Nokea
You are meeting with parents of a 12-year-old girl who recently diagnosed with papillary thyroid carcinoma (PTC). The statement that should be included in your discussion is
- A. PTC has a grim overall prognosis
- B. FTC do not require radioactive iodine therapy
- C. supraphysiologic levothyroxine therapy is required during long-term follow-up
- D. calcitonin/carcinogenic antigen monitoring is required during the course of treatment
Correct Answer: C
Rationale: Levothyroxine suppression therapy is standard in differentiated thyroid cancer.
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What is an early clinical manifestation of bilirubin encephalopathy in the newborn?
- A. Cognitive impairment
- B. Absence of stooling
- C. Lethargy or irritability
- D. Increased or decreased temperature
Correct Answer: C
Rationale: An early clinical manifestation of bilirubin encephalopathy in a newborn is lethargy or irritability. Bilirubin encephalopathy, also known as kernicterus, is a serious condition that occurs when high levels of unconjugated bilirubin build up in the brain tissues. Initially, the baby may become lethargic or irritable due to the toxic effects of bilirubin on the central nervous system. As the condition progresses, symptoms may include poor feeding, high-pitched crying, muscle tone abnormalities, and eventually may lead to more severe consequences such as seizures and irreversible neurological damage. Prompt recognition and treatment of bilirubin encephalopathy are crucial to prevent long-term complications.
Which of the following medications should then nurse explain may cause headache as a side effect?
- A. Furosemide (Lasix)
- B. Clonidine (Catapres)
- C. Atenolol ((Tenormin)
- D. Adalat (Procardia)
Correct Answer: D
Rationale: Adalat (Procardia) belongs to a class of medications known as calcium channel blockers. Headache is a common side effect associated with the use of calcium channel blockers, including Adalat (Procardia). The mechanism behind this side effect is related to the vasodilatory effects of calcium channel blockers, which can lead to relaxation and widening of blood vessels, potentially causing headaches. It is important for the nurse to explain to the patient that headache is a possible side effect of Adalat (Procardia) and to consult the healthcare provider if it becomes bothersome or severe.
JR is admitted to the medical-surgical unit because of a diagnosis of nephritic syndrome. What is the hallmark of this syndrome?
- A. osmotic dieresis
- B. hypolipidemia
- C. edema
- D. hyperproteinemia
Correct Answer: C
Rationale: Nephritic syndrome is characterized by inflammation of the glomeruli in the kidneys, leading to proteinuria, hematuria, and decreased kidney function. The hallmark symptom of nephritic syndrome is edema, which occurs due to the loss of proteins in the urine as a result of damaged glomeruli. The loss of proteins leads to a decrease in colloid osmotic pressure, causing fluid to leak out from the blood vessels into the surrounding tissues, resulting in edema. Osmotic diuresis, hypolipidemia, and hyperproteinemia are not typically associated with nephritic syndrome.
A client metastatic ovarian cancer is prescribed cisplatin (Platinol). Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin. Which drug may cause significant interactions when given concomitantly with cisplatin?
- A. Erythromycin
- B. A cephalosporin
- C. A tetracycline
- D. An amino glycoside Situation: A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug.
Correct Answer: D
Rationale: Amino glycosides, such as gentamicin or amikacin, can interact significantly with cisplatin, leading to increased risk of kidney damage or hearing loss. Both amino glycosides and cisplatin are known to have nephrotoxic and ototoxic effects independently. When combined, the risk of these side effects is potentiated, making it important to monitor renal function and hearing closely when these drugs are co-administered. Therefore, it is crucial to avoid the concomitant use of amino glycosides with cisplatin in order to prevent harmful drug interactions and reduce the risk of adverse effects in the client with metastatic ovarian cancer.
The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketonic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?
- A. Elevated serum acetone level
- B. Serum alkalosis
- C. Serum ketone bodies
- D. Below-normal serum potassium level
Correct Answer: D
Rationale: Hyperosmolar hyperglycemic nonketonic syndrome (HHNS) is characterized by extremely elevated blood glucose levels without significant ketosis. Unlike diabetic ketoacidosis (DKA), patients with HHNS usually do not have high levels of ketone bodies in their blood or urine. Therefore, the nurse should anticipate below-normal serum potassium levels in a client with HHNS, as hyperglycemia can lead to profound potassium losses through osmotic diuresis. Monitoring and treating electrolyte imbalances, including hypokalemia, are crucial in managing HHNS. It is important to correct these imbalances promptly to prevent further complications.