Nokea
A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritus caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. Which action should the nurse implement?
- A. Schedule an appointment for the client to see the healthcare provider
- B. Advise the client to apply more corticosteroid cream
- C. Recommend using an antibiotic ointment.
- D. Instruct the client to stop using the medication for 24 hours.
Correct Answer: A
Rationale: Increased erythema and purulent exudate suggest infection. The client needs evaluation and possible treatment with antibiotics.
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Consequences of a median nerve section in the ante-cubital fossa include:
- A. Complete paralysis of pronation
- B. Loss of sensation over palmar aspect of middle finger
- C. Wasting of hypothenar eminence
- D. Paralysis of abductor pollicis brevis
Correct Answer: D
Rationale: The median nerve controls the abductor pollicis brevis, and its injury at the ante-cubital fossa results in an inability to perform thumb abduction.
The following tests are routine in the management of an epileptic on carbamazepine:
- A. Blood counts
- B. Serum levels
- C. Liver function tests
- D. Renal function tests
Correct Answer: C
Rationale: Liver function tests are routinely monitored in patients taking carbamazepine due to the risk of liver toxicity, which can occur with prolonged use.
Recognised associations of Addison's disease include:
- A. Neurofibromatosis
- B. Phaeochromocytoma
- C. IDDM
- D. Nephrogenic diabetes insipidus
Correct Answer: C
Rationale: The correct answer is C because IDDM (insulin-dependent diabetes mellitus) is a recognized association of Addison's disease. The other options (a, b, d, e) are less commonly associated.
What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?
- A. A fat intake reduction of 5-10% of total calories
- B. A fat intake reduction of 10-15% of total calories
- C. A fat intake reduction of 15-20% of total calories
- D. A fat intake reduction of 25-35% of total calories
Correct Answer: D
Rationale: For a child with increased cholesterol, a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.
Proteins found in muscle fibers include:
- A. Vimentin
- B. Saccharin
- C. Keratin
- D. Desmin
Correct Answer: D
Rationale: Desmin: Desmin is an intermediate filament protein found in muscle cells, providing structural support and maintaining the integrity of muscle fibers.