Nokea
The nurse is reviewing laboratory values for a client. Which of the following lab values should the nurse address immediately?
- A. Potassium 5.9 mmol/L
- B. Phosphorus 5.1 mg/dL
- C. Creatinine 6.2 mg/dL
- D. Sodium 147 mEq/L
Correct Answer: A
Rationale: Potassium 5.9 mmol/L above 5.5 sparks hyperkalemia, risking arrhythmias, a now-or-never fix over phosphorus's mild bump (3.0-4.5 normal). Creatinine's renal cry waits; sodium's high but tolerable. Nurses jump on potassium, anticipating ECG or kayexalate, a heart-stopping lab in this urgent sweep.
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The nurse is assessing a 3-year-old child whose mother complains that he is listless and has been having trouble swallowing. Which of the following findings would suggest the child has a brain tumor?
- A. Observation reveals nystagmus and head tilt
- B. Vital signs show blood pressure measures 120/80
- C. Examination shows temperature of 38.5°C and headache
- D. Observation reveals a cough and labored breathing
Correct Answer: A
Rationale: Brain tumors in young children often cause neurological signs from mass effect or increased intracranial pressure (ICP). Nystagmus (involuntary eye movement) and head tilt suggest cerebellar or brainstem involvement, common in pediatric brain tumors like medulloblastoma, disrupting coordination and posture key findings in a listless child with swallowing issues (possibly cranial nerve dysfunction). Blood pressure of 120/80 is elevated but lacks widened pulse pressure typical of ICP; it's non-specific without context. Fever and headache might indicate meningitis, not a tumor, unless paired with focal signs. Cough and labored breathing point to respiratory issues, not neurological ones. Nurses noting nystagmus and tilt prompt urgent imaging, critical in pediatric oncology for diagnosing brain tumors early and preventing further deterioration.
The thickening of the glomerular basal membrane in an early stage of diabetes mellitus is a consequence of which mechanism?
- A. AGE deposition
- B. Proteinuria
- C. Inflammation
- D. All mechanisms mentioned above
Correct Answer: A
Rationale: Early diabetic kidney AGEs glue GBM thick, not protein spill or inflammation yet. Nurses catch this, a chronic sugar scar.
Certain drug classes may cause harm in patients with symptomatic (NYHA classes II-IV) reduced ejection Heart failure (HFrEF), and thus should be avoided. If they are strongly indicated, they are to be used with caution, and with close monitoring. Such drugs include all of the following except:
- A. Thiazolidinediones (glitazones, e.g., pioglitazone, rosiglitazone)
- B. Nonsteroidal anti-inflammatory drugs and COX-2 inhibitors
- C. Nutritional supplements (e.g., coenzyme Q10, carnitine, taurine, and antioxidants)
- D. Non-dihydropyridine calcium-channel blockers (verapamil, diltiazem)
Correct Answer: C
Rationale: HFrEF hates fluid and strain glitazones swell, NSAIDs tank kidneys, verapamil/diltiazem slow too much, trastuzumab trashes hearts. Supplements like CoQ10? Neutral or helpful, not harmful, a safe outlier. Clinicians dodge the rest, easing chronic pump woes, not this add-on.
The movement patterns of 80 students who participated in a training programme have been measured. One of the measurement variables is the number of hours the student plays sports per week. This variable is measured both after and before the training programme. Subsequently, the average number of hours the student played sports before the training programme is compared with the number of hours the student plays sports after the training programme. Question: Which test is suitable to compare these two average values?
- A. Chi-square test
- B. Fisher's exact test
- C. Two-sample t-test
- D. Paired t-test
Correct Answer: D
Rationale: Same kids, before-after sports hours paired t-test ties each shift, not chi-square's counts, Fisher's tables, or two-sample splits. Nurses stat this, a chronic match check.
Which is not a differential diagnosis for tetanus?
- A. strychnine poisoning
- B. dystonic reactions
- C. quinsy
- D. rabies
Correct Answer: C
Rationale: Tetanus mimics strychnine, dystonia, rabies flex muscles; cyanide gasps, quinsy's throat, not spasms. Nurses sift this chronic stiffness list.