Nokea
About the mineralocorticoid antagonists (MRAs) which of the following is correct?
- A. Patiromer is a new MRA
- B. Losartan is a MRA
- C. MRAs can cause hypokalemia
- D. Finerenone is a novel nonsteroidal MRA
Correct Answer: D
Rationale: MRAs finerenone's new, not patiromer, losartan; hyperkalemia, albumin cuts fit. Nurses tap this chronic kidney tweak.
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During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next?
- A. Obtain more information about the family history.
- B. Schedule a sigmoidoscopy to provide baseline data.
- C. Teach the patient about the need for a colonoscopy at age 50.
- D. Teach the patient how to do home testing for fecal occult blood.
Correct Answer: A
Rationale: Family history of colon cancer flags risk first step's digging deeper: who, when, how many cases? That shapes if it's sporadic or hereditary (e.g., Lynch syndrome), guiding screening timing. Jumping to sigmoidoscopy or fecal tests skips assessment too soon without details. Colonoscopy at 50's standard, but family history might bump it earlier (e.g., 40 or 10 years before kin's diagnosis). Nurses in oncology start here, gathering intel to tailor prevention, not rushing tools that might miss the mark without context.
Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
- A. Yearly Pap tests
- B. Testicular self-examination
- C. Teaching patients to wear sunscreen
- D. Screening mammograms
Correct Answer: C
Rationale: Primary prevention stops cancer before it starts by reducing risk factors in healthy folks. Teaching sunscreen use blocks UV radiation a prime cause of skin cancer like melanoma fitting this category perfectly. Pap tests and mammograms are secondary prevention, detecting cervical and breast cancer early for treatment. Testicular self-exams also fall under secondary, aiming to catch testicular cancer sooner. The shift to primary efforts, like sun protection, reflects a proactive stance, cutting UV-induced DNA damage that kicks off carcinogenesis. Nurses pushing this can slash skin cancer rates, especially in fair-skinned populations, by fostering habits that shield against environmental triggers, unlike reactive screening or post-diagnosis care.
Which is not a differential diagnosis for tetanus?
- A. strychnine poisoning
- B. dystonic reactions
- C. quinsy
- D. rabies
Correct Answer: C
Rationale: Tetanus mimics strychnine, dystonia, rabies flex muscles; cyanide gasps, quinsy's throat, not spasms. Nurses sift this chronic stiffness list.
Which of these pulmonary conditions is most likely to be seen with a CD4 count between 200 and 500 ?
- A. pulmonary TB
- B. CMV
- C. PCP
- D. Kaposi sarcoma
Correct Answer: A
Rationale: CD4 200-500 TB sneaks in, lungs ripe before deeper drops. CMV, PCP crave <200; Kaposi's skin-first; cryptococcus hits brains more. Nurses clock TB's early strike, a chronic lung foe at this immune ledge.
Your junior trainee has been in theatre for 5 h with a patient undergoing a femorodistal bypass procedure. He is yawning and seems withdrawn. The trainee's fatigue is likely to be improved by:
- A. Imbibing one 60 ml shot of espresso coffee.
- B. Taking a 1-h nap.
- C. Increasing the brightness of the theatre lighting.
- D. Walking around and chatting to other members of staff.
Correct Answer: B
Rationale: Fatigue during long procedures impairs performance. A 60 ml espresso shot (50-100 mg caffeine) boosts alertness temporarily (20-30 minutes onset), but its effect wanes after 5 hours of sustained effort. A 1-hour nap restores cognitive function and vigilance significantly, countering sleep pressure per sleep research (e.g., NASA nap studies), with benefits lasting hours. Bright lighting enhances alertness via circadian stimulation but is less effective mid-fatigue. Walking and chatting provide a break, mildly boosting arousal, but lack restorative depth. Microsleeps signal severe fatigue, worsening performance. A nap's superiority lies in addressing accumulated sleep debt, critical in high-stakes settings like surgery, offering sustained recovery over stimulants or environmental tweaks.