Nokea
All of the following are true about erysipelas EXCEPT
- A. facial and scalp manifestations occur in infants and the elderly
- B. it progresses to skin desquamation
- C. bacteremia common in the lower extremity manifestations
- D. fever
Correct Answer: C
Rationale: Erysipelas face, scalp, peeling, fever, sharp edge fit; bacteremia's rare, not common. Nurses mark this chronic skin truth.
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A 3-year-old girl with a Wilms tumor is returning to the unit after a simple nephrectomy. Which of the following actions have the highest priority in caring for this child?
- A. Maintaining NPO.
- B. Monitoring the BP every 2 hours.
- C. Turning her every 2 hours.
- D. Administering pain medication every 4 hours.
Correct Answer: B
Rationale: After a nephrectomy for Wilms tumor, monitoring blood pressure (BP) every 2 hours is the highest priority because kidney removal disrupts renin-angiotensin regulation, risking hypo- or hypertension, especially in a young child with one remaining kidney. Using the ABCs (airway, breathing, circulation), BP falls under circulation, a critical postoperative focus to detect shock or fluid imbalance early. Maintaining NPO is temporary post-anesthesia but shifts to hydration once awake, less urgent than BP. Turning every 2 hours prevents pressure ulcers, but a mobile 3-year-old post-simple nephrectomy likely moves independently unless sedated, lowering its priority. Pain medication is key but ranks lower (e.g., G' in extended ABCs) than circulation. Frequent BP checks ensure stability, aligning with nursing's role in pediatric surgical care to prevent complications in a child adapting to single-kidney function.
The Pulmonary rehabilitation program consists of several specific components. Which of the following are not a part of the program?
- A. Education and self-management
- B. Exercise training
- C. Coping measures to relieve anxiety, depression and changes in behaviour
- D. Spirometry
Correct Answer: D
Rationale: Pulmonary rehab builds COPD strength education, exercise, coping tools for mind and mood, all in. Spirometry's a test, not therapy diagnoses, doesn't train. Nurses skip it here, a chronic fix's focus.
Triglycerides in VLDL particles can be passed on to HDL particles. Question: Which enzyme mediates this process?
- A. Cholesteryl ester transfer protein (CETP)
- B. Hepatic lipase (HL)
- C. Hormone sensitive lipase (HSL)
- D. Lipoprotein lipase (LPL)
Correct Answer: A
Rationale: CETP swaps triglycerides VLDL to HDL, not lipase cutters. Nurses know this, a chronic lipid shuffle.
The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Threaten patient into adherence with insulin therapy
- B. Engage the patient in shared decision-making, select an insulin regimen that they can adhere to
- C. Provide close supervision and follow up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLP-1RA
Correct Answer: A
Rationale: Effective insulin therapy strategies include shared decision-making, close supervision at initiation, and weight gain mitigation via lifestyle and adjunctive drugs like metformin all fostering adherence and success. Threatening patients, however, is counterproductive, increasing resistance, anxiety, and non-compliance, contrary to patient-centered care principles. It undermines trust, critical in chronic disease management, where collaboration and support drive outcomes. Physicians must avoid coercive tactics, focusing instead on empowerment and tailored solutions to overcome insulin therapy barriers.
A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is best?
- A. Call the client at home the next day to review teaching.
- B. Give the client information about a cancer support group.
- C. Provide all the preoperative instructions in writing.
- D. Reassure the client that surgery will be over soon.
Correct Answer: A
Rationale: A new cancer diagnosis combined with the urgency of surgery in three days can overwhelm a client, impairing their ability to process and retain preoperative instructions due to emotional stress and anxiety. Calling the client the next day to review teaching allows the nurse to reinforce key points, answer questions, and ensure comprehension when the client may be calmer and more receptive. While providing written instructions is helpful, it assumes literacy and may not address immediate confusion or emotional barriers. Offering support group information is valuable for long-term coping but doesn't prioritize the urgent need for surgical preparation. Reassuring the client that surgery will be over soon dismisses their concerns and doesn't enhance understanding. The follow-up call is the best action, as it aligns with adult learning principles and nursing's role in ensuring informed consent and readiness, reducing perioperative risks and anxiety for the client.