Nokea
According to the World Health Organization's ICF Bio-Psycho-Social Model, which of the following factors is an environmental contextual factor?
- A. Social background
- B. Behaviour pattern
- C. Social attitudes
- D. Coping style
Correct Answer: C
Rationale: ICF's environment slot social attitudes shape disability's feel, a nurse's external lens. Background, behavior, coping are personal, not outer. It's a chronic context key, world over self.
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A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?
- A. Encourage several small meals daily
- B. Provide skin care to maintain skin integrity
- C. Assist the patient with hygiene, as needed
- D. Assess the integrity of the patient's oral mucosa regularly
Correct Answer: B
Rationale: Myelosuppression from chemo or cancer slashes white cells, making infection a top killer sepsis often starts at breached barriers like skin. Maintaining skin integrity via cleansing and protection stops bugs (e.g., Staph) from sneaking in, directly tackling this risk. Small meals fight malnutrition, a secondary factor, not the leading death driver. Hygiene helps, but it's broad, not specific to the prime entry point. Oral mucosa checks catch stomatitis, another risk, but skin's the bigger battlefield in oncology stats. Nurses prioritize this, knowing intact skin's the first defense against fatal infections in these fragile patients.
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.
With regards to metabolic and bariatric surgery performed in East Asia, which ONE of the following is most commonly performed?
- A. Roux-en-Y gastric bypass (RYGB)
- B. Adjustable gastric banding (AGB)
- C. Mini-gastric bypass
- D. Sleeve gastrectomy (SG)
Correct Answer: D
Rationale: In East Asia, sleeve gastrectomy (SG) has emerged as the most common bariatric surgery, surpassing Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB), per regional data and trends. SG's popularity stems from its technical simplicity, lower complication rates, and effectiveness in weight loss and metabolic improvement, appealing in populations with lower average BMI but high visceral fat, like Asians. RYGB, while effective, is less favored due to complexity and malabsorption risks. AGB has declined globally due to less sustained outcomes. Mini-gastric bypass is rising but not dominant. SG's prominence reflects practical and cultural fit, informing physicians on regional preferences for obesity management.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.
The nurse Questions which order for a client with thrombocytopenia?
- A. Apply ice to areas of trauma
- B. Administer intramuscular (IM) medication
- C. Test all urine and stool for the presence of occult blood
- D. Avoid enemas
Correct Answer: B
Rationale: Thrombocytopenia's bleed risk IM shots pierce muscle, risking hematomas, a questionable order nurses flag, as low platelets can't clot it. Ice curbs swelling, occult blood tests track bleeds, enemas avoid rectal tears all fit. Nurses challenge IM, pushing IV routes, a safety catch in this platelet-poor state.