Nokea
A healthcare worker with no known exposure to tuberculosis has received a Mantoux tuberculosis skin test. The nurse's assessment of the test after 62 hours indicates 5 mm of erythema without induration. What is the best initial nursing action?
- A. Document negative results in the client's medical record
- B. Repeat the test immediately on the opposite forearm
- C. Notify the healthcare provider for further evaluation
- D. Schedule the worker for a chest X-ray
Correct Answer: A
Rationale: Erythema without induration is not considered a positive result. Documentation of negative findings is appropriate.
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Nystagmus can be a presenting sign in:
- A. Partial albinism
- B. Retinopathy of prematurity
- C. Acute vestibulitis
- D. Medulloblastoma
Correct Answer: D
Rationale: Medulloblastoma, a type of brain tumor, can present with nystagmus due to its impact on the cerebellum and brainstem.
The following are recognised in coeliac disease:
- A. Oesophageal carcinoma
- B. Malignant lymphoma
- C. Hyposplenism
- D. Amyloidosis
Correct Answer: C
Rationale: Hyposplenism: Coeliac disease is associated with hyposplenism, which can result in impaired immune responses and increased susceptibility to infections.
Coxsackie viruses are implicated in:
- A. Herpangina
- B. Dermatitis herpetiformis
- C. Meningitis
- D. Orchitis
Correct Answer: A
Rationale: Coxsackie viruses are a common cause of herpangina. They can also cause meningitis and orchitis, but dermatitis herpetiformis is not associated with Coxsackie viruses.
Nurse Mariane is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus?
- A. Measuring head circumference
- B. Obtaining skull X-ray
- C. Performing a lumbar puncture
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Measuring head circumference is a non-invasive way to monitor for hydrocephalus, a common complication of spina bifida.
Regarding cough receptors:
- A. There is increased sensitivity in viral infections
- B. ~2-agonists decrease the sensitivity of cough receptors
- C. Exercise can stimulate the cough receptors in asthmatics
- D. They are predominantly seen in the large airways
Correct Answer: A
Rationale: Cough receptor sensitivity increases during viral infections, leading to heightened cough reflex.