Nokea
The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer?
- A. Teach the patient about the seven warning signs of cancer.
- B. Plan to monitor the patient's carcinoembryonic antigen (CEA) level.
- C. Teach the patient about annual chest x-rays for lung cancer screening.
- D. Discuss risks associated with cigarette smoking during each patient encounter.
Correct Answer: D
Rationale: Smoking's the lung cancer kingpin two packs a day screams risk. Hitting the patient with smoking's dangers every visit pushes primary prevention, aiming to cut exposure to tar and carcinogens fueling 85% of cases. Warning signs (CAUTION) and chest x-rays are secondary catching cancer, not stopping it. CEA's a tumor marker for tracking, not prevention. Nurses in oncology know preaching cessation at every chance leverages behavior change, the gold standard to slash lung cancer odds, trumping screening or monitoring in a heavy smoker like this.
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Toxic shock syndrome:
- A. will often manifest without fever
- B. is a misnomer because BP is often maintained
- C. is caused by pseudomonas species
- D. often produces elevated creatinine kinase
Correct Answer: D
Rationale: TSS fever burns, BP drops, staph rules, CK jumps, rash spreads. Nurses clock this chronic toxin surge.
What is the essence of motivational interviewing?
- A. That change strategies must exactly match the patient's motivation
- B. That behavioural change is impossible if the patient does not want it
- C. That the counsellor motivates the patient to change and increases patient involvement
- D. That the patient's motives to show unhealthy behaviour are systematically analysed
Correct Answer: C
Rationale: Motivational interviewing counsellor sparks, pulls patients in, not rigid matches, impossibles, or motive digs. Nurses roll this, a chronic engagement art.
After a road traffic accident at 50 miles per hour, a healthy 30-year-old patient is admitted to a major trauma centre with a closed femoral shaft fracture and pulmonary contusion. Routine management in the intensive care unit is likely to include:
- A. A tertiary survey.
- B. A course of broad-spectrum antibiotics.
- C. Non-specific medical treatment of a rising creatinine kinase concentration (CK).
- D. Delay in physiotherapy to minimize bleeding.
Correct Answer: A
Rationale: ICU care post-trauma ensures comprehensive management. A tertiary survey (head-to-toe reassessment) identifies missed injuries (e.g., fractures), routine within 24-48 hours per trauma protocols, critical with polytrauma risks like this case. Antibiotics aren't routine without infection (e.g., open fracture); pulmonary contusion alone doesn't justify them. Rising CK from muscle damage (femoral fracture) may need monitoring (rhabdomyolysis risk), but treatment (e.g., fluids) is specific, not non-specific. Early physiotherapy aids recovery, not delayed bleeding risk is minimal with closed fractures post-stabilization. Surviving Sepsis guidelines apply only with sepsis. The tertiary survey's systematic approach prevents oversight, ensuring holistic care in a high-energy trauma patient.
Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity.
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity.
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds.
- D. The ratio of respiratory effort and respiratory rate.
Correct Answer: A
Rationale: Spirometry is the gold standard for COPD diagnosis and staging, measuring airflow obstruction. The ratio of forced expiratory volume in 1 second (FEVâ‚) to forced vital capacity (FVC) FEVâ‚/FVC quantifies limitation; a value <0.7 post-bronchodilator confirms COPD, with FEVâ‚ percentage grading severity (e.g., GOLD stages). Residual volume (RV) to FVC isn't standard in basic spirometry RV requires advanced testing (e.g., plethysmography) and reflects air trapping, not routine staging. FVC versus a 6-second exhale (FEV₆) approximates in some settings but isn't the clinical norm for COPD. Respiratory effort and rate aren't spirometric; they're observational. FEVâ‚/FVC's precision, per Deravin and Anderson (2019), tracks obstruction progression and guides therapy, making it foundational for assessing COPD's irreversible nature.
Which agent should not be part of the management of generalized tetanus?
- A. metronidazole
- B. penicillin
- C. midazolam
- D. tetanus immunoglobulin
Correct Answer: B
Rationale: Tetanus penicillin's old school, metronidazole's better for Clostridium now; midazolam calms, Ig neutralizes, labetalol steadies. Nurses skip this chronic bug zapper.