Mr Xavier, a 60-year-old accountant, was recently started on allopurinol 100 mg two months ago. This was increased to 200 mg three weeks ago in your clinic. He informed you that he was diagnosed with UTI and started on ciprofloxacin. Today, he returns to your clinic with maculopapular rashes on his trunk and abdomen. He has a low-grade fever of 37.5°C. Which is the most appropriate next step?
- A. Stop Ciprofloxacin and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to Moxifloxacin 500 mg bd instead
- C. Continue medications and check for Dengue serology
- D. Stop Allopurinol
Correct Answer: D
Rationale: Rashes and fever post-allopurinol hike scream drug reaction stopping it nips hypersensitivity, like SJS risk, tied to uric acid meds over cipro's rarer skin hit. Quitting cipro alone misses the likely culprit; swapping antibiotics or dengue checks dodge the drug link; full stop's overkill. Clinicians halt allopurinol, watching this chronic fix's nasty turn, a swift call.
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Which of the following clients would not be a candidate for thrombolytic therapy?
- A. Client with a pulse of 102 beats/minute
- B. Client with a blood pressure of 100/60 mm Hg
- C. Client with a history of hemorrhagic stroke one month ago
- D. Client age 65 years
Correct Answer: C
Rationale: Thrombolytics bust clots but bleed big hemorrhagic stroke history, even a month back, bans them, as re-bleed risk soars, a firm no-go. Tachycardia, low BP, or age 65 don't nix it BP's workable, age isn't a cutoff. Nurses screen this, dodging brain bleeds, a safety lock in this clot-dissolving call.
Which of the following interventions should be included in the nutrition care plan of the client with atherosclerosis?
- A. Limit sodium intake to 6 g per day
- B. Increase full-fat dairy products
- C. Increase saturated fats
- D. Increase daily intake of vegetables, fruits, and whole grains
Correct Answer: D
Rationale: Atherosclerosis plaque-laden arteries thrives on poor diet. Boosting vegetables, fruits, and whole grains slashes cholesterol and inflammation, slowing plaque via fiber and antioxidants, a cornerstone of cardiac nutrition. Sodium limits help hypertension, but 6 g exceeds heart-healthy goals (2.3 g). Full-fat dairy and saturated fats fuel plaque, worsening disease. Nurses push plant-based eating, aligning with evidence to reverse atherosclerosis's march, a proactive step over mere restriction in this vascular battle.
The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first?
- A. A 35-yr-old patient who has wet desquamation associated with abdominal radiation
- B. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer
- C. A 24-yr-old patient who received neck radiation and has blood oozing from the neck
- D. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation
Correct Answer: C
Rationale: Neck oozing post-radiation flags carotid rupture a bleed-out risk trumping wet skin , sobs , or heart rub (D tamponade's slower). Nurses in oncology bolt here airway and blood loss kill fastest, demanding stat checks.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient's subsequent plan of care?
- A. Limit the time that visitors spend at the patient's bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patient's care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: HDR implants (brachytherapy) emit radiation limiting visitor time (e.g., 30 min) cuts exposure risk. Self-care's nice but not safety-driven. Gender's irrelevant pregnant staff avoid, not males. Shared rooms up exposure, not safety. Nurses in oncology enforce this, shielding others while the source's active, a radiation rule of thumb.
Which of the following medication is recommended for all patients with NAFLD in improving liver histology?
- A. Statins
- B. Aspirins
- C. Ursodeoxycholic acid
- D. None of the above
Correct Answer: D
Rationale: NAFLD no med fits all; statins, aspirin, ursodiol, E lack universal proof. Nurses skip this chronic blanket pill.