Nokea
Why is heart biopsy performed throughout a clients lifetime after heart transplantation?
- A. To detect rejection
- B. To check the heart functionality
- C. To check rate of the heartbeat
- D. To check for heart tumor CARING FOR CLIENTS WITH HYPERTENSION
Correct Answer: A
Rationale: Heart biopsy is performed throughout a client's lifetime after heart transplantation mainly to detect rejection. Rejection is a common complication following a heart transplant where the recipient's immune system recognizes the transplanted heart as foreign tissue and attacks it. By conducting heart biopsies, healthcare providers can monitor the health of the transplanted heart and detect signs of rejection early on. This allows for prompt intervention and adjustment of the client's immunosuppressive therapy to prevent further damage to the transplanted heart. Monitoring for rejection through heart biopsies is crucial in ensuring the long-term success of heart transplants and the overall well-being of the recipient.
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You are evaluating a 6-mo-old girl with a firm right suprarenal mass. Histologically, there is no bony involvement, 10% bone marrow involvement, subcutaneous nodules involvement, and massive abdominal mass. The N-myc oncogene is not amplified. According to the international neuroblastoma staging system, the infant is stratified as
- A. stage I
- B. stage II A
- C. stage III
- D. stage IV S
Correct Answer: D
Rationale: Stage IV S refers to infants <1 year with localized primary tumor, distant metastases limited to liver, skin, or bone marrow (with <10% involvement), and no amplification of N-myc.
The nurse evaluates a certified nursing assistant. Which of the following actions by the CAN demonstrates understanding of standard precautions?
- A. Wears gloves during all client contact
- B. Cleans blood spills with soap and water
- C. Pours bulk blood and other secretions down a drain connected to a sanitary sewer
- D. Carries blood sample to the lab in an open basket
Correct Answer: A
Rationale: The correct action that demonstrates understanding of standard precautions is wearing gloves during all client contact. Standard precautions are designed to prevent the transmission of infectious agents from both recognized and unrecognized sources of infection. Wearing gloves during client contact helps protect both the patient and the healthcare worker from potential infection transmission through contact with bodily fluids, skin, mucous membranes, and non-intact skin. Cleaning blood spills with soap and water is also part of standard precautions to prevent the spread of infection. However, pouring bulk blood and other secretions down a drain connected to a sanitary sewer and carrying a blood sample to the lab in an open basket do not align with standard precautions and could pose infection control risks.
The nurse notes vigorous bubbling in the water-seal chamber of a chest-drainage system. Which of the following actions should the nurse take to correct the bubbling?
- A. Examine the entire system and tubing for air leaks.
- B. Lower the level of suction.
- C. Nothing; vigorous bubbling is expected
- D. Ask the patient to cough forcefully.
Correct Answer: A
Rationale: The nurse should examine the entire system and tubing for air leaks when observing vigorous bubbling in the water-seal chamber of a chest-drainage system. Vigorous bubbling indicates that there is air escaping from the system, which can lead to suboptimal drainage and potential complications. By identifying and correcting any air leaks, the nurse can ensure the chest-drainage system functions effectively, allowing for proper drainage and the prevention of complications such as pneumothorax. Lowering the level of suction or asking the patient to cough forcefully would not address the underlying issue of air leaks and may not resolve the problem effectively.
A client with autoimmune thrombocytopenia and a platelet count of 8,000/ul develops epistaxis and melena. Treatment with corticosteroids and immunoglobulins has been unsuccessful, and the physician recommends a splenectomy. The client states, "I don't need surgery-this will go away on its own". In considering her response to the client, the nurse must depend on the ethical principle of:
- A. Beneficence
- B. Advocacy
- C. Autonomy
- D. Justice
Correct Answer: C
Rationale: The ethical principle most relevant in this situation is autonomy. Autonomy refers to a person's right to make decisions about their own care and treatment. In this case, the client is expressing her wish to avoid surgery and believes her condition will improve on its own. It is important for the nurse to respect the client's autonomy and involve her in the decision-making process regarding her treatment. The nurse should provide information, support, and guidance to help the client make an informed decision that aligns with her values and preferences. While the nurse can provide education and encourage the client to consider the physician's recommendation, ultimately the decision should respect the client's autonomy.
The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?
- A. Administering penicillin
- B. Avoiding salicylates (aspirin)
- C. Imposing strict bed rest for 4 to 6 weeks
- D. Administering corticosteroids if chorea develops
Correct Answer: D
Rationale: Therapeutic management for rheumatic fever includes administering penicillin to eradicate the streptococcal infection, avoiding salicylates (aspirin) to prevent Reye's syndrome, and imposing strict bed rest for the acute phase to decrease cardiac workload and prevent joint complications. Corticosteroids are used if chorea (involuntary movement disorder) develops to reduce inflammation and control symptoms. Therefore, the nurse should expect to administer corticosteroids if chorea develops in a child with rheumatic fever.