Nokea
The following are common abnormal laboratory markers in patients with NAFLD except:
- A. Elevated uric acid
- B. Elevated triglycerides
- C. Elevated hct
- D. Elevated GGT
Correct Answer: C
Rationale: NAFLD's lab quirks high triglycerides, GGT, glucose tie to fat and insulin woes; uric acid tags along in gouty pals. Elevated hematocrit? Not here, more polycythemia's game. Clinicians spot this odd-out, focusing chronic liver's true markers.
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The nurse knows which of the following is the most common problem for a client with valvular heart disease?
- A. Altered body image
- B. Difficulty coping
- C. Bradycardia
- D. Decreased cardiac output
Correct Answer: D
Rationale: Valvular disease stenosis or regurgitation slashes flow; decreased cardiac output reigns as pump falters, driving fatigue and dyspnea, the top issue. Body image or coping lag; bradycardia's rare. Nurses peg output drop, targeting meds or surgery, a core fight in this valve-wrecked heart.
An oncology patient has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
- A. Apply an ice pack or heating pad PRN to relieve pain and pruritis
- B. Avoid skin contact with water whenever possible
- C. Apply phototherapy PRN
- D. Avoid rubbing or scratching the affected area
Correct Answer: D
Rationale: Radiation erythema's tender rubbing or scratching tears it open, risking infection. Ice or heat burns it worse; water's fine for gentle cleaning, not avoidance. Phototherapy's for jaundice, not this. Nurses push hands off' to protect radiated skin, a staple in oncology to heal without added damage.
A 58 year old woman is known to have diabetes mellitus for 20 years. Her glycaemic control has deteriorated over the last three years. She is currently on Insulin and Metformin. Her serum creatinine is 140 μmol/L. Urinalysis performed over the last six months showed persistent proteinuria 1+. What should be the MOST appropriate target blood pressure for this lady?
- A. <125/75 mmHg
- B. <130/85 mmHg
- C. <130/80 mmHg
- D. <120/70 mmHg
Correct Answer: C
Rationale: Diabetes 20 years, proteinuria, creatinine 140 CKD stage 3 needs BP under 130/80 to shield kidneys, per guidelines. Tighter risks perfusion; looser misses protection. Insulin and metformin tag along, but BP's the chronic guard nurses enforce here.
A 7-year-old child with osteosarcoma is being treated with chemotherapy. Which medication would the nurse expect the physician to order most commonly as a prophylaxis against Pneumocystis jirovecii?
- A. Trimethoprim-sulfamethoxazole
- B. Ketoconazole
- C. Filgastim
- D. Prednisone
Correct Answer: A
Rationale: Osteosarcoma chemotherapy compromises the immune system, increasing susceptibility to opportunistic infections like Pneumocystis jirovecii pneumonia (PCP), a serious risk in immunocompromised children. Trimethoprim-sulfamethoxazole (TMP-SMX) is the most common prophylactic antibiotic for PCP, effectively preventing this lung infection by targeting its causative organism. Ketoconazole treats fungal infections but not PCP, which is caused by a fungus-like organism requiring specific therapy. Filgrastim stimulates neutrophil production to combat neutropenia, not PCP directly. Prednisone, a corticosteroid, suppresses immunity and reduces tumor-related edema but doesn't prevent infections and may increase risk. The nurse anticipates TMP-SMX due to its established role in pediatric oncology protocols, ensuring protection against a preventable, potentially fatal complication during chemotherapy.
Which organism is most commonly responsible for travelers diarrhea?
- A. toxigenic strain of e coli
- B. clostridium difficile
- C. salmonella
- D. rotavirus
Correct Answer: A
Rationale: Travelers' trots E. coli's toxigenic strain leads, not C. diff, salmonella, rotavirus, or cholera's flood. Nurses peg this chronic globe-trotter.