Nokea
After change-of-shift report on the oncology unit, which patient should the nurse assess first?
- A. Patient who has a platelet count of 82,000/µL after chemotherapy
- B. Patient who has xerostomia after receiving head and neck radiation
- C. Patient who is neutropenic and has a temperature of 100.5°F (38.1°C)
- D. Patient who is worried about getting the prescribed long-acting opioid on time
Correct Answer: C
Rationale: Neutropenia plus 100.5°F screams infection sepsis looms, outranking low platelets (A bleeding's later), dry mouth , or opioid timing . Nurses in oncology bolt here fever in a white-cell wasteland's a killer, needing stat eyes.
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Which does not cause genital ulceration?
- A. syphilis
- B. herpes simplex infection
- C. HIV
- D. lymphogranuloma venereum
Correct Answer: C
Rationale: HIV no direct ulcers; syphilis, herpes, LGV, chancroid carve sores. Nurses rule this chronic outlier.
Which of the following management activities is not part of the nursing care of a patient with COPD?
- A. Achieving airway clearance and improving breathing patterns
- B. Ensuring the patient stays in bed and does not exert themselves causing increased dyspnoea
- C. Improving activity tolerance and assisting with lifestyle modification
- D. Monitoring and managing potential complications
Correct Answer: B
Rationale: COPD nursing pushes clearance, tolerance, and complication watch active goals. Bedrest flops deconditions, worsens breathlessness, a chronic care no-no nurses dodge.
A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.
Which of the following are not part of the diabetic retinopathy that cause visual impairment in patients with diabetes?
- A. Pre proliferative retinopathy
- B. Macular oedema
- C. Proliferative retinopathy
- D. Macular degeneration
Correct Answer: D
Rationale: Diabetic retinopathy pre-proliferative, edema, proliferative blur eyes from sugar's vessel rot. Macular degeneration's age, not diabetes. Nurses spot this, a chronic sight split.
Which drug should not be given with midazolam?
- A. zidovudine
- B. lamivudine
- C. nevirapine
- D. indinavir
Correct Answer: D
Rationale: Indinavir boosts midazolam P450 clash sedates too deep, unlike zidovudine, lamivudine, nevirapine, or ritonavir's fit. Nurses dodge this chronic sleep trap.