Nokea
A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate?
- A. The cancer involves only the cervix.
- B. The cancer cells look like normal cells.
- C. Further testing is needed to determine the spread of the cancer.
- D. It is difficult to determine the original site of the cervical cancer.
Correct Answer: A
Rationale: Tis, N0, M0 means carcinoma in situ cancer's stuck to the cervix's surface, no invasion (T0), no lymph nodes (N0), no metastases (M0). It's early, contained. B's wrong grading, not staging, covers cell look (differentiation). C's off no spread's confirmed already. D's nonsense the cervix is the origin. Nurses break this down in oncology to ease fears only the cervix' signals a shot at cure with local treatment, not systemic chaos yet.
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A 58-year-old woman with chronic gout is visiting the dietitian and the correct dietary advice given is:
- A. To stop fried food and eat fish for better gout control
- B. To increase fructose drinks as it removes uric acid from urine
- C. Avoid soybeans and plant proteins
- D. Stop alcohol and reduce animal protein
Correct Answer: D
Rationale: Gout diet cut booze, meat; fructose spikes uric, soy's fine, mushrooms hurt, cherries help. Nurses steer this chronic food fix.
In Europe and the USA, drugs licensed for use in intrathecal drug delivery systems include:
- A. Diamorphine.
- B. Methadone.
- C. Morphine.
- D. Ziconotide.
Correct Answer: C
Rationale: Intrathecal drug delivery systems (IDDS) use specific licensed drugs in Europe and the USA. Morphine is widely approved for its efficacy in cancer and chronic pain, binding spinal opioid receptors with a strong evidence base. Ziconotide, a non-opioid, is also licensed, targeting calcium channels for refractory cases. Diamorphine (heroin) isn't licensed intrathecally; it's used epidurally or systemically in some regions (e.g., UK palliative care) but lacks IDDS approval. Methadone's long half-life and oral efficacy preclude intrathecal use; it's not licensed. Ketamine has experimental use but no formal approval. Morphine's prominence stems from its pharmacokinetic suitability high potency and spinal receptor affinity making it a cornerstone of IDDS therapy alongside ziconotide.
During hourly rounding the nurse enters a room where the client is unresponsive without pulse. What is the nurse's priority action?
- A. Begin ventilation at 1 breath every 6-8 seconds
- B. Start chest compressions at a rate of 100-120 compressions per minute
- C. Wait for the emergency response team for direction
- D. Call the family
Correct Answer: B
Rationale: No pulse, no response cardiac arrest kicks in chest compressions, 100-120/min, pumping life per ACLS, trumping breaths first in lone-rescuer mode. Waiting or calling delays; ventilation follows. Nurses hammer compressions, buying brain time, a priority slam in this code blue crash.
Foam cells are a prominent feature of atherosclerosis. Question: Foam cells develop as a result of which of the following options?
- A. Uptake of LDL in macrophages
- B. Uptake of LDL by LDL-R
- C. Uptake of ox-LDL by scavenger receptors
- D. Uptake of LDL by scavenger receptors
Correct Answer: C
Rationale: Foam cells ox-LDL via scavenger receptors stuff macrophages, not plain LDL or LDL-R. Nurses see this, a chronic plaque birth.
The nurse is caring for a 65-year-old female who presented to the emergency department with shortness of breath and chest discomfort. The client has not been feeling well for the past few days and complains of a productive cough of blood-tinged sputum. Laboratory tests reveal an elevated brain natriuretic peptide (BNP), and chest x-ray reveals pulmonary congestion. Based on the assessment findings, which of the following diagnosis are consistent with these findings?
- A. Heart failure (left-sided)
- B. Lung cancer
- C. Heart failure (right-sided)
- D. Pulmonary embolism
Correct Answer: A
Rationale: Elevated BNP and pulmonary congestion plus dyspnea, chest pain, hemoptysis point to left-sided heart failure, where ventricle falters, flooding lungs with fluid. Lung cancer might bleed but lacks BNP spike. Right-sided failure swells periphery, not lungs initially. Pulmonary embolism clots, not congests, with normal BNP. Nurses link this to left heart strain, anticipating diuretics, a diagnosis fitting this wet-lung picture.