Nokea
Choose from the following the primary goals of TPN? I. promote weight gain II. improve nutritional status III. maintain muscle mass IV. establish nitrogen balance! V. enhance healing process
- A. I, II, & III
- B. I, & II,
- C. I, II, III, & IV
- D. I, II , III , IV & V
Correct Answer: C
Rationale: Total Parenteral Nutrition (TPN) is a method of providing nutrition to patients who cannot or should not obtain their nutrition through regular oral intake. The primary goals of TPN include promoting weight gain, improving nutritional status, maintaining muscle mass, and establishing nitrogen balance. These goals are crucial to support the overall health and well-being of the patient receiving TPN. Enhancing the healing process is an important aspect of TPN as well, but it is not considered one of the primary goals as weight gain, nutritional status, muscle mass, and nitrogen balance are typically the immediate priorities when administering TPN.
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A patient with a history of Hodgkin lymphoma presents with fever, chills, and generalized malaise. Laboratory tests reveal pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement. Which of the following conditions is most likely to cause these findings?
- A. Autoimmune hemolytic anemia (AIHA)
- B. Myelodysplastic syndrome (MDS)
- C. Aplastic anemia
- D. Paraneoplastic syndrome
Correct Answer: D
Rationale: The patient is presenting with symptoms and laboratory findings consistent with a paraneoplastic syndrome related to Hodgkin lymphoma. In this case, the fever, chills, generalized malaise, pancytopenia, circulating Reed-Sternberg cells, and bone marrow involvement are all indicative of a paraneoplastic syndrome associated with Hodgkin lymphoma. Paraneoplastic syndromes are a group of disorders that are triggered by an abnormal immune response to a neoplasm, such as Hodgkin lymphoma, leading to various systemic manifestations.
Following a severe traumatic brain injury, a patient is experiencing alterations in consciousness characterized by periods of wakefulness but with no meaningful interaction with the environment. Which term best describes this state?
- A. Coma
- B. Vegetative state
- C. Minimally conscious state
- D. Locked-in syndrome
Correct Answer: B
Rationale: A vegetative state, now more commonly referred to as unresponsive wakefulness syndrome, describes a condition where the patient is awake but with no awareness of themselves or their surroundings. This state usually follows a severe brain injury, such as traumatic brain injury. Patients in a vegetative state may have sleep-wake cycles, open their eyes, and even exhibit reflex movements, but they do not demonstrate any meaningful interaction with the environment. Differentiating between coma and vegetative state is important, as coma implies a complete lack of consciousness, while patients in a vegetative state have preserved wakefulness without awareness. Minimally conscious state (choice C) refers to a condition where there are some minimal signs of awareness or purposeful interaction, making it a different state than the one described in the scenario. Locked-in syndrome (choice D) is a condition where the patient is conscious and aware but unable to move or communicate due to paralysis, which is not consistent
Nurse Rica is in charge of the animal bite program of the health center, which of the following is the causative agent of rabies?
- A. Parasite
- B. Bacteria
- C. Virus
- D. Fungi
Correct Answer: C
Rationale: Rabies is a viral disease that affects the central nervous system. It is primarily transmitted through the bite of an infected animal, such as dogs, bats, raccoons, and foxes. The causative agent of rabies is the rabies virus, specifically from the genus Lyssavirus. Once the virus enters the body, it spreads through the nervous system to the brain, leading to severe neurological symptoms and, if left untreated, is almost always fatal. This is why prompt medical attention and vaccination following an animal bite are crucial in preventing the development of rabies in humans.
Should the investigation of the fall go further, which of the following is the best source of factual information ?
- A. incident report.
- B. nurse's notes in the chart
- C. anecdotal record
- D. process recording
Correct Answer: A
Rationale: The incident report is the best source of factual information to investigate the fall further. Incident reports are official documents that provide a detailed account of what happened leading up to and during an incident. They include factual information such as the date, time, location, individuals involved, and details of the event. By reviewing the incident report, investigators can gather accurate information to determine the cause of the fall and any contributing factors. This document serves as an essential tool in conducting a thorough investigation into the fall and helps in identifying preventive measures to avoid similar incidents in the future.
A patient with heart failure is prescribed digoxin. Which electrolyte imbalance increases the risk of digoxin toxicity?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hyponatremia
Correct Answer: C
Rationale: Hypokalemia (low levels of potassium) increases the risk of digoxin toxicity. This is because digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in the cell membrane. When potassium levels are low, there is an increased binding of digoxin to these pumps, leading to enhanced entry of calcium into the cells. This can result in an increased intracellular calcium concentration, leading to digoxin toxicity and potential cardiac arrhythmias. Therefore, monitoring and correcting potassium levels is crucial in patients prescribed digoxin to reduce the risk of toxicity.