Nokea
The nurse is caring for a 55-year-old male who presented to this primary physician's office for his yearly check-up. Upon the physical assessment, the provider noted enlarged lymph nodes in the groin and neck region. The provider Questioned Joe regarding the possible causes of the finding. Which of the following diagnosis are consistent with this finding?
- A. Leukemia
- B. Lymphoma
- C. Sickle cell anemia
- D. Polycythemia vera
Correct Answer: B
Rationale: Lymphoma swells nodes neck and groin lumps fit this cancer's lymphoid sprawl, a diagnosis matching this check-up find. Leukemia bones out, sickle cell pains, polycythemia thickens none node-centric. Nurses tie this to lymphoma, anticipating biopsy, a nodal tale in this cancer hunt.
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Ziconotide is:
- A. Licensed for administration by the intrathecal route in Europe and North America.
- B. Associated with intrathecal granuloma formation.
- C. Contraindicated in schizophrenic patients.
- D. Likely to lead to hypogonadotropic hypogonadism during long-term infusion.
Correct Answer: A
Rationale: Ziconotide, a non-opioid analgesic, blocks N-type calcium channels intrathecally. It's licensed in Europe and North America for chronic pain (e.g., cancer, neuropathic), delivered via pumps. Unlike opioids, it doesn't form granulomas at catheter tips those are opioid-specific complications. It's contraindicated in psychosis (e.g., schizophrenia) due to neuropsychiatric side effects (confusion, hallucinations), per prescribing guidelines. Hypogonadism isn't linked; that's an opioid effect via hypothalamic suppression. Tolerance occurs, requiring dose escalation, but it's manageable. Its licensure reflects extensive trials showing efficacy and safety for refractory pain, distinguishing it as a targeted, non-addictive option in intrathecal therapy, critical for patients intolerant to opioids.
Which antibiotic is not recommended as first line therapy for the associated bug?
- A. legionella - erythromycin
- B. chlamydia psittaci - doxycycline
- C. chlamydia pneumoniae - doxycycline
- D. mycoplasma pneumoniae - roxithromycin
Correct Answer: C
Rationale: Chlamydia pneumoniae doxycycline's gold, not erythromycin, roxi, or others mispaired. Nurses tweak this chronic lung fix.
Which condition assessed by the nurse would be an early warning sign of childhood cancer?
- A. Difficulty swallowing
- B. Frequent cough or hoarseness
- C. Change in bowel and bladder habits
- D. Swellings, lumps or masses anywhere on the body
Correct Answer: D
Rationale: Childhood cancers often present with subtle, non-specific signs, but swellings, lumps, or masses anywhere on the body are a key early warning, indicating possible tumors like leukemia (lymphadenopathy), Wilms tumor, or sarcomas. Nurses must assess these palpable abnormalities, as they prompt urgent diagnostic workup imaging or biopsy to catch cancer early when treatment is most effective. Difficulty swallowing might suggest esophageal or brain tumors but isn't a common early childhood cancer sign. Frequent cough or hoarseness could indicate adult cancers (e.g., lung) or late-stage disease, not typical pediatric onset. Bowel and bladder changes are more adult-specific (e.g., colorectal cancer) or late effects in children. Lumps' prominence in pediatric guidelines underscores their priority, aligning with nursing's role in early detection to improve survival rates in young patients.
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
- A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
- B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
- C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
- D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.
Correct Answer: C
Rationale: Terminal pancreatic cancer pain's relentless around-the-clock opioids with breakthrough doses keep it tamed, per hospice norms. Waiting for 5/10 lags; IV isn't inherently better oral's fine. Nonopioids at max opioid miss the mark escalation's the play. Nurses in oncology teach this steady dosing plus rescues nails chronic cancer pain, a win if families get it.
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.