Nokea
Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
- A. Yearly Pap tests
- B. Testicular self-examination
- C. Teaching patients to wear sunscreen
- D. Screening mammograms
Correct Answer: C
Rationale: Primary prevention stops cancer before it starts by reducing risk factors in healthy folks. Teaching sunscreen use blocks UV radiation a prime cause of skin cancer like melanoma fitting this category perfectly. Pap tests and mammograms are secondary prevention, detecting cervical and breast cancer early for treatment. Testicular self-exams also fall under secondary, aiming to catch testicular cancer sooner. The shift to primary efforts, like sun protection, reflects a proactive stance, cutting UV-induced DNA damage that kicks off carcinogenesis. Nurses pushing this can slash skin cancer rates, especially in fair-skinned populations, by fostering habits that shield against environmental triggers, unlike reactive screening or post-diagnosis care.
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Which condition assessed by the nurse would be an early warning sign of childhood cancer?
- A. Difficulty swallowing
- B. Frequent cough or hoarseness
- C. Change in bowel and bladder habits
- D. Swellings, lumps or masses anywhere on the body
Correct Answer: D
Rationale: Childhood cancers often present with subtle, non-specific signs, but swellings, lumps, or masses anywhere on the body are a key early warning, indicating possible tumors like leukemia (lymphadenopathy), Wilms tumor, or sarcomas. Nurses must assess these palpable abnormalities, as they prompt urgent diagnostic workup imaging or biopsy to catch cancer early when treatment is most effective. Difficulty swallowing might suggest esophageal or brain tumors but isn't a common early childhood cancer sign. Frequent cough or hoarseness could indicate adult cancers (e.g., lung) or late-stage disease, not typical pediatric onset. Bowel and bladder changes are more adult-specific (e.g., colorectal cancer) or late effects in children. Lumps' prominence in pediatric guidelines underscores their priority, aligning with nursing's role in early detection to improve survival rates in young patients.
Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary approaches are not as important as pharmacological approaches
- B. Carbohydrates have a greater satiating effect compared with proteins and fats, especially in individuals with prediabetes and obesity
- C. Intermittent fasting has consistently shown superior weight loss to very-low calorie and ketogenic diets as it is the easiest to adhere to
- D. Patient preference of dietary interventions plays a key part in adherence and ultimately weight loss and maintenance
Correct Answer: D
Rationale: Dietary approaches to obesity vary, but patient preference significantly influences adherence and long-term weight loss success, per behavioral studies making this true. Pharmacological approaches complement, not overshadow, diet. Proteins/fats are more satiating than carbohydrates, especially in prediabetes/obesity. Intermittent fasting's superiority isn't consistent adherence varies, not universally easier than ketogenic or very-low calorie diets. Preference drives sustainability, key for physicians tailoring chronic obesity interventions.
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.
Mr Yee, 45 years old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over his left elbow. He says that two years ago he took allopurinol 100 mg for one month followed by 200 mg OM for one month, but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago. He says he took it likely 'once or twice a week'. He states that he did not experience any rashes or other side effects to it then. He did not go back to see his previous GP as he has moved house and your clinic is nearer to his home. He does not drink alcohol except one glass of wine once or twice a year on special occasions. Two weeks ago, he was admitted to the hospital for a gout flare. He had blood tests done, which returned the results below. He is asking you to give him Arcoxia standby as it usually works for his gout flare. Uric acid 620 mmol/L, Creatinine 96 umol/L, eGFR >90 mL/min, BP 144/94 mmHg. He has HTN on HCTZ long-term. Which is incorrect advice?
- A. Offer to restart allopurinol and explain that it does not work immediately. You may wish to discuss HLA B5801 testing particularly as it is unclear how frequent and for how long he was taking allopurinol previously
- B. Advise that he will need stepwise up-titration of a urate lowering agent to reach uric acid target. Regular blood tests will allow this to be done safely
- C. Advice that colchicine prophylaxis is helpful to prevent gout attacks, as it takes time for a urate lowering agent to reach uric acid target
- D. Advise him that allopurinol is ineffective. Offer to initiate febuxostat or probenecid immediately
Correct Answer: D
Rationale: Tophus and 620 uric acid yell chronic gout allopurinol's not bunk; past spotty use tanked it, not the drug. Restarting with titration, colchicine cover, and allergy watch fits; HLA testing flags risk. Swapping to febuxostat or probenecid skips allopurinol's shot wrong call when adherence, not efficacy, flopped. Clinicians correct this, steering chronic control right.
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.