Nokea
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.
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The physician tells the patient that there will be an initial course of treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a prolonged period of time. You can help the patient by reinforcing that the primary goal for this type of treatment is:
- A. Cure
- B. Control
- C. Palliation
- D. Permanent remission
Correct Answer: B
Rationale: The physician's plan initial treatment, maintenance, and long-term monitoring suggests a chronic cancer unamenable to cure, aiming instead to control growth and spread. Control stabilizes disease, extending life and quality, unlike cure, which eradicates cancer, or permanent remission, implying no recurrence both unfeasible here. Palliation focuses on symptom relief, not longevity, misaligning with ongoing treatments. Reinforcing control clarifies expectations, reducing anxiety by framing therapy as proactive management, not defeat. Nurses bolster this by explaining observation's role in adjusting care, aligning patient understanding with realistic goals, vital for adherence and emotional resilience in prolonged cancer battles.
A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most appropriate?
- A. Assess the client's gait and balance.
- B. Ask the client about the ease of urine flow.
- C. Document the report completely.
- D. Inquire about the client's job risks.
Correct Answer: A
Rationale: Prostate cancer commonly metastasizes to bones, especially the spine, causing spinal cord compression a medical emergency that can lead to paralysis if untreated. New, severe low back pain in this context suggests possible metastasis, making gait and balance assessment the most appropriate action to check for neurological deficits (e.g., weakness, unsteady gait) indicating compression. This prioritizes client safety, as falls or worsening paralysis could result without intervention. Asking about urine flow relates to prostate obstruction, less urgent here given the pain's prominence. Documentation is essential but passive without assessment. Job risks might contribute to back pain but are secondary to cancer history. Assessing gait and balance first ensures rapid escalation if needed, reflecting oncology nursing's focus on detecting metastatic complications early.
Which of these pulmonary conditions is most likely to be seen with a CD4 count between 200 and 500 ?
- A. pulmonary TB
- B. CMV
- C. PCP
- D. Kaposi sarcoma
Correct Answer: A
Rationale: CD4 200-500 TB sneaks in, lungs ripe before deeper drops. CMV, PCP crave <200; Kaposi's skin-first; cryptococcus hits brains more. Nurses clock TB's early strike, a chronic lung foe at this immune ledge.
Which agent is the usually choice for moderate to severe travelers diarrhea?
- A. metronidazole
- B. doxycycline
- C. norfloxacin
- D. penicillin
Correct Answer: C
Rationale: Norfloxacin fluoroquinolone zaps travelers' E. coli, not metro, doxy, pen, or cotrim's fade. Nurses pick this chronic gut punch.
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.