Nokea
A 36 year old woman visits her family doctor requesting blood test to check her cholesterol. She has family history of premature coronary heart disease. Physical examinations are unremarkable. Lipid profile is done and shows it the following results: Total cholesterol 5.8 mmol/L, HDL-cholesterol 1.1 mmol/L, LDL-cholesterol 3.6 mmol/L, Triglyceride 2.4 mmol/L. What is the MOST likely diagnosis?
- A. Familial hyperlipidemia
- B. Mixed hyperlipidemia
- C. Hypercholesterolaemia
- D. Familial combined hyperlipidemia
Correct Answer: B
Rationale: Cholesterol 5.8, LDL 3.6, triglycerides 2.4 both up, HDL lowish screams mixed hyperlipidemia, not lone cholesterol or triglyceride spikes. Family heart history hints genetics, but numbers don't pin familial types yet. Nurses flag this chronic dual lipid mess, tied to early coronary risk.
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Assessment of NAFLD at primary care clinic includes for followings except:
- A. Fibroscan
- B. Fasting glucose
- C. Liver biopsy
- D. Liver function test
Correct Answer: C
Rationale: NAFLD's primary peek Fibroscan, glucose, lipids, and LFTs flags fat and fallout, all doable outpatient. Liver biopsy, gold but invasive, stays secondary, not routine. Clinicians lean on non-pokey tools, screening chronic liver load smart, a practical dodge of the knife.
Tetanus:
- A. typically has an incubation period of 23 days
- B. immunization status is particularly poor in elderly women
- C. toxoid is more effective by S.C. injection
- D. IgG will provide passive protection for about a week
Correct Answer: B
Rationale: Tetanus 7-10 days incubate, elderly women lag shots, IM toxoid, Ig lasts longer, pregnancy's fine. Nurses tag this chronic gap.
According to the theory of planned behaviour, what is the best predictor of behaviour?
- A. Attitude
- B. Habit
- C. Intention
- D. Social norm
Correct Answer: C
Rationale: Planned behaviour intention rules, not just liking, routine, or peer push. Nurses bet on this, a chronic action cue.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.
The client is diagnosed with laryngeal cancer and is scheduled for a laryngectomy next week. Which intervention would be priority for the clinic nurse?
- A. Assess the client's ability to swallow
- B. Refer the client to a speech therapist
- C. Order the client's preoperative lab work
- D. Discuss the client's operative unit
Correct Answer: B
Rationale: Laryngectomy severs voice referring to a speech therapist pre-op sets up post-surgical communication, a priority as clients lose speech, facing isolation without aids like electrolarynx training. Swallowing matters, but airway and cancer trump function now. Labs are routine, delegated often; unit talk's secondary. Nurses push this referral, easing the mute transition, a proactive step in laryngeal cancer's life-altering prep, ensuring clients adapt to this voiceless future from day one.