Nokea
An intra-venous drug user with endocarditis has a TOE and multiple blood cultures taken. He is most likely to have:
- A. tricuspid valve involvement and s.aureus on blood culture
- B. tricuspid valve involvement and enterococci on blood culture
- C. mitral valve involvement and mixed growth on blood culture
- D. tricuspid valve involvement and candida on blood culture
Correct Answer: A
Rationale: IVDU endocarditis tricuspid flops, Staph aureus spikes, not enterococci, mixed, candida, or blanks. Nurses hear this chronic junkie beat.
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The nurse should suggest which food choice when providing dietary teaching for a patient scheduled to receive external-beam radiation for abdominal cancer?
- A. Fruit salad
- B. Baked chicken
- C. Creamed broccoli
- D. Toasted wheat bread
Correct Answer: B
Rationale: Abdominal radiation zaps the gut, sparking diarrhea from irritated bowels baked chicken's lean protein fuels healing without roughage to rile things up. Fruit salad's fiber and whole-grain toast's bulk worsen diarrhea; dairy in creamed broccoli risks lactose issues post-radiation. Nurses steer patients here to low-residue diets, dodging raw fruits and grains that scrape an already tender GI tract. In oncology, it's about balancing nutrition with symptom control chicken keeps strength up without the bowel chaos, key for tolerating treatment.
Which is not a common cause of respiratory symptoms in HIV/AIDS patients?
- A. community acquired bacterial pneumonia
- B. non hodgkins lymphoma
- C. Pulmonary Embolus
- D. CMV
Correct Answer: C
Rationale: Pulmonary embolus isn't HIV's lung usual clots tie to beds, not AIDS' immune dive. Pneumonia, lymphoma, CMV, PCP thrive in CD4's fall; emboli don't care. Nurses chase opportunists first, a chronic breath thief lineup skipping this oddball.
Which of the following has been shown to be useful in managing fatty liver?
- A. Insulin injection
- B. Metformin
- C. Vitamin E
- D. Exercises
Correct Answer: C
Rationale: Vitamin E, an antioxidant, reduces hepatic inflammation in non-alcoholic steatohepatitis (NASH), per AASLD guidelines, aiding NAFLD management. Insulin treats diabetes, not NAFLD directly. Metformin improves insulin sensitivity but lacks strong evidence for NAFLD reversal. Exercise and diet are key but split here; exercise aids weight loss, indirectly helping. Vitamin E's specific benefit makes it notable in chronic liver disease care.
Inhaled medications, such as bronchodilators and glucocorticoids are the main medication treatment methods for COPD. What is the biggest reason for ineffective outcomes?
- A. Patient compliance with dose prescription
- B. Incorrect use of the device
- C. Incorrect prescribing
- D. Reduced drug inhalation due to respiratory disease
Correct Answer: B
Rationale: COPD inhalers flop most when puffed wrong technique, not timing, trumps compliance, bad scripts, or weak lungs. Spacers, shaky hands nurses fix this, a chronic breath's weak link.
A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?
- A. Assessing the IV site every hour
- B. Educating the client on side effects
- C. Monitoring the client for nausea
- D. Providing warm packs for comfort
Correct Answer: A
Rationale: Chemotherapy drugs administered via peripheral IV can be vesicants, meaning they can cause severe tissue damage if they leak (extravasate) into surrounding tissues. Peripheral lines are more prone to this than central lines due to smaller vein size and less secure placement. Assessing the IV site hourly or per facility policy is the most important action to prevent extravasation, ensuring the line remains patent and no swelling, redness, or pain develops. Early detection allows prompt intervention, like stopping the infusion, to minimize harm. Educating about side effects and monitoring for nausea are key aspects of care but address systemic effects, not the immediate risk of local tissue injury. Warm packs might soothe discomfort but could worsen damage if extravasation occurs. Prioritizing IV site assessment reflects the nurse's role in safety and prevention, critical in oncology where chemotherapy's potency demands vigilant monitoring to protect the client from serious complications.