You are evaluating a 9-year-old boy child with ALL who recently develops relapse; an important statement that should be mentioned to his parents is
- A. testicular relapse occurs in the majority of boys with ALL
- B. such relapse occurs as painful swelling of one or both testes
- C. the diagnosis is confirmed by ultrasonography
- D. the majority of affected boys can be successfully retreated, and the survival rate is good
Correct Answer: D
Rationale: Most boys with testicular relapse can be successfully treated, and their overall survival remains favorable.
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Deteriorating insulation is found in the ceilings of a local school built in 195Parents and teachers are extremely concerned that it may be asbestos, and they call on you, the local pediatrician, to give advice in an open meeting. What advice would you give?
- A. Immediately remove all of the insulation.
- B. Confirm the presence of asbestos by laboratory evaluation, and do nothing further.
- C. Confirm the presence of asbestos by laboratory evaluation. If asbestos is confirmed, call a certified engineer for expert assessment.
- D. Reassure the parents that the hazards of asbestos have been overstated.
Correct Answer: C
Rationale: Asbestos should be confirmed by laboratory testing, and if present, a certified engineer should assess the situation to determine the safest course of action.
. A female client experiences trauma to her urinary tract during an accident. Which of the ff factors should the nurse consider while assessing the client?
- A. Assessment of sexual habits
- B. Assessment and recognition of abnormal findings
- C. Assessment of allergies to seafood
- D. Assessment of insurance coverage
Correct Answer: B
Rationale: When assessing a female client who has experienced trauma to her urinary tract, it is essential for the nurse to focus on assessment and recognition of abnormal findings. This includes assessing for signs and symptoms such as pain, blood in the urine, difficulty urinating, frequent urination, or any other unusual changes in urinary habits. These abnormal findings can help the nurse identify the extent of the trauma and provide appropriate intervention or treatment. It is crucial to prioritize the client's physical health and well-being in this situation. Factors such as sexual habits, allergies to seafood, and insurance coverage may be important in other contexts but are not directly relevant to assessing trauma to the urinary tract.
What orders would likely be included fro a client diagnosed with multiple myeloma?
- A. Bed rest
- B. Fluid restriction
- C. Corticosteroid therapy
- D. Calcium replacement therapy
Correct Answer: C
Rationale: Corticosteroid therapy is commonly used in the treatment of multiple myeloma. It is often part of the initial treatment plan for this disease and is used to help control the cancer cells by reducing inflammation and immune responses. Corticosteroids can help manage symptoms such as pain and complications related to the disease. Bed rest, fluid restriction, and calcium replacement therapy may not be directly indicated for multiple myeloma treatment.
Which instruction about insulin administration should the nurse give to a client?
- A. "Always follow the same order when drawing the different insulin into the syringe."
- B. "Shake the vial before withdrawing the insulin."
- C. "Store unopened vials of insulin in the freezer at temperatures well below freezing."
- D. "Discard the intermediate-acting insulin if it disappears cloudy."
Correct Answer: A
Rationale: The correct instruction the nurse should give to the client is to "Always follow the same order when drawing the different insulin into the syringe." This is important because mixing different insulins in the same syringe can alter their action profiles and lead to inaccurate dosing. It is crucial to follow a consistent order to prevent mixing the insulins inadvertently. It is advisable to consult a healthcare provider or pharmacist for specific instructions on insulin administration to ensure safety and effectiveness.
A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
- A. "Inject insulin into healthy tissue with large blood vessels and nerves."
- B. "Rotate injection sites within the same anatomic region, not among different regions."
- C. "Administer insulin into areas of scar tissue or hypotrophy whenever possible."
- D. "Administer insulin into sites above muscles that you plan to exercise heavily later that day."
Correct Answer: B
Rationale: The nurse should instruct the client to rotate injection sites within the same anatomic region, not among different regions. Proper rotation of injection sites helps prevent lipodystrophy (changes in fat tissue) and ensures consistent absorption of insulin. By rotating sites within the same region, the client can minimize the risk of developing localized skin complications. Additionally, rotating sites helps to ensure that the insulin is absorbed consistently, leading to more predictable blood glucose control. It is important to avoid injecting into areas of scar tissue, hypotrophy, large blood vessels, or nerves, as these can affect the absorption of insulin and may lead to inconsistent blood glucose levels.