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Triglycerides in VLDL particles can be passed on to HDL particles. Question: Which enzyme mediates this process?
- A. Cholesteryl ester transfer protein (CETP)
- B. Hepatic lipase (HL)
- C. Hormone sensitive lipase (HSL)
- D. Lipoprotein lipase (LPL)
Correct Answer: A
Rationale: CETP swaps triglycerides VLDL to HDL, not lipase cutters. Nurses know this, a chronic lipid shuffle.
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A 3-year-old girl with a Wilms tumor is returning to the unit after a simple nephrectomy. Which of the following actions have the highest priority in caring for this child?
- A. Maintaining NPO.
- B. Monitoring the BP every 2 hours.
- C. Turning her every 2 hours.
- D. Administering pain medication every 4 hours.
Correct Answer: B
Rationale: After a nephrectomy for Wilms tumor, monitoring blood pressure (BP) every 2 hours is the highest priority because kidney removal disrupts renin-angiotensin regulation, risking hypo- or hypertension, especially in a young child with one remaining kidney. Using the ABCs (airway, breathing, circulation), BP falls under circulation, a critical postoperative focus to detect shock or fluid imbalance early. Maintaining NPO is temporary post-anesthesia but shifts to hydration once awake, less urgent than BP. Turning every 2 hours prevents pressure ulcers, but a mobile 3-year-old post-simple nephrectomy likely moves independently unless sedated, lowering its priority. Pain medication is key but ranks lower (e.g., G' in extended ABCs) than circulation. Frequent BP checks ensure stability, aligning with nursing's role in pediatric surgical care to prevent complications in a child adapting to single-kidney function.
Appropriate statements concerning radiology and trauma interventional radiology include:
- A. To rule out injury of the cervical spine in the unconscious patient, application of a protocol involving a computed tomography (CT) scan to the neck is recommended.
- B. A FAST (Focused Assessment with Sonography for Trauma) scan is a specific investigation for assessment of intraperitoneal bleeding.
- C. In a patient who is persistently hypotensive in the emergency department despite adequate fluid resuscitation, radiological interventions to treat bleeding caused by a pelvic fracture are not recommended.
- D. Interventional radiology has a role in the management of injuries to the liver, kidney and spleen.
Correct Answer: A
Rationale: Trauma radiology optimizes diagnosis and intervention. CT is the gold standard for cervical spine assessment in unconscious patients, per NICE guidelines, offering high sensitivity for fractures/ligamentous injury versus plain films. FAST scans detect free fluid (e.g., blood) intraperitoneally but lack specificity positive findings need confirmation (e.g., CT). Persistent hypotension with pelvic fracture warrants interventional radiology (e.g., embolization), not dismissal contrary to the statement. Interventional radiology manages solid organ injuries (liver, kidney, spleen) via embolization, reducing surgical need. Staffing in radiology matches theatre for critical cases. CT's diagnostic precision in cervical spine trauma ensures timely, accurate management, critical in unconscious patients where clinical exam is unreliable.
Which is not true of secondary syphilis?
- A. it occurs 3-6 weeks after the primary stage
- B. it involves nonspecific symptoms eg, headache malaise
- C. there is lymphadenopathy
- D. there is a rash, which is pink plaques
Correct Answer: D
Rationale: Secondary syphilis rash spreads, not just pink plaques; timing, malaise, nodes, tests fit. Nurses map this chronic bloom.
For a patient who is receiving chemotherapy, which laboratory result is of particular importance?
- A. WBC
- B. PT and PTT
- C. Electrolytes
- D. BUN
Correct Answer: A
Rationale: Chemotherapy suppresses bone marrow, slashing white blood cell counts especially neutrophils heightening infection risk, making WBC monitoring paramount. Low counts trigger protective measures or treatment holds, directly tied to therapy's myelosuppressive core. PT and PTT track clotting, relevant for bleeding but less immediate. Electrolytes matter for overall status, but imbalances aren't chemotherapy's primary threat. BUN reflects kidney function, indirectly affected by some drugs, not the frontline concern. WBC's critical drop demands swift action fevers in neutropenia are emergencies underscoring its priority in safeguarding patients through treatment's immune-compromising phases.
A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan?
- A. Donor bone marrow is transplanted through a sternal or hip incision.
- B. Hospitalization is required for several weeks after the stem cell transplant.
- C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
- D. Transplant of the donated cells can be very painful because of the nerves in the tissue lining the bone.
Correct Answer: B
Rationale: HSCT for leukemia means 2-4 weeks in hospital engraftment's slow, and infection risk's sky-high in isolation. No incision it's IV. No OR it's bedside. Pain's minimal no bone nerves hit. Nurses in oncology stress this long haul, sterile stay, not surgical drama, prepping patients for the real grind.