Autologous stem cell transplantation is a procedure in which:
A. Stem cells are transferred to the patient from an identical twin.
B. There is a high... [Show More] rejection rate.
C. Stem cells are harvested from the patient and then returned to the same patient.
D. Stem cells are transferred to the patient from an HLA-matched donor.
C. Stem cells are harvested from the patient and then returned to the same patient.
In autologous transplantation, the stem cells are collected from the patient's own blood and then stored and reinfused in the same patient after chemotherapy and radiation. The use of autologous transplants eliminates the problem of graft-versus-host disease. Transplant from a closely matched donor is known as allogeneic transplant. In autologous transplant, stem cells are used from the patient's own blood.
Emesis causes:
A. Metabolic alkalosis.
B. Respiratory acidosis.
C. Metabolic alkalosis.
D. Respiratory alkalosis.
A. Metabolic alkalosis.
Emesis causes metabolic alkalosis as the stomach is a major reservoir for acids. Emesis causes a metabolic acid-base imbalance as it is not related to the respiratory system. Emesis involves loss of gastric acid and fluid and causes an alkalotic disruption.
Which clinical finding is indicative of compartment syndrome?
A. Peripheral edema.
B. Redness and swelling.
C. Atrophy of distal tissues.
D. Absent peripheral pulses.
D. Absent peripheral pulses.
Compartment syndrome creates an effective absence of arterial circulation to an extremity. Swelling within a cast or tight dressing may contribute to the development of compartment syndrome. Compartment syndrome creates pallor in the affected extremity. Acute arterial occlusion is an emergency, and could result in profound ischemia in the involved limb.
A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is:
A. Unstable angina.
B. Coronary vasospasm.
C. Myocardial infarction.
D. Stable angina.
D. Stable angina.
Stable angina is the most common form of chest pain and is characterized by pain that is caused under conditions of increased myocardial workload, such as physical exertion or emotional strain. Pain related to myocardial infarction is not relieved by rest. Coronary vasospasm is characterized by unpredictable attacks of angina pain. A patient with unstable angina presents with symptoms similar to myocardial infarction.
The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?
A. Since there is not wheezing, asthma is the problem, but oxygen should be started immediately anyway.
B. The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
C. The child probably has consolidated pneumonia; oxygen should be started immediately.
D. The signs and symptoms are consistent with asthma; start oxygen and then check to see that your stethoscope is working properly.
B. The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
The airway inflammation, edema, and bronchoconstriction of acute asthma may occlude small airways completely, so that no air is moving, which requires emergency intervention. Alicia has a history of asthma rather than pneumonia. Asthma can occur without wheezing. This is an emergency situation that requires you to start oxygen and notify the physician.
The hypersecretion of mucus resulting for chronic bronchitis is the result of:
A. Destruction of alveolar septa.
B. Reduced inflammation.
C. Recurrent infection.
d. Barrel chest.
C. Recurrent infection.
Mucus provides a hospitable environment for bacterial colonization and recurrent infection. Destruction of alveolar septa and reduced inflammation are not complications of chronic bronchitis. Hypersecretion of mucus does not contribute to barrel chest.
The major cause of death from leukemic disease is:
A. Malnutrition.
b. Kidney failure.
C. Infection.
D. Hypovolemic shock.
C. Infection.
Infection is the most common cause of death in the immunocompromised patient, because it can become a life-threatening sepsis. Malnutrition can be a side effect of the disease process or the treatment. Hypovolemic shock is not generally associated with leukemic disease. There is no direct connection between kidney failure and death in leukemia, although kidney failure may occur as a result of treatment.
When a parent asks how they will know if their 2-month-old baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse's best response is:
A. "If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated."
B. "If he doesn't wet his diaper all afternoon and his neck veins look flat when he is lying down, then he is probably dehydrated."
C. "If he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated."
D. "Clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, so those are the diagnostic criteria."
A. If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and gums, then he is probably dehydrated.
Checking whether the head feels sunken and the mouth is dry between check and gums are useful assessments of ECV deficit in an infant, which is an important part of clinical dehydration. It is true that clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, but it does not address the question Mr. Worry is asking. Although the diaper information provides a useful assessment, neck veins are not a reliable assessment in an infant. Drowsiness and fatigue are not reliable assessments for dehydration.
Manifestations from sodium imbalances occur primarily as a result of:
A. Hypovolemia.
B. Vascular collapse.
C. Hyperosmolarity.
D. Cellular fluid shifts.
D. Cellular fluid shifts.
Sodium imbalances alter osmolality of fluid compartment leading to osmosis of water from the hypo-osmolar compartment to the hyperosmolar compartment. In brain cells, this leads to swelling or shrinkage of cells, and associated manifestations. [Show Less]
