Nokea
You have just received the morning report from the night shift nurses. List the order of priority for assessing and caring for these patients.
- A. A patient who developed tumor lysis syndrome around 5:00 AM
- B. A patient with frequent reports of break-through pain over the past 24 hours
- C. A patient scheduled for exploratory laparotomy this morning
- D. A patient with anticipatory nausea and vomiting for the past 24 hours
Correct Answer: A
Rationale: Tumor lysis syndrome, an oncologic emergency from rapid cell breakdown, spikes electrolytes and risks renal failure its 5:00 AM onset demands immediate assessment for stability, trumping others. Surgery prep follows laparotomy needs readiness checks like NPO status, time-sensitive but stable. Breakthrough pain, chronic over 24 hours, requires analgesia adjustment, urgent but not life-threatening. Anticipatory nausea, psychogenic, needs comfort and antiemetics, least acute. Prioritizing tumor lysis aligns with ABCs circulation and organ function ensuring rapid intervention like fluids or dialysis, a nurse's critical triage call in this lineup.
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Which statement with respect to the disadvantages of insufficient physical activity is most correct?
- A. People are not so much concerned with the disadvantages, because these will only affect them in the long run
- B. The disadvantages can be compensated by moderate eating
- C. When explained, the disadvantages are enough to motivate people to change their behaviour
- D. The disadvantages result from inadequate behavioural control (self-efficacy)
Correct Answer: A
Rationale: Inactivity's downsides long-term creep, folks shrug, not diet-fixed, rarely spur change, or just control flops. Nurses see this apathy, a chronic slow burn.
The pathophysiology of Asthma differs from COPD as:
- A. It is characterised by airflow limitation
- B. There is abnormal inflammatory response to exposure to noxious particles or gases
- C. The airflow limitation is reversible
- D. It is considered an obstructive lung disease
Correct Answer: C
Rationale: Asthma's twist reversible airflow block sets it apart from COPD's fixed choke. Both obstruct, inflame to triggers, but asthma's airways bounce back with puffs. Nurses spot this, a chronic split for treatment.
Early Goal Directed Therapy in severe sepsis and septic shock (Rivers et al) does NOT recommend:
- A. hydrocortisone 100 mg QID
- B. maintaining mixed venous oxygen saturation measurement >70%
- C. maintaining CVP between 8-12 mmHg
- D. using inotropes to keep MAP >65 mmHg<90 mmHg
Correct Answer: A
Rationale: Rivers' sepsis hydrocortisone's out, SvO2, CVP, MAP, dobutamine hold. Nurses skip this chronic steroid sidestep.
The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, 'I am so tired I can hardly get out of bed in the morning.' Which intervention should the nurse add to the plan of care?
- A. Minimize activity until the treatment is completed.
- B. Establish time to take a short walk almost every day.
- C. Consult with a psychiatrist for treatment of depression.
- D. Arrange for delivery of a hospital bed to the patient's home.
Correct Answer: B
Rationale: Radiation fatigue's brutal Hodgkin's therapy saps energy, but short walks fight deconditioning without overtaxing. Resting fully risks weakness; depression isn't assumed fatigue's treatment-driven. A bed doesn't fix it. Nurses in oncology balance this activity preserves function, key for lymphoma patients slogging through radiation's grind.