Nokea
Lymphoma is differentiated in stages to assisting classifications. Stage III is when there are
- A. Diffuse or disseminated involvement of one or more extra lymphatic organs
- B. Involvement limited to one side of the diaphragm with two or more lymph node regions
- C. Involvement of lymph node regions on both sides of the diaphragm
- D. Involvement of a single lymph node region or single extralymphatic organ or site
Correct Answer: C
Rationale: Lymphoma's Stage III nodes jump diaphragm's sides, not one-sided, organ-wide, or solo. Nurses stage this, a chronic spread mark.
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Which vaccination should not be given to HIV sufferers?
- A. ADT
- B. Pneumococcal
- C. MMR
- D. DPT
Correct Answer: C
Rationale: MMR's live HIV's immune slump says no, unlike ADT, pneumococcal, DPT, or dead polio's safety. Nurses nix live shots, a chronic viral risk dodge.
Triglycerides in VLDL particles can be passed on to HDL particles. Question: Which enzyme mediates this process?
- A. Cholesteryl ester transfer protein (CETP)
- B. Hepatic lipase (HL)
- C. Hormone sensitive lipase (HSL)
- D. Lipoprotein lipase (LPL)
Correct Answer: A
Rationale: CETP swaps triglycerides VLDL to HDL, not lipase cutters. Nurses know this, a chronic lipid shuffle.
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.
Mr Yee, a 45-year-old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over the left elbow. He says that two years ago he took allopurinol 100 mg for one month, then 200 mg OM for one month but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago, and he says he probably took it 'once or twice a week'. He states he did not experience any rashes or other side effects to it then. He does not drink alcohol except one glass of wine once or twice a year on special occasions. He has past history of renal stones and also underlying ischaemic cardiomyopathy for which he is still being followed up by the cardiologist. Two weeks ago, he was admitted to the hospital for a gout flare. He had a blood test done, with the following results: Uric acid 620 mmol/L, Creatinine 120 umol/L, eGFR 55 mL/min, BP 144/94 mmHg, he has Hypertension on HCTZ long-term. He is asking you to give him Arcoxia 120 mg OM standby as it usually works for his gout flare. Which is correct advice?
- A. Discuss HLA B5801 testing particularly as febuxostat is being prescribed for him
- B. Advise that he will need stepwise up-titration of allopurinol to reach the uric acid target. Regular blood tests will allow this to be done safely
- C. Advise that colchicine prophylaxis is helpful to prevent gout attacks and increase hydrochlorothiazide to optimise his BP control
- D. Offer to initiate probenecid immediately as allopurinol is ineffective
Correct Answer: B
Rationale: Tophus and frequent flares with uric acid 620 mmol/L indicate chronic gout needing ULT. Prior allopurinol failure' likely stems from non-adherence (once/twice weekly), not ineffectiveness. Stepwise up-titration of allopurinol, starting low (e.g., 100 mg) due to eGFR 55, with regular blood tests (uric acid, creatinine), targets <360 mmol/L safely, per ACR guidelines. HLA-B5801 testing is for high-risk groups (e.g., Han Chinese) before allopurinol, not febuxostat-specific here. Colchicine helps, but increasing HCTZ (urate-retaining) may worsen gout. Probenecid suits renal underexcretors, not proven here. This approach optimizes chronic gout control.
Which of the following nursing interventions would be appropriate for a client with sickle cell disease?
- A. Prepare the client for surgery
- B. Encourage fluid intake
- C. Provide a warm environment
- D. Keep the client strictly NPO
Correct Answer: B
Rationale: Sickle cell's sticky cells crave hydration fluids thin blood, easing vaso-occlusion, a top intervention to cut crisis. Surgery's rare, warmth helps pain, NPO starves. Nurses push intake, preventing sickling, a hydration win in this hemoglobin war.