Nokea
A study by Epstein & Sowers found that hypertension was X times as prevalent in patients with diabetes compared to the general population. What is X?
- A. Two
- B. Three
- C. Four
- D. Five
Correct Answer: A
Rationale: Diabetes doubles hypertension's odds Epstein & Sowers peg it at two times higher, as insulin resistance and vascular stiffness team up, amplifying prevalence over the general crowd. Three, four, five, or six inflate the risk beyond data, skewing the synergy. This duo's frequent dance tied to shared pathways like RAAS pushes clinicians to screen harder, tackling both to cut cardiovascular and renal doom, a chronic combo grounded in solid stats.
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A 56-year-old patient comes to the walk-in clinic for scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history for colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?
- A. Diarrhea/Constipation related to altered bowel patterns
- B. Knowledge Deficit related to disease process and diagnostic procedure
- C. Risk for Fluid Volume Deficit related to rectal bleeding and diarrhea
- D. Anxiety related to unknown outcomes and perceived threat to body integrity
Correct Answer: D
Rationale: The patient's anger and threat to leave during colonoscopy teaching signal emotional distress overriding physical symptoms. Anxiety stemming from uncertain outcomes and perceived bodily threat fits, as colorectal cancer risk tied to polyps and family history heightens fear, blocking education uptake. Diarrhea/constipation reflects symptoms but isn't immediately urgent with scant bleeding. Knowledge deficit exists but is secondary fear drives the refusal, not just ignorance. Fluid volume risk is plausible with bleeding, yet no data suggests acute loss; stability allows focus on emotions. Addressing anxiety first calms the patient, enabling teaching and care, a priority in this tense encounter where psychological barriers could delay critical colorectal screening and intervention.
A parent of a child with Wilms tumor asks the nurse about surgery. Which statement concerning the type of surgery for Wilms tumor is most accurate?
- A. Surgery is only done if chemotherapy and radiation fail.
- B. Surgery is usually performed within 24 to 48 hours of admission.
- C. Surgery is the least favorable therapy for the treatment of Wilms tumor.
- D. Surgery will be delayed until the child's overall health status improves.
Correct Answer: B
Rationale: Wilms tumor, a kidney cancer in children, is primarily treated with surgical resection (nephrectomy) as the cornerstone of therapy, typically performed within 24 to 48 hours of diagnosis to remove the tumor before it spreads. This urgency stems from its responsiveness to surgery and the need to stage the cancer accurately, guiding subsequent chemotherapy or radiation. Delaying surgery until chemotherapy or radiation fails is incorrect surgery is the initial step, not a last resort. It's not the least favorable option; rather, it's the preferred first-line treatment due to high cure rates when combined with adjuvant therapies. Waiting for health improvement isn't standard unless the child is critically unstable, which isn't typical at diagnosis. The nurse's accurate explanation reassures parents and underscores surgery's role, aligning with pediatric oncology protocols to optimize outcomes in Wilms tumor management.
In CSF of a patient with viral meningitis, the most prominent white cell is usually?
- A. monocytes
- B. lymphocytes
- C. polymorphs
- D. eosinophils
Correct Answer: B
Rationale: Viral meningitis pulls lymphocytes immune sentinels flood CSF, not polymorphs of bacterial wars, monocytes lagging, eosinophils for worms, or vague granulocytes. It's the chronic viral signature nurses spot this shift, ruling out pus-filled bacterial chaos with one cell peek.
An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider?
- A. Patient complains of severe fatigue.
- B. Patient voids every hour during the day.
- C. Patient takes only 50% of meals and refuses snacks.
- D. Patient has crackles up to the midline posterior chest.
Correct Answer: D
Rationale: High-rate fluids (175 mL/hr) plus chemo in an older colorectal patient can swamp the heart crackles to midline yell heart failure, trumping fatigue , peeing , or poor eating . Nurses in oncology flag this lungs drowning need stat help, a fluid overload crisis.
Question: Which statement applies to glucose measurement in a central laboratory? Statement 1: Glucose values are normally determined in venous blood. Statement 2: Glucose values are given in plasma values. Which answer is correct?
- A. Both statements are correct
- B. Both statements are incorrect
- C. Statement 1 is correct; statement 2 is incorrect
- D. Statement 1 is incorrect; statement 2 is correct
Correct Answer: A
Rationale: Lab glucose venous blood, plasma read, both true, a chronic standard nurses trust.