Nokea
The nurse teaching a young women's community service group about breast self-examination (BSE) will include that:
- A. BSE will reduce the risk of dying from breast cancer
- B. BSE should be done daily while taking a bath or shower
- C. Annual mammograms should be scheduled in addition to BSE
- D. Performing BSE after the menstrual period is more comfortable
Correct Answer: D
Rationale: BSE timing matters post-menstrual breasts are less tender, swollen, or lumpy, making self-checks comfy and accurate, a key teaching point for young women. BSE doesn't cut mortality evidence lags; daily checks overdo it, monthly's enough. Mammograms start later (e.g., 40), not yet for this group. Nurses stress this timing, boosting compliance and awareness, a practical nudge in breast health education, sidestepping unproven claims for a doable habit.
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The spinothalamic and dorsal column sensation are examined as part of a neurological examination. One of the items belonging to dorsal column sensation is the sense of vibration, which is examined by means of a tuning fork. Question: What is the required frequency of this tuning fork?
- A. 512 Hz
- B. 256 Hz
- C. 128 Hz
- D. 64 Hz
Correct Answer: C
Rationale: Vibration check 128 Hz hums right, dorsal column's sweet spot, not higher or lower. Nurses tune this, a chronic nerve test.
The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Engage the patient in shared decision making
- B. Threaten the patient into adherence with insulin therapy
- C. Provide close supervision and follow-up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLPIRA
Correct Answer: B
Rationale: Insulin's hurdles yield to shared decisions, close watch, weight tricks, and goal setting empowering, not bullying. Threats tank trust and adherence, backfiring in chronic care where buy-in's king. Support beats scare tactics, aligning with diabetes' need for partnership, a strategy flop amid solid aids.
The nurse is preparing an adolescent diagnosed with leukemia for a lumbar puncture. The nurse determines that the child understands the reason for the procedure when the child states that the procedure is done to:
- A. Make sure I don't have meningitis along with my cancer.
- B. Relieve some of the pressure on my brain.
- C. Remove the blood cancer cells so I don't have to have surgery.
- D. Check to see if the cancer has spread through my spinal cord and brain.
Correct Answer: D
Rationale: A lumbar puncture (LP) in leukemia is performed to collect cerebrospinal fluid (CSF) to check for central nervous system (CNS) involvement cancer cells spreading to the spinal cord and brain a critical staging step that influences treatment, like intrathecal chemotherapy. The adolescent's statement about checking for spread reflects accurate understanding, essential for informed consent and reducing anxiety through clarity. Ruling out meningitis is a possible LP use, but in leukemia, CNS metastasis is the primary concern unless symptoms suggest infection. Relieving brain pressure applies to conditions like hydrocephalus, not leukemia's typical presentation. Removing cancer cells via LP isn't a treatment; it's diagnostic. The nurse's confirmation of this understanding ensures the child is prepared, aligning with pediatric oncology's emphasis on patient education and procedural readiness.
Appropriate statements regarding markers of outcome after major surgery in England in 2014 include:
- A. Data about each hospital's complication rates after surgery are readily available.
- B. Data about each hospital's 30-day mortality after surgery are readily available.
- C. For most procedures, 90-day mortality rate are similar to 30-day mortality rates.
- D. National Hospital Episode Statistics (HES) data are useful for monitoring the performance of units.
Correct Answer: B
Rationale: In 2014 England, surgical outcome transparency increased. Complication rates weren't universally published per hospital, varying by procedure and trust. However, 30-day mortality data were widely available, notably via NHS initiatives and specialty audits (e.g., National Joint Registry), reflecting short-term success. Ninety-day mortality often exceeds 30-day rates (e.g., in vascular surgery), capturing delayed deaths, so they're not typically similar. HES data, capturing inpatient episodes, help monitor trends and performance, though coding accuracy limits granularity. Weekend admission mortality was higher, per studies like 2015 BMJ, due to staffing and care differences. The availability of 30-day mortality data was a key quality metric, driving accountability and improvement in surgical care.
A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this patient most likely undergo?
- A. Lymphadenectomy
- B. Needle biopsy
- C. Open biopsy
- D. Sentinel node biopsy
Correct Answer: D
Rationale: Sentinel node biopsy (SLNB) is the modern go-to less invasive than old-school dissection (lymphadenectomy), it maps the first lymph node cancer hits, sparing arm swelling (lymphedema) if clean. Needle or open biopsies are less targeted, more for diagnosis than staging here. SLNB's standard for breast cancer now, checking spread without ripping out nodes like her mom's era. Nurses in oncology highlight this shift less trauma, same intel easing her fears with precision care.