Nokea
Biochemical abnormalities in a chronic carrier of hepatitis B are:
- A. Raised AST
- B. Low serum albumin
- C. Raised gamma GT
- D. Raised transferrin
Correct Answer: A
Rationale: The correct answer is A because chronic hepatitis B carriers often have raised AST (aspartate aminotransferase) due to liver inflammation. The other options are less specific or not typically associated with chronic hepatitis B.
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Of the following, the cyanotic cardiac lesion with decreased pulmonary blood flow is
- A. transposition of the great vessels
- B. single ventricle
- C. truncus arteriosus
- D. tricuspid atresia
Correct Answer: D
Rationale: Tricuspid atresia results in decreased pulmonary blood flow due to lack of right ventricular input.
Which client has the highest risk for developing skin cancer?
- A. A 16-year old dark-skinned female who tans in tanning beds once a week
- B. A 65 year-old fair-skinned male who is a construction worker
- C. A 25 year-old dark-skinned male whose mother had skin cancer
- D. A 70 year-old fair-skinned female who works as a secretary
Correct Answer: B
Rationale: Fair-skinned individuals with prolonged sun exposure, such as construction workers, are at higher risk for skin cancer.
A diagnosis of primary pulmonary hypertension of the newborn can be made if:
- A. Oxygen saturation in the hand is 80% and in the foot 67%
- B. A tachypnoeic baby has a saturation of 60%
- C. A baby with history of being covered in thick meconium at birth has PaO2 of 4kPa
- D. A septic baby is hypoxic in 100% oxygen
Correct Answer: A
Rationale: A significant difference in oxygen saturation between the upper and lower extremities (e.g., hand 80%, foot 67%) is indicative of persistent pulmonary hypertension of the newborn (PPHN).
Mechanisms of dyspnea in left heart disease include all, except
- A. PVH and decreased lung compliance
- B. Respiratory muscle fatigue
- C. Elevated LV End diastolic pressure leads to decreased antegrade coronary blood flow
- D. Reverse 'Bernheim' effect
Correct Answer: C
Rationale: Elevated LV end-diastolic pressure does not typically lead to decreased antegrade coronary blood flow.
A healthcare worker with no known exposure to tuberculosis has received a Mantoux tuberculosis skin test. The nurse's assessment of the test after 62 hours indicates 5 mm of erythema without induration. What is the best initial nursing action?
- A. Document negative results in the client's medical record
- B. Repeat the test immediately on the opposite forearm
- C. Notify the healthcare provider for further evaluation
- D. Schedule the worker for a chest X-ray
Correct Answer: A
Rationale: Erythema without induration is not considered a positive result. Documentation of negative findings is appropriate.