Nokea
Cytomegalovirus causes:
- A. infantile bronchiolitis
- B. retinitis
- C. chronic
- D. neonatal encephalitis
Correct Answer: B
Rationale: CMV retinitis blinds HIV, not bronchiolitis, vague chronic, brain hits, or Kaposi's herpes 8. Nurses eye this chronic sight thief.
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Which of the following would predispose a client to mitral stenosis?
- A. Obesity
- B. Rheumatic fever
- C. Intravenous drug use
- D. Diabetes
Correct Answer: B
Rationale: Mitral stenosis narrows the valve rheumatic fever's scarring, from streptococcal aftermath, is the prime culprit, stiffening leaflets over years. Obesity, IV drug use (tied to endocarditis), or diabetes don't directly scar valves. Nurses link rheumatic history to this, watching for dyspnea or murmurs, a legacy of infection shaping this cardiac bottleneck.
During general anaesthesia for orthognathic surgery:
- A. A head-down supine position is popular to minimize the risk of airway soiling.
- B. Lidocaine with adrenaline 1:80000 is used for infiltration.
- C. Non-steroidal anti-inflammatory drugs (NSAIDs) are avoided even after haemostasis is achieved.
- D. Blocks of both mandibular and maxillary nerves are possible and useful.
Correct Answer: D
Rationale: Anaesthesia for orthognathic surgery balances airway and bleeding risks. Head-up positioning, not head-down, reduces venous congestion and airway soiling from blood head-down risks aspiration. Lidocaine with adrenaline (typically 1:80,000-1:200,000) minimizes bleeding via vasoconstriction, a standard infiltration. NSAIDs are used post-haemostasis for analgesia, not universally avoided, unless bleeding risk persists. Mandibular and maxillary nerve blocks (e.g., V2, V3) reduce opioid needs and enhance pain control, leveraging regional anaesthesia's precision in jaw surgery. Propofol TIVA may improve recovery versus volatiles, per studies, but isn't definitive. Nerve blocks' utility optimizes perioperative pain management, critical in extensive osteotomies.
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.
A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?
- A. Encourage several small meals daily
- B. Provide skin care to maintain skin integrity
- C. Assist the patient with hygiene, as needed
- D. Assess the integrity of the patient's oral mucosa regularly
Correct Answer: B
Rationale: Myelosuppression from chemo or cancer slashes white cells, making infection a top killer sepsis often starts at breached barriers like skin. Maintaining skin integrity via cleansing and protection stops bugs (e.g., Staph) from sneaking in, directly tackling this risk. Small meals fight malnutrition, a secondary factor, not the leading death driver. Hygiene helps, but it's broad, not specific to the prime entry point. Oral mucosa checks catch stomatitis, another risk, but skin's the bigger battlefield in oncology stats. Nurses prioritize this, knowing intact skin's the first defense against fatal infections in these fragile patients.
A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most appropriate?
- A. Assess the client's gait and balance.
- B. Ask the client about the ease of urine flow.
- C. Document the report completely.
- D. Inquire about the client's job risks.
Correct Answer: A
Rationale: Prostate cancer commonly metastasizes to bones, especially the spine, causing spinal cord compression a medical emergency that can lead to paralysis if untreated. New, severe low back pain in this context suggests possible metastasis, making gait and balance assessment the most appropriate action to check for neurological deficits (e.g., weakness, unsteady gait) indicating compression. This prioritizes client safety, as falls or worsening paralysis could result without intervention. Asking about urine flow relates to prostate obstruction, less urgent here given the pain's prominence. Documentation is essential but passive without assessment. Job risks might contribute to back pain but are secondary to cancer history. Assessing gait and balance first ensures rapid escalation if needed, reflecting oncology nursing's focus on detecting metastatic complications early.