Nokea
Many factors in nasopharyngeal carcinoma patients may affect the prognosis. Which of the following carries the worst outcome?
- A. elevated lactate dehydrogenase (LDH) level
- B. advanced disease
- C. extensive cervical lymph node involvement
- D. evidence of Epstein-Barr virus (EBV) DNA
Correct Answer: A
Rationale: Elevated LDH levels are strongly associated with aggressive disease and poor prognosis.
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The procedure that has to be performed in order to shift thehigh pressure from the right ventricle to the left ventricle in Transposition of the Great Arteries (TGA) is:
- A. Rashkind Procedure
- B. Rastelli Procedure
- C. Pulmonary Artery Banding
- D. Jatene Procedure
Correct Answer: D
Rationale: The Jatene procedure is a surgical technique used to correct Transposition of the Great Arteries (TGA). In this procedure, the great arteries (aorta and pulmonary artery) are switched back to their correct positions. The aorta is connected to the left ventricle, and the pulmonary artery is connected to the right ventricle. This correction allows for oxygen-rich blood to flow from the left side of the heart to the body, and oxygen-poor blood to flow from the right side of the heart to the lungs for oxygenation. The Jatene procedure is preferred over other methods like the Rashkind procedure, Rastelli procedure, or pulmonary artery banding for this specific purpose of correcting the high-pressure circulation seen in TGA.
Which is an effective strategy to reduce the stress of burn dressing procedures?
- A. Give the child as many choices as possible.
- B. Reassure the child that dressing changes are not painful.
- C. Explain to the child why analgesics cannot be used.
- D. Encourage the child to master stress with controlled passivity.
Correct Answer: A
Rationale: Giving the child as many choices as possible is an effective strategy to reduce the stress of burn dressing procedures. Allowing the child to have some control over the situation can help them feel more empowered and less anxious. By giving choices, such as letting the child choose the order in which things are done or the type of dressing used, the child is more likely to feel a sense of autonomy and reduced stress during the procedure. This approach can help the child cope better with the dressing changes and make the experience more manageable for them.
Nurse Raymond is handling a group of student nurses and he is teaching them about fluids and electrolytes. He is correct when he says that a substance moves from an area of higher concentration, this is:
- A. osmosis
- B. filtration
- C. diffusion
- D. active transport
Correct Answer: C
Rationale: Diffusion is the movement of molecules from an area of higher concentration to an area of lower concentration. In the context of fluids and electrolytes, this process plays a crucial role in maintaining the balance of these substances in the body. Nurse Raymond is correct in stating that diffusion is the mechanism by which substances move down their concentration gradient. Osmosis involves the movement of water across a semipermeable membrane, filtration is the process of separating substances based on size through a filtering mechanism, and active transport requires energy to move substances against their concentration gradient.
A 16-year-old mother complaining of breast engorgement feels unhappy living with her husband. The MOST appropriate action is
- A. refer her to an obstetrician
- B. advise her to apply stimulant medications for milk expression
- C. explain that this is a normal phenomenon
- D. stop feeding the baby
Correct Answer: A
Rationale: Referral to an obstetrician is necessary for proper evaluation and management.
Many factors in nasopharyngeal carcinoma patients may affect the prognosis. Which of the following carries the worst outcome?
- A. elevated lactate dehydrogenase (LDH) level
- B. advanced disease
- C. extensive cervical lymph node involvement
- D. evidence of Epstein-Barr virus (EBV) DNA
Correct Answer: A
Rationale: Elevated LDH levels are strongly associated with aggressive disease and poor prognosis.