A client with cancer that has metastazised to the liver is started on chemotherapy- His physician has specified divided doses of the antimetabolite. The client asks why he could take the drug in divided doses. The appropriate response is:

Correct Answer: D

Rationale: The correct answer is D) "Because these drugs prevent cell division, they are more effective in divided doses." This response is accurate because antimetabolites are drugs that interfere with the process of cell division by inhibiting the synthesis of DNA or RNA. By administering these drugs in divided doses, a more continuous and sustained level of the drug is maintained in the body, which helps in preventing the rapid growth and division of cancer cells. Option A is incorrect because medical treatments are not typically prescribed arbitrarily; there is usually a specific rationale behind the dosing instructions. Option B is also incorrect as dividing doses may not necessarily reduce side effects but rather optimize the drug's efficacy. Option C is incorrect because while divided doses may enhance the drug's effect, it is primarily due to the continuous exposure to the drug rather than the direct cytotoxic effects on the cells. Educationally, understanding the pharmacokinetics and pharmacodynamics of chemotherapy drugs like antimetabolites is crucial for nurses caring for pediatric oncology patients. By comprehending how these drugs work and the rationale behind dosing regimens, nurses can provide safe and effective care, monitor for potential side effects, and educate patients and families on the importance of treatment adherence.

Correct Answer: A

Rationale: Rationale: The correct answer is A) 2 and 4. 1. Morphine sulfate is given to patients with pulmonary edema to reduce anxiety (i) and increase blood pressure (iv). The anxiolytic properties of morphine help calm the patient, reducing stress and anxiety associated with difficulty breathing and chest discomfort. Additionally, morphine can help vasodilate peripheral vessels, leading to increased blood pressure, which can be beneficial in cases of hypotension associated with pulmonary edema. 2. Option B) 3 and 5 is incorrect because while strengthening heart contractions (iii) and reducing preload and afterload (v) are important goals in managing pulmonary edema, morphine sulfate does not directly achieve these effects. In fact, morphine can potentially worsen preload and exacerbate respiratory depression, which can further compromise the patient's condition. 3. Option C) 1 and 5 is incorrect because reducing anxiety (i) is a valid reason as discussed earlier, but reducing preload and afterload (v) is not a direct effect of morphine sulfate administration in the context of pulmonary edema. 4. Option D) 2 and 3 is incorrect because while increasing blood pressure (iv) is a known effect of morphine sulfate administration in patients with pulmonary edema, relieving chest pain (ii) is not a primary indication for giving morphine in this scenario. Educational Context: Understanding the rationale behind using morphine sulfate in patients with pulmonary edema is crucial for nurses caring for critically ill pediatric patients. By selecting the correct answer, nurses demonstrate knowledge of pharmacological management strategies to alleviate symptoms and improve outcomes in patients with pulmonary edema. It also highlights the importance of understanding the specific effects and considerations of medications in pediatric patients to provide safe and effective care.

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.

Correct Answer: D

Rationale: The patient being able to ambulate 25 feet without pain is the most appropriate outcome to indicate the success of the plan for impaired mobility related to nerve compression due to a herniated lumbar disk. This outcome directly reflects an improvement in mobility, which is the primary goal when addressing impaired mobility caused by nerve compression. A reduction in pain intensity (choice A) is important but not as specific to mobility impairment. Having full range of motion (choice B) in the upper extremities is not directly related to the issue of lumbar disk herniation. Correct self-administration of analgesics (choice C) is important for pain management but does not directly reflect improvement in mobility.

Correct Answer: B

Rationale: The Heimlich maneuver, also known as abdominal thrusts, is performed on a client to clear the airway if the client is choking and cannot speak or breathe after swallowing food. The maneuver involves applying upward pressure on the abdomen in an effort to forcefully expel the object blocking the airway. It is a crucial life-saving technique that can prevent the client from suffocating due to an obstructed airway. In cases of choking emergencies, the Heimlich maneuver should be administered promptly to effectively remove the obstruction and restore breathing.