Nokea
A female client is being treated for a deep-vein thrombus she developed post-operatively about one week ago and was treated with unfractionated heparin. Today she presents to the clinic with petechiae on bilateral hands and feet. Laboratory results show a platelet count of 42,000/mm³. The nurse is concerned about a drug reaction and anticipates the client has which of the following?
- A. Heparin-induced thrombocytopenia (HIT)
- B. Hemophilia A (classic hemophilia)
- C. Thrombotic thrombocytopenic purpura (TTP)
- D. Sickle cell crisis
Correct Answer: A
Rationale: Heparin can backfire petechiae and a platelet plunge to 42,000/mm³ post-DVT treatment scream HIT, an immune reaction trashing platelets, risking clots. Hemophilia's genetic, not drug-tied. TTP adds fever, neuro signs absent here. Sickle crisis pains, not bleeds like this. Nurses suspect HIT, anticipating heparin cessation and alternatives, a twist in this anticoagulation tale.
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The BMI that does NOT INCREASE the risk of renal disease and CKD is X. What is X?
- A. 25 or more
- B. 30 or more
- C. 35 or more
- D. 40 or more
Correct Answer: A
Rationale: Body Mass Index (BMI) correlates with chronic kidney disease (CKD) risk, with higher values linked to increased incidence due to obesity-related glomerular hypertension and inflammation. A BMI of 25 or more defines overweight and obesity, elevating CKD risk, though 18.5-24.9 is the range typically not increasing risk. The question's phrasing implies the threshold where risk begins, making 25 or more the level where renal disease risk rises, per studies like the Framingham Heart Study. Higher BMIs (30+, 35+, 40+) progressively worsen risk, with 30 marking obesity. Thus, 25 or more is the correct cutoff, guiding family physicians in counseling patients on weight management to prevent CKD onset.
Which of the following models calls for a political response to disability?
- A. Social
- B. Medical
- C. Activist
- D. Collaborative
Correct Answer: A
Rationale: Social model demands political fixes disability's a society fail, not body flaw nurses see it push access, not just meds. Medical treats; activist's vague; collaborative teams up, no policy call. It's a chronic shift, environment over anatomy.
Mr Tan, a 50-year-old with hypertension, sees you for a routine review. He reports three gout flares in the past two months, relieved with three days of Arcoxia for each episode. You perform some blood tests, which result in the following returns: Creatinine 95 umol/L, eGFR >90 mL/min, Uric acid 460 mmol/L, HbA1c 5.4 percent, Random hypo-count 7.5 mmol/L. He is currently on Amlodipine 10 mg OM. He does not drink alcohol except one glass of wine once or twice a year on special occasions. His BMI is 20.5 kg/m². Which is the most appropriate next step?
- A. Prescribe NSAIDs standby for gout flare
- B. Offer dietary advice and advise regular exercise only
- C. Discuss urate lowering therapy as he has had >2 gout flares in the past year, ideally with colchicine prophylaxis
- D. Offer exercise and dietary advice
Correct Answer: C
Rationale: Three gout flares in two months uric acid 460 beg for urate-lowering therapy like allopurinol, with colchicine to dodge attacks, fitting >2 flares yearly guideline. NSAIDs or steroids treat, not prevent; diet and exercise tweak, not tame, this level. Clinicians push this combo, curbing chronic gout's fire, a proactive leap.
The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells?
- A. Benign tumors grow through invasion of other tissue.
- B. Benign tumors have lost their cellular regulation from contact inhibition.
- C. Growing in the wrong place or time is typical of benign tumors.
- D. The loss of characteristics of the parent cells is called anaplasia.
Correct Answer: C
Rationale: Benign tumors are fundamentally different from malignant tumors in their behavior and characteristics. Unlike malignant tumors, which invade surrounding tissues, benign tumors do not grow through invasion but rather through hyperplasia, a controlled increase in cell number. They retain contact inhibition, a regulatory mechanism where normal cells stop dividing when they touch each other, preventing uncontrolled growth. The defining feature of benign tumors is that they consist of cells that are essentially normal but are growing in an inappropriate location or at an incorrect time, such as a lipoma in fatty tissue. Anaplasia, on the other hand, refers to the loss of differentiation and is a hallmark of malignant cancer cells, not benign ones. Thus, the instructor would emphasize that benign tumors are misplaced normal cells, making this the accurate statement. This distinction is critical for nursing students to understand, as it impacts diagnosis, treatment decisions, and patient education regarding the non-threatening nature of benign tumors compared to cancerous growths.
Rehabilitation utilises two types of rehabilitation interventions. The goal of the intervention support is to
- A. Maintaining existing abilities
- B. Restoring function
- C. Preventing deterioration and further disability
- D. Maintaining existing abilities while preventing new or further disabilities
Correct Answer: D
Rationale: Rehab's dual play hold steady, fend off worse blends maintenance and prevention, a chronic balance. Nurses aim here, a full guard.