Nokea
A male client tells the clinic nurse that he is experiencing burning on urination, and assessment reveals that he had sexual intercourse four days ago with a woman he casually met. Which action should the nurse implement?
- A. Observe the perineal area for a chancroid-like lesion
- B. Obtain a specimen of urethral drainage for culture
- C. Assess for perineal itching, erythema and excoriation
- D. Identify all sexual partners in the last four days
Correct Answer: B
Rationale: A culture of urethral drainage is necessary to diagnose a potential sexually transmitted infection (STI).
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On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never mentioned the murmur. The nurse explains:
- A. The pediatrician is not a cardiologist.
- B. Murmurs are difficult to detect, especially in children.
- C. The fever increased the intensity of the murmur.
- D. We need to refer the child to an interventional cardiologist.
Correct Answer: C
Rationale: The increased cardiac output associated with fever can accentuate a heart murmur, making it more noticeable.
Mycoplasma pneumonia:
- A. Is associated with bullous myringitis
- B. Cold haemaglutinin antibodies are a recognised finding
- C. Guillain-Barre syndrome is a recognised sequel
- D. Is associated with erythema marginatum
Correct Answer: B
Rationale: Cold haemagglutinin antibodies are a recognized finding in Mycoplasma pneumonia. Bullous myringitis and Guillain-Barre syndrome are also associated.
Which occurs in septic shock?
- A. Hypothermia
- B. Increased cardiac output
- C. Vasoconstriction
- D. Angioneurotic edema
Correct Answer: B
Rationale: Increased cardiac output, which results in warm, flushed skin, is one of the manifestations of septic shock. Fever and chills are characteristic of septic shock. Vasodilation is more common than vasoconstriction. Angioneurotic edema occurs as a manifestation in anaphylactic shock.
The aminoacid used in the treatment of hyperammonemia due to certain urea cycle disorders is
- A. Leucine
- B. Valine
- C. Arginine
- D. Isoleucine
Correct Answer: C
Rationale: Arginine is used in the treatment of hyperammonemia due to urea cycle disorders, as it helps in the detoxification of ammonia.
The nurse is caring for a child with Kawasaki disease. A student nurse who is on the unit asks if there are medications to treat the disease. The nurse’s best response to the student nurse is:
- A. Immunogloulin G and ACE inhibitors
- B. Immunoglobulin and heparin
- C. Immunoglobulin G and aspirin
- D. Immunoglobulin and ibuprofen
Correct Answer: C
Rationale: The standard treatment for Kawasaki disease includes Immunoglobulin G and aspirin to reduce inflammation and prevent coronary artery complications.