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In Netherlands, women who had pregnancy diabetes are advised to be tested regularly for diabetes. Question: This test is an example of which type of prevention?
- A. Universal prevention
- B. Selective prevention
- C. Indicated prevention
- D. Care-related prevention
Correct Answer: C
Rationale: Post-gestational checks indicated, high-risk group, not all, some, or sick. Nurses track this, a chronic red flag watch.
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A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is best?
- A. Call the client at home the next day to review teaching.
- B. Give the client information about a cancer support group.
- C. Provide all the preoperative instructions in writing.
- D. Reassure the client that surgery will be over soon.
Correct Answer: A
Rationale: A new cancer diagnosis combined with the urgency of surgery in three days can overwhelm a client, impairing their ability to process and retain preoperative instructions due to emotional stress and anxiety. Calling the client the next day to review teaching allows the nurse to reinforce key points, answer questions, and ensure comprehension when the client may be calmer and more receptive. While providing written instructions is helpful, it assumes literacy and may not address immediate confusion or emotional barriers. Offering support group information is valuable for long-term coping but doesn't prioritize the urgent need for surgical preparation. Reassuring the client that surgery will be over soon dismisses their concerns and doesn't enhance understanding. The follow-up call is the best action, as it aligns with adult learning principles and nursing's role in ensuring informed consent and readiness, reducing perioperative risks and anxiety for the client.
A 72 years old man is diagnosed to have Type 2 DM, hypertension and hyperlipidemia with stage 3 chronic kidney disease. He is otherwise well and asymptomatic. He is referred to you for follow-up care. His blood pressure is 142/70 mmHg with HbA1c 6.5%. You would continue his following medications EXCEPT
- A. Hydrochlorothiazide 12.5 mg OD
- B. Simvastatin 40 mg ON
- C. Aspirin 100 mg OD
- D. Glibenclamide 10 mg bid
Correct Answer: D
Rationale: Stage 3 CKD eGFR 30-59 means glibenclamide's out; it piles up, risking hypoglycemia in shaky kidneys. Thiazide holds BP, simvastatin guards lipids, aspirin shields heart, irbesartan protects kidneys all stay. Nurses swap sulphonylureas here, dodging chronic sugar crashes in fragile renal states.
Which ONE of the following is consistent with scarlet fever:
- A. Punctate rash on neck and trunk
- B. Circumoral erythema
- C. Geographic tongue
- D. Only occurs in association with streptococcal pharyngitis
Correct Answer: B
Rationale: Scarlet fever circumoral pallor, not erythema, rash, tongue, strep, peeling fit. Nurses spot this chronic strep face.
In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.
The nurse is caring for a patient who has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patient's care needs are unable to be met in a home environment. What might you suggest as an alternative?
- A. Discuss a referral for rehabilitation hospital
- B. Panel the patient for a personal care home
- C. Discuss a referral for acute care
- D. Discuss a referral for hospice care
Correct Answer: D
Rationale: Extensive small-cell lung cancer with a 6-month clock screams end-stage hospice fits, offering comfort-focused care in settings like home (with support), hospitals, or community sites. It matches his wish to avoid aggressive fixes, unlike rehab (for recovery) or acute care (for crises). Personal care homes lack the palliative punch needed here. Hospice blends patient and family needs, easing symptoms like pain or dyspnea, a cornerstone in oncology for terminal cases where quality trumps quantity.