Nokea
Mr. Mendres asks Nurse Rose what causes peptic ulcer to develop. Nurse Rose responds that recent research indicates that peptic ulcers are the result of which of the following?
- A. genetic defect in the gastric mucosa
- B. helicobacter pylori infection
- C. high fat diet
- D. work related stress
Correct Answer: B
Rationale: Recent research suggests that the majority of peptic ulcers are caused by an infection with Helicobacter pylori bacteria. This bacterium weakens the protective mucous coating of the stomach and duodenum, leading to damage from stomach acid. Genetic defects in the gastric mucosa, high fat diet, and work-related stress may exacerbate the condition but are not the primary cause of peptic ulcers. Therefore, the most likely cause based on current understanding is H. pylori infection.
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Which is instituted for the therapeutic management of minimal change nephrotic syndrome?
- A. Corticosteroids
- B. Antihypertensive agents
- C. Long-term diuretics
- D. Increased fluids to promote diuresis
Correct Answer: A
Rationale: Corticosteroids are the mainstay of therapy for minimal change nephrotic syndrome. Minimal change disease is the most common cause of nephrotic syndrome in children, and corticosteroids are highly effective in inducing remission in these patients. They work by reducing inflammation and decreasing the permeability of the glomerular filtration barrier in the kidneys, thereby reducing proteinuria. Antihypertensive agents are used to control blood pressure in patients with renal involvement, and long-term diuretics are not typically recommended in nephrotic syndrome due to the risk of worsening kidney function. Increased fluids to promote diuresis are also not indicated as the primary treatment for minimal change nephrotic syndrome.
A 12-year-old male adolescent, recently diagnosed with Hodgkin lymphoma, shows left cervical and supraclavicular lymph node involvement and drenching night sweats. Based on Ann Arbor Classification, the patient is classified as
- A. stage IA
- B. stage IB
- C. stage IIA
- D. stage IIB
Correct Answer: D
Rationale: Involvement of two lymph node regions above the diaphragm with systemic symptoms corresponds to stage IIB.
To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?
- A. Place flat in bed
- B. Turn on the affected side
- C. Turn on the unaffected side
- D. On bed rest SENSORY DISORDERS
Correct Answer: C
Rationale: After thoracentesis, it is important to position the client on the unaffected side to prevent leakage of fluid into the thoracic cavity. Placing the client on the unaffected side helps to promote proper drainage and reduce the risk of complications such as pneumothorax or fluid leakage. This position also allows for adequate lung expansion and facilitates proper re-expansion of the lung on the side where the fluid was removed. It is essential to follow this positioning to optimize outcomes and minimize risks associated with the procedure.
An adult has a Hickman type central venous catheter and needs to have blood drawn from it. Which of the following should the nurse do first?
- A. Use sterile technique to assemble supplies needed
- B. Aspirate and discard the first 10 ml of the blood
- C. First flush the catheter with heparinized solution, then withdraw the blood
- D. Remove the cap of the catheter and replace it with a new one
Correct Answer: C
Rationale: Before drawing blood from a central venous catheter like a Hickman type, it is essential to ensure that the catheter is patent and free of any clots. Flushing the catheter with a heparinized solution (to prevent clot formation) before withdrawing blood helps clear the catheter and ensures accurate blood sample collection. Removing clots or obstructions from the catheter is crucial to prevent complications and maintain the catheter's function. Therefore, it is important to first flush the catheter with a heparinized solution before drawing blood from it.
Regarding physical growth of preschool children (3-5 years), all are true EXCEPT
- A. 7-8 kg weight increment/yr
- B. 20 primary teeth erupted by 3 years
- C. brain stops myelinization by 8 years
- D. height increment/yr average is 5-6 cm up to 18 years
Correct Answer: A
Rationale: Weight increment varies and is generally less than 7-8 kg/yr.