The suture material which poses the highest risk of infection is
- A. Vicryl
- B. Chromic gut
- C. Silk
- D. Prolene
Correct Answer: C
Rationale: Silk braided, bacteria's nest tops infection risk, not Vicryl, gut's absorb, or slick Prolene, nylon. Nurses stitch this chronic trap warily.
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A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?
- A. Slow rate of mitosis of cancer cells
- B. Different proteins in the cell membrane
- C. Differing size of the cells
- D. Different molecular structure in the cells
Correct Answer: B
Rationale: Malignant breast cancer cells flaunt tumor-specific antigens (e.g., CEA) on their membranes, unlike benign ones from the same tissue think of it as a wanted' sign for the immune system. Mitosis isn't slow it's fast in malignant cells. Size varies, not the defining split. Molecular structure shifts, but membrane proteins are the standout marker. Nurses use this to explain why her cancer's a threat those antigens tag it as invasive, a core oncology lesson for scared patients piecing it together.
A government initiative to reduce the effects of fatigue in the workforce has recently been rolled out. As anaesthetic lead, you are asked by the chief executive of your institution to develop strategies to reduce fatigue in your department. Appropriate strategies are likely to include:
- A. Changing the frequency of night shifts on the on-call rota from every 3 days to every 2 weeks.
- B. Including a section in the trainee's handbook on the signs of fatigue, along with prevention and management strategies.
- C. Acquiring a departmental exercise bike.
- D. Reducing the number of night shifts worked by colleagues over 55 years of age.
Correct Answer: A
Rationale: Fatigue mitigation in anaesthesia enhances safety. Reducing night shift frequency from every 3 days to every 2 weeks allows recovery (per sleep science, 48-72 hours post-night shift), significantly cutting cumulative fatigue versus less impactful measures. A handbook educates on fatigue signs (e.g., yawning, errors) and strategies (naps, caffeine), but it's passive. An exercise bike offers minor alertness boosts but not sustained relief. Age-based shift reduction addresses older workers' recovery needs, yet evidence favors roster spacing for all. Refreshments help minimally. Frequent night shifts disrupt circadian rhythms and sleep homeostasis, amplifying error risk (e.g., medication misdosing); a 2-week gap aligns with occupational health guidelines for sustained performance.
The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?
- A. Tumor lysis syndrome (TLS)
- B. Syndrome of inappropriate antidiuretic hormone (SIADH)
- C. Disseminated intravascular coagulation (DIC)
- D. Hypercalcemia
Correct Answer: A
Rationale: Non-Hodgkin lymphoma's fast cell turnover, plus recent chemo, primes for TLS dead cells dump potassium, phosphorus, and uric acid, risking kidney failure days post-treatment. SIADH (low sodium) and hypercalcemia (bone mets) are less tied to this timeline. DIC's bleeding chaos isn't lymphoma's usual post-chemo hit. Nurses hunt TLS signs fatigue, nausea, arrhythmias knowing it's a fatal oncology curveball if missed early.
A 4 week old baby is due for her second Hepatitis B vaccine dose. However, you note that the baby is mildly jaundiced. What would be the most appropriate step to take next?
- A. Screen for the Hepatitis B virus and only proceed with immunisation if the results are negative
- B. Immunisation is not required as the baby may already have hepatitis
- C. Give the hepatitis B vaccine and arrange for investigation for the jaundice
- D. Proceed with the vaccination but also give the Hepatitis B immunoglobulin at another site
Correct Answer: C
Rationale: Mild jaundice at 4 weeks likely physiologic or breast milk, not hep B vaccine's safe, so jab and probe cause. Screening delays, skipping's wrong, deferring's cautious overkill, immunoglobulin's for exposure. Nurses roll this, a chronic vax-plus-check play.
The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment?
- A. I have frequent muscle aches and pains.'
- B. I rarely have the energy to get out of bed.'
- C. I experience chills after I inject the interferon.'
- D. I take acetaminophen (Tylenol) every 4 hours.'
Correct Answer: B
Rationale: Interferon's flu-like hell aches , chills , and Tylenol use are par but crushing fatigue flags dose-limiting toxicity, hinting at overdose or depression. Nurses in oncology dig deeper here rarely out of bed' could mean more than side effects, needing med tweaks or psych consult, critical for home care balance.