Nokea
An HIV-positive patient presents to the ED complaining of shortness of breath and non-productive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85% on room air. All of the following statements regarding this patient's probable diagnosis are TRUE, EXCEPT
- A. Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients
- B. Pentamidine isothionate is an effective alternate therapy to TMP-SMX
- C. A normal chest x-ray rules out acute PCP infection
- D. 65% of patients relapse within 18 months
Correct Answer: H
Rationale: PCP top AIDS bug, pentamidine swaps TMP-SMX, relapse hits, steroids for hypoxia; normal CXR misses 20%. Nurses nix this chronic x-ray lie.
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The nurse is assessing a client with severe anemia. Which clinical manifestation does the nurse expect to see in this client?
- A. Bradycardia
- B. Pale, cool skin
- C. Hypertension
- D. Warm, flushed skin
Correct Answer: B
Rationale: Severe anemia starves oxygen pale, cool skin reflects shunted flow and low hemoglobin, a classic find as body compensates. Bradycardia's rare; tachycardia revs to pump more. Hypertension doesn't fit BP may drop. Warm, flushed skin suits overload, not anemia. Nurses expect pallor, tying it to blood's oxygen flop, a sign guiding transfusion or iron.
Which is the most common organism/s causing osteomyelitis in all age groups?
- A. streptococci
- B. staph aureus
- C. gm negatives
- D. hemophilus
Correct Answer: B
Rationale: Staph aureus reigns in osteomyelitis bone's bane across kids to geezers, sticking to marrow like glue. Streptococci hit less, gram-negatives tag trauma, hemophilus fades post-vaccine, fungi creep rare. Nurses bank on this staph stat, a chronic skeleton scourge needing targeted juice.
Epigenetic changes play a role in the development of type 2 diabetes mellitus. Question: Which of the following statements about epigenetics is correct?
- A. Epigenetic modifications lead to mutations in DNA
- B. Mutations in DNA lead to epigenetic modifications
- C. Epigenetic modifications only take place at a young age
- D. None of the statements provided above is correct
Correct Answer: D
Rationale: Epigenetics tweaks gene dials no mutations, not from mutations, not age-locked. Diet, stress flip switches anytime, a chronic type 2 player nurses note this, no false leads fit.
A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- A. Helping clients adjust to their appearance
- B. Reassuring clients that this change is temporary
- C. Referring clients to a reputable wig shop
- D. Teaching measures to prevent scalp injury
Correct Answer: D
Rationale: Alopecia, or hair loss, is a common chemotherapy side effect due to drugs targeting rapidly dividing cells, including hair follicles. While emotional support is vital, the priority is client safety. Teaching measures to prevent scalp injury such as avoiding harsh brushing or sun exposure takes precedence because the scalp becomes vulnerable without hair's protective barrier, risking cuts, infections, or burns. Helping clients adjust to appearance and reassuring them about regrowth address psychosocial needs but don't mitigate physical risk. Referring to a wig shop is practical but secondary to safety. In oncology nursing, prioritizing physical protection aligns with the hierarchy of needs, ensuring the client avoids complications like infection, especially if immunocompromised, before addressing emotional impacts.
Heart failure with preserved ejection fraction is caused by:
- A. Ventricular hypertrophy reducing contractility of muscles
- B. Decreased perfusion of the myocardium
- C. Dilated cardiomyopathy
- D. Impaired ventricular relaxation resulting in the lack of ability of ventricles to fill with blood
Correct Answer: D
Rationale: HFpEF stiff ventricles won't relax, slashing fill-up, not pump-out. Hypertrophy aids, doesn't cause; perfusion dips hurt supply; dilated's HFrEF. Nurses target this, a chronic fill flaw.