Nokea
As per Johnson and Chang (2014) which of the following is not a component of the Chronic Care Model?
- A. Person centred care
- B. Population health approach
- C. Community setting, collaborative across both primary and secondary care
- D. Reactive, symptom driven
Correct Answer: D
Rationale: The Chronic Care Model thrives on proactive pillars person-centered focus, population health, and community-primary-secondary teamwork aiming to preempt, not just patch, chronic woes. Reactive, symptom-driven care's old-school, clashing with this forward lean. Nurses ditch that lag, embracing prevention, a model shift for chronic mastery.
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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.
While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as the priority in the client's care?
- A. Ineffective peripheral tissue perfusion
- B. Alteration in body image
- C. Impaired skin integrity
- D. Alteration in activity tolerance
Correct Answer: C
Rationale: Varicose veins with ulcerations, edema, and heaviness scream venous stasis impaired skin integrity tops the list as open sores risk infection, a pressing threat needing immediate wound care. Ineffective perfusion drives the issue, but skin breakdown's acuity trumps. Body image matters emotionally, less urgently. Activity tolerance lags behind active complications. Nurses prioritize skin integrity, addressing ulcers' vulnerability, a direct care focus to halt deterioration in this chronic venous picture, aligning with safety and healing goals.
Which condition assessed by the nurse would be an early warning sign of childhood cancer?
- A. Difficulty swallowing
- B. Frequent cough or hoarseness
- C. Change in bowel and bladder habits
- D. Swellings, lumps or masses anywhere on the body
Correct Answer: D
Rationale: Childhood cancers often present with subtle, non-specific signs, but swellings, lumps, or masses anywhere on the body are a key early warning, indicating possible tumors like leukemia (lymphadenopathy), Wilms tumor, or sarcomas. Nurses must assess these palpable abnormalities, as they prompt urgent diagnostic workup imaging or biopsy to catch cancer early when treatment is most effective. Difficulty swallowing might suggest esophageal or brain tumors but isn't a common early childhood cancer sign. Frequent cough or hoarseness could indicate adult cancers (e.g., lung) or late-stage disease, not typical pediatric onset. Bowel and bladder changes are more adult-specific (e.g., colorectal cancer) or late effects in children. Lumps' prominence in pediatric guidelines underscores their priority, aligning with nursing's role in early detection to improve survival rates in young patients.
Mdm Koh, a 55-year-old housewife with hypertensive nephropathy was recently started on allopurinol 50 mg per day with prophylactic colchicine 500 mg OM 3 weeks ago in your clinic. She is on Lasix 20 mg OM, nifedipine LA 30 mg OM, aspirin 100 mg OM and renalvite 1 tab OM. She came down with flu like symptoms 4 days ago and developed rashes after being given Amoxil by another General Physician. Today, she returns to your clinic. What should be the next step?
- A. Stop Amoxil and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to clarithromycin 500 mg BD instead
- C. Continue medications and check for Dengue serology
- D. Stop all medications and refer for possible SJS
Correct Answer: D
Rationale: Rash post-Amoxil, allopurinol new SJS looms, stop all, refer fast; not just Amoxil, clarithro, dengue, or colchicine tweaks. Nurses flag this chronic skin scare.
An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells
- B. Malignant cells contain proteins called tumor-specific antigens
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells
- D. The nuclei of cancer cells are unusually large, but regularly shaped
Correct Answer: B
Rationale: Cancer cells sport tumor-specific antigens (e.g., CEA) proteins marking them as rogue, unlike normal cells. Fibronectin's less in malignant cells, aiding their slipperiness. Chromosomes are fragile and jumbled (aneuploidy), not stable. Nuclei are big and wonky (pleomorphic), not regular. Nurses in oncology education lean on this antigen trait it's why tests spot cancer and therapies target it, a clear line from normal to malignant.