Nokea
Lenore White is an 80-year-old woman who smokes two packs of cigarettes per day. What two ethical principles are in conflict?
- A. Beneficence and community
- B. Nonmaleficence and justice
- C. Autonomy and justice
- D. Autonomy and nonmaleficence
Correct Answer: D
Rationale: The nurse faces a dilemma between respecting autonomy (the patient’s choice to smoke) and preventing harm (nonmaleficence).
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Which of the following findings could indicate a need for further evaluation of the cardiac patient?
- A. Hematocrit 42%
- B. Potassium 4.2 mg/dl
- C. Sodium 140 mEq/dl
- D. Low-density lipoprotein of 190 mg/dl
Correct Answer: D
Rationale: LDL levels over 160 mg/dl warrant further evaluation for cardiovascular risk.
Joyce Mitchell is a 73-year-old frail female with a history of frequent falls, presenting with nausea, vomiting, sweating, and horizontal nystagmus. She is diagnosed with vestibular neuritis. What is the best initial course of treatment?
- A. Vestibular rehabilitation
- B. Supportive care with anti-nausea and anti-vertigo medication
- C. Fluids
- D. Epley maneuver
Correct Answer: B
Rationale: Supportive care with anti-nausea and anti-vertigo medication is appropriate for vestibular neuritis.
Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have:
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Type 2 diabetes
- D. Celiac disease
Correct Answer: B
Rationale: Hyperthyroidism can lead to fine, silky hair due to the effects of thyroid hormones.
A 78-year-old man has an emergency partial colectomy for lower gastrointestinal bleeding. A localized colonic adenocarcinoma is completely resected. The surgeon did not dissect lymph nodes for metastatic sampling. The patient wants to know if he should have chemotherapy. Should he?
- A. Yes because without knowing his complete staging it would be safer.
- B. No because he can be followed with serial carcinoembryonic antigens and CT scans.
- C. Yes because the severe bleeding indicates advanced disease.
- D. No because he is too old and will not likely have any problems during his lifetime.
Correct Answer: B
Rationale: Follow-up with serial carcinoembryonic antigens and CT scans is appropriate after resection of localized disease.
Which immunization reduces a patient’s risk for infection with the virus that causes painful localized blistering rash?
- A. Smallpox vaccine
- B. Varicella vaccine (chicken pox)
- C. Shingles (herpes zoster) vaccine
- D. Meningococcal vaccine
Correct Answer: C
Rationale: Shingles vaccine reduces the risk of herpes zoster, which causes painful rash.