Nokea
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.
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Which of the following hormones retains sodium in the body?
- A. Antidiuretic hormone
- B. Aldosterone
- C. Thyroid hormone
- D. Insulin
Correct Answer: B
Rationale: Aldosterone is a hormone produced by the adrenal glands that plays a crucial role in regulating the balance of sodium and potassium in the body. One of its primary functions is to retain sodium in the body, leading to increased reabsorption of sodium in the kidneys. This retention of sodium helps to maintain blood pressure and fluid balance. In contrast, other hormones like antidiuretic hormone (ADH) primarily regulate water reabsorption, while thyroid hormone and insulin do not have a direct role in retaining sodium in the body.
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.
The nurse is caring for a newborn whose mother is diabetic. Which clinical manifestations should the nurse expect to see?
- A. Hypoglycemic, large for gestational age
- B. Hyperglycemic, large for gestational age
- C. Hypoglycemic, small for gestational age
- D. Hyperglycemic, small for gestational age
Correct Answer: C
Rationale: Infants born to mothers with diabetes, especially uncontrolled diabetes, are at risk for hypoglycemia due to exposure to high glucose levels in utero. The infant's pancreas may have been producing high levels of insulin in response to the mother's high blood glucose levels, leading to hypoglycemia after birth. Additionally, these infants are typically smaller for gestational age (SGA) due to the effects of high blood sugar levels on fetal growth. Therefore, the nurse should expect the newborn of a mother with diabetes to exhibit signs of hypoglycemia and be small for gestational age.
While bathing an 82 y.o. man hospitalized with pneumonia, a nurse notes an ulcerated area on his penis. What action should the nurse take first?
- A. Report the ulcer to the admitting care provider.
- B. Teach the man about STD prevention.
- C. Ask the man if he has a history of syphilis.
- D. Clean the ulcer; reporting is not necessary because an STD is unlikely in a man this age.
Correct Answer: A
Rationale: The nurse should report the ulcer to the admitting care provider as the first action. An ulcerated area on the penis in an older adult may be indicative of various serious conditions, such as sexually transmitted infections (STIs) or skin breakdown. It is important for the healthcare provider to assess the ulcer, determine the cause, and initiate appropriate treatment. Reporting the finding promptly ensures timely intervention and appropriate management of the patient's condition. This initial action takes priority over teaching about STD prevention or inquiring about the patient's history of syphilis. Cleaning the ulcer without proper assessment and diagnosis by a healthcare provider can potentially worsen the patient's condition.
What is an appropriate screening test for hearing that can be administered by the nurse to a 5- year-old child?
- A. The Rinne test
- B. The Weber test
- C. Conventional audiometry
- D. Eliciting the startle reflex
Correct Answer: C
Rationale: Conventional audiometry is the appropriate screening test for hearing that can be administered by a nurse to a 5-year-old child. This test involves using specialized equipment to measure the child's ability to hear sounds at various frequencies and volumes. It is a comprehensive and reliable test that can accurately assess the child's hearing abilities across the auditory spectrum. The other options listed (A. Rinne test, B. Weber test, and D. Eliciting the startle reflex) are not suitable for screening the hearing of a 5-year-old child as they are either more applicable to adults or not as comprehensive and reliable as conventional audiometry when assessing hearing in children.