Nokea
In which of these do you see clue cells?
- A. trichomonas vaginalis
- B. bacterial vaginosis
- C. candida
- D. HSV 2
Correct Answer: B
Rationale: Clue cells BV's fishy flag, not trich's swim, candida's yeast, HSV's sores, or syphilis' chancre. Nurses scope this chronic hint.
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A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient's cancer cells spread?
- A. Hematologic spread
- B. Lymphatic circulation
- C. Invasion
- D. Angiogenesis
Correct Answer: B
Rationale: Lung cancer loves lymphatics its cells hitch rides via nodes, the most common metastasis route, hitting bones and liver downstream. Blood (hematologic) spread happens too, but lymph's king for lung primaries. Invasion's local creep, not distant jumps. Angiogenesis feeds tumors, not moves them. Nurses track this pattern, knowing lymph drainage from lungs seeds those far-off sites, a grim oncology reality shaping staging and prognosis.
Prescription of long term oxygen therapy has some very strict guidelines. In order to qualify for this treatment, the patient has to:
- A. Be admitted to hospital 3 times within a 12 month time frame with acute exacerbation of COPD
- B. Demonstrate a significant impairment of QOL because of dyspnoea and decreased exercise capacity
- C. Have very high levels of anxiety which impact on their ability to self-manage and increase stress on carer
- D. Have a diagnosis of severe COPD with PaO2 of >55 mmHg, or evidence of tissue hypoxia and end organ damage
Correct Answer: D
Rationale: O2's lifeline demands proof severe COPD with PaO2 ≤55 mmHg or hypoxia's organ bite, a strict cut. Admissions, QOL dips, anxiety don't seal it hypoxemia does. Nurses gatekeep this, a chronic oxygen rule.
Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy?
- A. Using lemon glycerin swabs for oral hygiene.
- B. Keeping the child NPO until all sores are healed.
- C. Having the child swish and swallow viscous lidocaine.
- D. Giving the child pudding for breakfast.
Correct Answer: D
Rationale: Mucositis, a painful chemotherapy side effect, involves inflamed, ulcerated mucous membranes, often in the mouth, complicating eating and hygiene. Offering pudding a soft, bland, cool food is the best intervention, as it minimizes irritation and pain, encouraging nutrition without exacerbating sores. Lemon glycerin swabs are harsh, with citric acid and chemicals worsening discomfort and delaying healing. Keeping the child NPO (nothing by mouth) for weeks until sores heal is impractical and risks malnutrition, as mucositis can persist throughout chemotherapy. Viscous lidocaine might numb pain but is a last resort if the child refuses all intake, not a first-line comfort measure. Pudding supports hydration and calorie intake safely, aligning with nursing's goal to maintain nutrition and comfort in pediatric oncology, reducing mucositis-related distress effectively.
You are seeing Mr Yee two months later. At your last visit, he did not want colchicine prophylaxis as he did not want to take 'too many tablets'. He has started and is adherent to his urate lowering agent. Last month, his uric acid had decreased to 390 mmol/L. He had a gout flare last week. Hence, he came to your clinic today to ask about colchicine prophylaxis. Which is INCORRECT advice regarding colchicine prophylaxis?
- A. Offer to start colchicine at 500 mcg once daily or alternate days as gout prophylaxis as his renal function is normal
- B. Colchicine can help to reduce the frequency of flares, especially during the first six months of Urate lowering therapy
- C. Tell him that if he is started on NEW medications, he should inform his doctor or pharmacist that he is on colchicine regularly as colchicine can have drug interactions. If unsure and he needs to take NEW medications, such as a short course of antibiotics, he is to omit colchicine until the new medication is completed
- D. Regular colchicine prophylaxis in someone with normal renal function and regular monitoring can lead to renal failure
Correct Answer: D
Rationale: Colchicine curbs flares 500 mcg fits normal kidneys, cuts attacks in urate-lowering's rocky start, and needs drug interaction flags or skips with gut upset. But renal failure from regular use with monitoring? False colchicine's safe there, not a kidney killer. Clinicians nix this myth, grounding chronic gout aid in truth.
When educating a female client on the signs and symptoms of myocardial infarction, the nurse recognizes which of the following should be included in the teaching?
- A. Pain usually resolves with rest and relaxation
- B. Older adults and women often present with atypical signs and symptoms
- C. Women experience intermittent claudication
- D. Substernal chest pain is the most common symptom in women
Correct Answer: B
Rationale: MI in women skews odd fatigue, nausea, not just chest pain, hit older females especially, a teaching must as atypical signs delay care. Rest eases angina, not MI. Claudication's PAD, not heart. Substernal pain's common, less so in women. Nurses stress this quirk, boosting recognition in this sneaky killer.