immediate need.
A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.
A client is receiving interleukins along with chemotherapy. What assessment by the nurse takes priority?
- A. Blood pressure
- B. Lung assessment
- C. Oral mucous membranes
- D. Skin integrity
Correct Answer: A
Rationale: Interleukins, a type of biologic response modifier used with chemotherapy, can cause capillary leak syndrome, where fluid shifts from blood vessels into tissues, leading to hypotension and edema. This makes blood pressure the priority assessment, as a drop could indicate intravascular depletion, risking shock or organ failure if undetected. Lung assessment is relevant for potential pulmonary edema, but hypotension precedes respiratory distress in this context. Oral mucous membranes and skin integrity matter for chemotherapy's broader effects (e.g., mucositis, rashes), but these are less urgent than hemodynamic stability. Monitoring blood pressure first ensures early detection of a life-threatening complication, aligning with nursing's focus on airway, breathing, and circulation principles, critical in managing interleukin therapy's systemic impact.
Assessment of a wound does not include which of the following?
- A. Location
- B. Size
- C. Blood Pressure
- D. Colour of wound
Correct Answer: C
Rationale: Wound checks where, how big, what hue guide care. BP's body-wide, not wound-specific. Nurses skip it, a chronic sore's focus.
The nurse is providing preoperative care for a 7-year-old patient with a brain tumor. Which of the following is the priority intervention?
- A. Assessing the child's level of consciousness
- B. Providing a tour of the intensive care unit for the child and parents
- C. Educating the child and parents about shunts
- D. Having the child talk to another child who has had this surgery
Correct Answer: A
Rationale: For a child with a brain tumor preoperatively, assessing level of consciousness (LOC) is the priority, as it monitors for increased intracranial pressure (ICP) from tumor mass effect vital signs like alertness or confusion shift rapidly and signal deterioration needing immediate action. No baseline data exists here, making LOC the first step in the nursing process to guide care. An ICU tour reduces anxiety but delays critical assessment. Shunt education applies post-diagnosis of hydrocephalus, not universally pre-op, and lacks urgency without LOC context. Peer support is psychosocial, not physiological, and secondary. LOC assessment aligns with ABCs (circulation includes cerebral perfusion), ensuring the nurse detects neurological decline early, a cornerstone of pediatric neuro-oncology care before surgery.