Nokea
Regarding infective endocarditis in an IVDU
- A. Usually presents with fever and respiratory symptoms
- B. Usually involves the mitral valve
- C. The commonest organism is staph epidermidis
- D. Negative blood cultures exclude the diagnosis
Correct Answer: A
Rationale: IVDU endocarditis fever, lung emboli from tricuspid, not mitral, Staph aureus, cultures miss some. Nurses hear this chronic right-side roar.
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What is an important independent risk factor for the development of type 2 diabetes mellitus?
- A. Alcohol use
- B. Ethnicity
- C. Socioeconomic status
- D. All three options above
Correct Answer: B
Rationale: Ethnicity stands tall South Asians, Hispanics outpace Caucasians in type 2 risk, genes and fat patterns at play. Alcohol's murky, socioeconomic status shapes access, not biology nurses see heritage trump these, a chronic marker needing tailored screens.
A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient's cancer cells spread?
- A. Hematologic spread
- B. Lymphatic circulation
- C. Invasion
- D. Angiogenesis
Correct Answer: B
Rationale: Lung cancer loves lymphatics its cells hitch rides via nodes, the most common metastasis route, hitting bones and liver downstream. Blood (hematologic) spread happens too, but lymph's king for lung primaries. Invasion's local creep, not distant jumps. Angiogenesis feeds tumors, not moves them. Nurses track this pattern, knowing lymph drainage from lungs seeds those far-off sites, a grim oncology reality shaping staging and prognosis.
A general practitioner (GP) advises an overweight patient to go to the gym to work out. Question: This advice is an example of which type of prevention?
- A. Primary prevention
- B. Secondary prevention
- C. Tertiary prevention
- D. Quaternary prevention
Correct Answer: A
Rationale: Gym nudge for overweight primary, stops diabetes before it starts, not screening or late fixes. Nurses push this, a chronic preemptive strike.
A nurse is performing discharge teaching for a client who was recently diagnosed with heart failure. Which of the following should be included in the client and family teaching?
- A. Low sodium diet
- B. Weekly weights
- C. Symptoms to report to the provider
- D. Fluid restriction
Correct Answer: A
Rationale: Heart failure management hinges on education to prevent exacerbations. A low sodium diet reduces fluid retention, easing cardiac workload crucial teaching for clients and families to grasp, as salt drives edema and hypertension, common pitfalls in heart failure. Weekly weights track fluid shifts daily is ideal, but weekly still aids while reporting symptoms like dyspnea flags worsening. Medication teaching ensures adherence, and fluid restriction may apply, but sodium's broader impact makes it foundational. Focusing on diet empowers lifestyle change, tackling a root cause over monitoring or restrictions alone, aligning with nursing's role in empowering self-care to stabilize this chronic condition long-term.
Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.