Nokea
Toxic shock syndrome:
- A. will often manifest without fever
- B. is a misnomer because BP is often maintained
- C. is caused by pseudomonas species
- D. often produces elevated creatinine kinase
Correct Answer: D
Rationale: TSS fever burns, BP drops, staph rules, CK jumps, rash spreads. Nurses clock this chronic toxin surge.
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What is the relationship between hyperlipidaemia and non-alcoholic steatohepatitis (NASH)?
- A. Hyperlipidaemia contributes to the development of NASH
- B. NASH contributes to the development of hyperlipidaemia
- C. There is no relationship between hyperlipidaemia and NASH
- D. Answers 1 and 2 are correct
Correct Answer: D
Rationale: NASH and hyperlipidaemia dance both ways high lipids pile fat, NASH pumps them back, a chronic loop. No split or null fits nurses track this lipid-liver ping-pong.
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.
Four clients are receiving tyrosine kinase inhibitors (TKIs). Which of these four clients should the nurse assess first?
- A. Client with dry, itchy, peeling skin
- B. Client with a serum calcium of $9.2 mg/dL
- C. Client with a serum potassium of $2.8 mEq/L
- D. Client with a weight gain of 0.5 pound (1.1 kg) in 1 day
Correct Answer: C
Rationale: Tyrosine kinase inhibitors (TKIs) target cancer cell signaling pathways but can cause electrolyte imbalances, among other side effects. A serum potassium of 2.8 mEq/L (normal 3.5-5.0 mEq/L) is critically low, risking cardiac arrhythmias or muscle dysfunction, making this client the priority for immediate assessment. Dry, itchy, peeling skin is a common TKI side effect, uncomfortable but not immediately life-threatening, warranting later attention for infection risk. A calcium level of 9.2 mg/dL is normal (8.5-10.2 mg/dL), requiring no urgent action. A 0.5-pound weight gain in a day is minor and less critical unless part of a pattern suggesting fluid retention. The nurse prioritizes the potassium imbalance due to its potential for rapid, severe consequences, reflecting oncology's emphasis on addressing physiological instability first.
A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient?
- A. A fluid bolus as ordered
- B. Fluid restrictions as ordered
- C. Urinalysis as ordered
- D. Sodium-restricted diet as ordered
Correct Answer: B
Rationale: SIADH, common in lung cancer, overproduces ADH, retaining water and diluting sodium hyponatremia causes weight gain, weakness, nausea. Fluid restriction, the initial fix, curbs water intake, raising sodium levels naturally, tackling the root imbalance. A fluid bolus worsens dilution, risking seizures. Urinalysis checks concentration, not a treatment. Sodium restriction deepens hyponatremia, counterproductive. Anticipating fluid limits aligns with SIADH's pathophysiology nurses expect this order to stabilize the patient, monitoring for symptom relief or escalation, a frontline step in managing this paraneoplastic crisis.
Mr Xavier, a 60-year-old accountant, was recently started on allopurinol 100 mg two months ago. This was increased to 200 mg three weeks ago in your clinic. He informed you that he was diagnosed with UTI and started on ciprofloxacin. Today, he returns to your clinic with maculopapular rashes on his trunk and abdomen. He has a low-grade fever of 37.5°C. Which is the most appropriate next step?
- A. Stop Ciprofloxacin and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to Moxifloxacin 500 mg bd instead
- C. Continue medications and check for Dengue serology
- D. Stop Allopurinol
Correct Answer: D
Rationale: Rashes and fever post-allopurinol hike scream drug reaction stopping it nips hypersensitivity, like SJS risk, tied to uric acid meds over cipro's rarer skin hit. Quitting cipro alone misses the likely culprit; swapping antibiotics or dengue checks dodge the drug link; full stop's overkill. Clinicians halt allopurinol, watching this chronic fix's nasty turn, a swift call.