Nokea
Tetanus:
- A. is caused by clostridium tetani endotoxin
- B. is associated with a better prognosis if the incubation period is short
- C. can be manifest by rigidity of muscles in close proximity to the area of the initial injury
- D. usually presents with weakness in the extremities which then progresses to the facial muscles
Correct Answer: C
Rationale: Tetanus exotoxin, not endo, long incubation's better, local rigidity fits, not weakness march, autonomic storms. Nurses lock this chronic spasm tale.
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The physician tells the patient that there will be an initial course of treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a prolonged period of time. You can help the patient by reinforcing that the primary goal for this type of treatment is:
- A. Cure
- B. Control
- C. Palliation
- D. Permanent remission
Correct Answer: B
Rationale: The physician's plan initial treatment, maintenance, and long-term monitoring suggests a chronic cancer unamenable to cure, aiming instead to control growth and spread. Control stabilizes disease, extending life and quality, unlike cure, which eradicates cancer, or permanent remission, implying no recurrence both unfeasible here. Palliation focuses on symptom relief, not longevity, misaligning with ongoing treatments. Reinforcing control clarifies expectations, reducing anxiety by framing therapy as proactive management, not defeat. Nurses bolster this by explaining observation's role in adjusting care, aligning patient understanding with realistic goals, vital for adherence and emotional resilience in prolonged cancer battles.
Mr Yee, 45 years old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over his left elbow. He says that two years ago he took allopurinol 100 mg for one month followed by 200 mg OM for one month, but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago. He says he took it likely 'once or twice a week'. He states that he did not experience any rashes or other side effects to it then. He did not go back to see his previous GP as he has moved house and your clinic is nearer to his home. He does not drink alcohol except one glass of wine once or twice a year on special occasions. Two weeks ago, he was admitted to the hospital for a gout flare. He had blood tests done, which returned the results below. He is asking you to give him Arcoxia standby as it usually works for his gout flare. Uric acid 620 mmol/L, Creatinine 96 umol/L, eGFR >90 mL/min, BP 144/94 mmHg. He has HTN on HCTZ long-term. Which is incorrect advice?
- A. Offer to restart allopurinol and explain that it does not work immediately. You may wish to discuss HLA B5801 testing particularly as it is unclear how frequent and for how long he was taking allopurinol previously
- B. Advise that he will need stepwise up-titration of a urate lowering agent to reach uric acid target. Regular blood tests will allow this to be done safely
- C. Advice that colchicine prophylaxis is helpful to prevent gout attacks, as it takes time for a urate lowering agent to reach uric acid target
- D. Advise him that allopurinol is ineffective. Offer to initiate febuxostat or probenecid immediately
Correct Answer: D
Rationale: Tophus and 620 uric acid yell chronic gout allopurinol's not bunk; past spotty use tanked it, not the drug. Restarting with titration, colchicine cover, and allergy watch fits; HLA testing flags risk. Swapping to febuxostat or probenecid skips allopurinol's shot wrong call when adherence, not efficacy, flopped. Clinicians correct this, steering chronic control right.
A client with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate?
- A. Have the patient eat large meals when nausea is not present
- B. Offer dry crackers and carbonated fluids during chemotherapy
- C. Administer prescribed antiemetics 1 hour before the treatments
- D. Give the patient two ounces of a citrus fruit beverage during treatments
Correct Answer: C
Rationale: Chemo's gut punch severe vomiting bows to preemptive antiemetics, given 1 hour before, blunting nausea's peak, the most effective move per oncology standards. Big meals overload; crackers help post-, not during; citrus risks acid reflux. Nurses time antiemetics, syncing with chemo's onslaught, a proactive strike to ease this metastatic misery, trumping reactive nibbles or sips.
Chemotherapeutic treatment of acute leukemia is done in four phases. Place these phases in the correct order.
- A. Maintenance
- B. Induction
- C. Intensification
- D. Consolidation
Correct Answer: B
Rationale: Acute leukemia's chemotherapy unfolds systematically: induction kicks off, aggressively killing leukemia cells to induce remission, a high-dose blitz. Intensification follows, targeting residual cells over months, relentless in early remission. Consolidation reinforces, eliminating lingering blasts post-remission, solidifying gains. Maintenance, with lower doses, sustains remission long-term, preventing relapse. This order induction, intensification, consolidation, maintenance mirrors the disease's need for initial eradication then sustained control, a structured approach nurses reinforce through patient education and monitoring, ensuring each phase's purpose aligns with leukemia's aggressive biology and treatment goals.
Which of the following is NOT part of the histology of non-alcoholic steatohepatitis?
- A. Fatty infiltration in liver
- B. Fibrosis of liver
- C. Inflammatory infiltrates in lobules
- D. Cirrhosis
Correct Answer: D
Rationale: NASH histology includes steatosis (fatty infiltration), lobular inflammation, and fibrosis, per pathology definitions. Mallory bodies (intracellular inclusions) are classic but not universal. Cirrhosis is an advanced NAFLD outcome, not a defining NASH feature progression, not initial histology. This distinction aids physicians in staging chronic liver disease accurately.