A patient is scheduled to have a central venous access device placed for administration of chemotherapy. When preparing the patient for the catheter insertion, the nurse explains that this method of administration is preferred for which reason?

it decreases the risk for extravasation at the infusion site

it reduces the incidence of systemic side effects of the medication

It allows continuous infusion of the medication directly to the tumor

It does not become occluded as peripherally inserted catheters can

Answer and Explanation

The Correct Answer is A

A. It decreases the risk for extravasation at the infusion site: Central venous access devices (CVADs) are preferred for chemotherapy because they deliver highly vesicant or irritant medications directly into a large central vein. The rapid dilution in high-flow vessels reduces the risk of local tissue damage (extravasation), which can occur with peripheral IV administration.

B. It reduces the incidence of systemic side effects of the medication: CVADs do not inherently reduce systemic side effects, as chemotherapy affects both tumor and normal cells systemically. The method of administration mainly affects local tissue safety rather than systemic toxicity.

C. It allows continuous infusion of the medication directly to the tumor: Chemotherapy delivered via a central line enters systemic circulation, not directly to the tumor site. Tumor targeting depends on pharmacologic properties, not catheter placement.

D. It does not become occluded as peripherally inserted catheters can: While CVADs are designed for long-term use, they can still become occluded due to thrombus formation or medication precipitates. Occlusion is not entirely prevented; proper maintenance and flushing protocols are required to reduce this risk.

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Correct Answer is D

Explanation

A. Urine specific gravity of 1.025: This value indicates concentrated urine but is only moderately elevated and not immediately life-threatening. While it supports the diagnosis of SIADH, it does not require rapid intervention compared with critically low sodium.

B. Severe headache: Headache is a common symptom of hyponatremia due to cerebral edema. Although it indicates neurologic involvement, it is a nonspecific symptom and does not quantify the severity of the underlying electrolyte disturbance.

C. Extreme thirst: Thirst is a compensatory mechanism for low serum osmolality, but in SIADH, fluid restriction is indicated. While it is a notable symptom, it does not represent an immediate danger compared with critically low sodium.

D. Serum sodium level of 119 mEq/L: Hyponatremia below 120 mEq/L is severe and can rapidly lead to cerebral edema, seizures, and potentially life-threatening neurologic complications. Prompt communication with the healthcare provider is essential to initiate interventions such as hypertonic saline, fluid restriction, or medications to correct sodium safely.

Correct Answer is "{\"xRanges\":[49.55442015209126,57.15898288973384],\"yRanges\":[60,70.8108108108108]}"

Explanation

The spouse is upset because the nurse is measuring the patient’s blood pressure on the left forearm where the dialysis shunt is located. For patients with an arteriovenous (AV) shunt or fistula, it is contraindicated to use that arm for blood pressure measurement, venipuncture, or IV insertion. Doing so can damage the shunt, compromise blood flow, or increase the risk of clotting and infection. The correct nursing action would be to measure blood pressure on the opposite arm (or another appropriate site if both arms are restricted) and to protect the dialysis access site at all times.

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A patient is scheduled to have a central venous access device placed for administration of chemotherapy. When preparing the patient for the catheter insertion, the nurse explains that this method of administration is preferred for which reason?

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Naxlex Comprehensive Predictor Exams

A patient is admitted with possible syndrome of inappropriate anti-diuretic hormone (SIADH). Which information obtained by the nurse is most important to communicate rapidly to the health care provider?

Correct Answer is D

Explanation

Correct Answer is "{\"xRanges\":[49.55442015209126,57.15898288973384],\"yRanges\":[60,70.8108108108108]}"

Explanation

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