Nokea
Neoadjuvant chemotherapy treatment for cancer is given to facilitate surgical resection. When the outcomes of cancer therapies are evaluated, the terms complete response and partial response often are used. Partial response means that
- A. 50% of the patients treated with a given regimen demonstrate remission
- B. 50% of the patients treated survive to the 5-year point
- C. The tumor mass has reduced by > 50%
- D. In 50% of cases, the tumor converts from unresectable to resectable
Correct Answer: D
Rationale: The correct answer is D because in the context of neoadjuvant chemotherapy, a partial response means converting an unresectable tumor to a resectable one. This is crucial as it allows for successful surgical removal of the tumor. Choices A, B, and C do not accurately define partial response in the context of cancer therapy. A, stating 50% of patients demonstrating remission, is not specific to the change in resectability. B, mentioning 50% survival at 5 years, is more related to overall survival rather than the response to treatment. C, stating a reduction in tumor mass by >50%, does not necessarily imply a change in resectability status. Therefore, option D is the most appropriate definition of partial response in the given scenario.
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Flexion-distraction injuries of the thoracolumbar spine are most commonly caused by
- A. Blunt trauma
- B. Rotational injury
- C. Seat belts
- D. Gunshot wounds
Correct Answer: B
Rationale: The correct answer is B: Rotational injury. Flexion-distraction injuries of the thoracolumbar spine are often caused by rotational forces that occur during accidents such as motor vehicle collisions or falls. These forces lead to the spine being twisted, causing separation of the vertebrae. Blunt trauma (A) can cause various spinal injuries but is not specific to flexion-distraction injuries. Seat belts (C) are designed to prevent spinal injuries by restraining the body during a collision. Gunshot wounds (D) can cause spinal cord injuries but are not commonly associated with flexion-distraction injuries of the thoracolumbar spine.
A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
- A. Low ACTH and low cortisol
- B. Low ACTH and high cortisol
- C. High ACTH and low cortisol
- D. High ACTH and high cortisol
Correct Answer: A
Rationale: The correct answer is A: Low ACTH and low cortisol. In a patient with an adrenal tumor causing Cushing's syndrome, the tumor itself produces excess cortisol independently of ACTH regulation. Therefore, ACTH levels are low due to negative feedback from high cortisol levels. As a result, cortisol levels are high, while ACTH levels are low.
Explanation for other choices:
B: Low ACTH and high cortisol - This suggests primary adrenal insufficiency (Addison's disease), not Cushing's syndrome.
C: High ACTH and low cortisol - This suggests secondary adrenal insufficiency, not Cushing's syndrome.
D: High ACTH and high cortisol - This is contradictory and not physiologically possible in the context of an adrenal tumor causing Cushing's syndrome.
Hypoplastic left heart syndrome is characterized by underdevelopment of
- A. Pulmonary veins, ventricles and aortic valve
- B. Left ventricle, atrium and pulmonary vessels
- C. Aorta arch, venacava and right atrium
- D. Left ventricle, aortic valve and arch
Correct Answer: D
Rationale: The correct answer is D because hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch. The left ventricle is typically small and unable to adequately pump blood to the body. The aortic valve is often malformed, leading to difficulties in blood flow from the heart to the body. Additionally, the aortic arch may be narrow or underdeveloped, further impacting blood circulation.
Choice A is incorrect as it includes the pulmonary veins, which are not typically affected in hypoplastic left heart syndrome. Choice B is incorrect as it focuses on the left atrium and pulmonary vessels, which are not the primary structures affected in this condition. Choice C is incorrect as it mentions the aorta arch, venacava, and right atrium, which are not primarily associated with hypoplastic left heart syndrome.
The PRIORITY health message to share with a client in the recovery room immediately following cesarean section includes
- A. Frequent coughing & deep breathing
- B. Importance of perineal self-care
- C. Importance of early ambulation
- D. Signs of puerperal infections
Correct Answer: C
Rationale: The correct answer is C: Importance of early ambulation. After a cesarean section, early ambulation is crucial to prevent complications like blood clots and promote circulation. It helps prevent post-operative complications. Choice A is important for respiratory health but not the priority right after surgery. Choice B focuses on perineal care which is important but not the immediate priority. Choice D is important, but recognizing signs of infection can wait until the client is more stable. Early ambulation is key to preventing complications and aiding in recovery.
The fetal head retracting against the perineum is a
- A. Gaskin sign
- B. Turtle sign
- C. Klumpke sign
- D. Chignon sign
Correct Answer: B
Rationale: The correct answer is B: Turtle sign. This sign refers to the fetal head retracting against the perineum during delivery. It indicates shoulder dystocia, a complication where the baby's shoulders get stuck after the head is delivered. This can lead to serious complications for both the baby and the mother if not managed promptly.
A: Gaskin sign is incorrect as it refers to a position where the mother is on her hands and knees during labor.
C: Klumpke sign is incorrect as it is a neurological condition affecting the lower arm and hand.
D: Chignon sign is incorrect as it is not a recognized medical term related to childbirth.