Nokea
The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
- A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer
- B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer
- C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer
- D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition
Correct Answer: B
Rationale: With a positive screening test and family history, she's high-risk tamoxifen, a SERM, cuts breast cancer odds by 50% in such cases, per NCI trials. It blocks estrogen fueling tumors, a proven chemoprevention move. Diet helps (antioxidants, less fat), but it's not enough solo. Exercise (30 min/day) trims risk via weight control, but tamoxifen's got stronger data here. Saying little can be done' ignores options genetics load the gun, but lifestyle and drugs can unload it. Nurses in oncology push tamoxifen for its edge, tailoring advice to her risk profile.
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A nurse is caring for a client diagnosed with peripheral artery disease. Which of the following is a common assessment finding?
- A. 4+ pedal pulses
- B. 3+ pedal pulses
- C. Bounding pulses in all 4 extremities
- D. 1+ pedal pulses
Correct Answer: D
Rationale: Peripheral artery disease (PAD) clogs arteries, slashing flow 1+ pedal pulses (weak, thready) are typical, reflecting ischemia below blockages. 4+ or 3+ pulses (strong) contradict PAD's hypoperfusion; bounding pulses suggest hyperdynamic states, not occlusion. Nurses expect weak pulses, checking for pain or pallor, key to tracking PAD's limb-threatening march, guiding interventions like revascularization.
A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?
- A. A client with a swollen and painful left great toe
- B. Client who reports dyspnea
- C. Client with a blood pressure of 180/98 mm Hg
- D. Client who reports calf tenderness and swelling
Correct Answer: B
Rationale: Polycythemia vera thickens blood, risking clots dyspnea signals possible pulmonary embolism, a life-threatening emergency needing instant assessment per ABCs. Toe pain suggests gout, common but less acute. Hypertension, a chronic issue here, waits behind respiratory distress. Calf tenderness hints at DVT, urgent but not immediately fatal like embolism. Nurses triage dyspnea first, ensuring airway and oxygenation, a critical call in this hyperviscous condition prone to thrombotic crises.
In the treatment of COPD:
- A. Inhaled long-acting β₂ agonists are a first-line treatment for breathlessness.
- B. Most patients require maintenance use of oral corticosteroids.
- C. The dosage of oral theophylline needs to be reduced in patients commenced on erythromycin.
- D. Long-term oxygen therapy is indicated in a stable patient with a Paâ‚“â‚‚ of 8.5 kPa.
Correct Answer: C
Rationale: COPD management focuses on symptom relief and preventing exacerbations. Inhaled long-acting β₂ agonists are indeed used for breathlessness but are not always first-line; short-acting bronchodilators often precede them. Maintenance oral corticosteroids are not standard due to significant side effects; inhaled corticosteroids are preferred. Theophylline, a bronchodilator, has its metabolism inhibited by erythromycin (a CYP3A4 inhibitor), increasing plasma levels and toxicity risk, necessitating dose reduction. Long-term oxygen therapy is indicated for severe hypoxemia (Paₓ₂ < 7.3 kPa or 7.3-8 kPa with complications), not at 8.5 kPa, which is relatively normal. Non-invasive ventilation is reserved for acute exacerbations, not first-line treatment. The interaction between theophylline and erythromycin is a critical pharmacological consideration in COPD management, making it the standout correct statement.
Proven treatment for patients with noncirrhosis from NAFLD include the following except:
- A. Liver transplant
- B. Bariatric surgery
- C. Vitamin E
- D. Weight loss
Correct Answer: A
Rationale: Noncirrhotic NAFLD bends to weight loss, bariatric cuts, and Vitamin E's antioxidant punch proven aids. Transplant's endgame for cirrhosis, not here. Metformin flops for fat, despite diabetes use. Clinicians skip this organ swap, leaning on lifestyle and pills, a chronic fix before scars hit.
A 63 years old woman who is known to have hypertension for 15 years presented to her family doctor with shortness of breath and ankle swelling. An echocardiogram confirmed compromised left ventricular function. Her blood pressure is 150/90 mmHg. She is currently on frusemide and Aspirin. What is the MOST appropriate medication to add?
- A. Aldosterone antagonists
- B. Calcium channel blockers
- C. Beta blockers
- D. Angiotensin converting enzyme - inhibitors
Correct Answer: D
Rationale: Heart failure with LV dysfunction ACE inhibitors cut mortality, ease load, atop frusemide's fluid flush and aspirin's clot block. Aldosterone blockers add later; calcium blockers don't help heart; beta blockers need stability first; ARBs sub if ACE flops. Nurses push this chronic heart saver, proven to stretch life.