Nokea
While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
- A. Stopping the administration of the drug immediately
- B. Notifying the patient's physician
- C. Continuing the infusion but decreasing the rate
- D. Applying a warm compress to the infusion site
Correct Answer: A
Rationale: Doxorubicin's a vesicant swelling and pain scream extravasation, where it leaks into tissue, risking severe necrosis. Stopping the IV stat is priority to limit damage; delaying could worsen injury. Notifying the physician follows, but action comes first. Slowing the infusion keeps pumping toxin into the site disastrous. Warm compresses might spread the drug, unlike ice, which can help post-stoppage per protocol. Nurses must act fast, knowing vesicants like doxorubicin (an anthracycline) demand immediate cessation and often antidotes (e.g., dexrazoxane), critical in oncology to prevent permanent harm from chemo mishaps.
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The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Threaten patient into adherence with insulin therapy
- B. Engage the patient in shared decision-making, select an insulin regimen that they can adhere to
- C. Provide close supervision and follow up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLP-1RA
Correct Answer: A
Rationale: Effective insulin therapy strategies include shared decision-making, close supervision at initiation, and weight gain mitigation via lifestyle and adjunctive drugs like metformin all fostering adherence and success. Threatening patients, however, is counterproductive, increasing resistance, anxiety, and non-compliance, contrary to patient-centered care principles. It undermines trust, critical in chronic disease management, where collaboration and support drive outcomes. Physicians must avoid coercive tactics, focusing instead on empowerment and tailored solutions to overcome insulin therapy barriers.
In which illness can hydrophobia be seen?
- A. tetanus
- B. malaria
- C. rabies
- D. EBV
Correct Answer: C
Rationale: Hydrophobia rabies' brain hates water, not tetanus' clench, malaria's sweat, EBV's glands, or HSV's sores. Nurses clock this chronic rabies red flag.
A 20 day old neonate born at term is exposed to a child with chicken pox, what intervention should take place?
- A. Give ZIG to all such neonates
- B. Give ZIG depending on mothers serology
- C. Give aciclovir to all
- D. Give aciclovir depending on mothers serology
Correct Answer: B
Rationale: Neonate, 20 days ZIG if mom's seronegative, not blanket or aciclovir guess. Nurses tie this chronic shield to history.
Appropriate statements concerning radiology and trauma interventional radiology include:
- A. To rule out injury of the cervical spine in the unconscious patient, application of a protocol involving a computed tomography (CT) scan to the neck is recommended.
- B. A FAST (Focused Assessment with Sonography for Trauma) scan is a specific investigation for assessment of intraperitoneal bleeding.
- C. In a patient who is persistently hypotensive in the emergency department despite adequate fluid resuscitation, radiological interventions to treat bleeding caused by a pelvic fracture are not recommended.
- D. Interventional radiology has a role in the management of injuries to the liver, kidney and spleen.
Correct Answer: A
Rationale: Trauma radiology optimizes diagnosis and intervention. CT is the gold standard for cervical spine assessment in unconscious patients, per NICE guidelines, offering high sensitivity for fractures/ligamentous injury versus plain films. FAST scans detect free fluid (e.g., blood) intraperitoneally but lack specificity positive findings need confirmation (e.g., CT). Persistent hypotension with pelvic fracture warrants interventional radiology (e.g., embolization), not dismissal contrary to the statement. Interventional radiology manages solid organ injuries (liver, kidney, spleen) via embolization, reducing surgical need. Staffing in radiology matches theatre for critical cases. CT's diagnostic precision in cervical spine trauma ensures timely, accurate management, critical in unconscious patients where clinical exam is unreliable.
A client hospitalized for chemotherapy has a hemoglobin of $6.1 mg/dL. What medication should the nurse prepare to administer?
- A. Epoetin alfa (Epogen)
- B. Filgrastim (Neupogen)
- C. Mesna (Mesnex)
- D. Oprelvekin (Neumega)
Correct Answer: A
Rationale: A hemoglobin of 6.1 mg/dL (normal 12-16 g/dL for women, 13-18 g/dL for men) indicates severe anemia, often from chemotherapy suppressing bone marrow red cell production. The nurse should prepare epoetin alfa (Epogen), a synthetic erythropoietin that stimulates red blood cell production, addressing anemia directly. Filgrastim (Neupogen) boosts white cells for neutropenia, not hemoglobin. Mesna (Mesnex) protects the bladder from chemotherapy toxicity, irrelevant here. Oprelvekin (Neumega) increases platelets, not red cells. Administering epoetin alfa corrects the anemia, improving oxygen delivery and reducing symptoms like fatigue and dyspnea, a critical intervention in oncology to support the client's recovery and quality of life during treatment.