Nokea
What is the highest likelihood that a doctor acquires HIV from a needlestick injury from an HIV pt?
- A. 0.30%
- B. 2%
- C. 5%
- D. 10%
Correct Answer: A
Rationale: HIV needlestick 0.3% odds, not 2-30's wild leaps. Nurses glove up, a chronic prick stat.
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A community health center is preparing a presentation on the prevention and detection of cancer. Which health care professional should be assigned to address the topic: Explain screening exams and diagnostic testing for common cancers?
- A. RN
- B. LPN/LVN
- C. Nurse Practitioner
- D. Nutritionist
Correct Answer: C
Rationale: Explaining screening exams and diagnostic testing for cancers like mammograms or colonoscopies requires advanced knowledge of procedures, interpretation, and patient counseling, fitting the nurse practitioner's role. NPs perform exams, order diagnostics, and educate on results, bridging clinical and teaching skills in community settings. RNs focus on care coordination and basic education, not diagnostics. LPN/LVNs handle practical tasks, lacking authority for in-depth screening discussions. Nutritionists address diet, not testing protocols. NPs' expertise ensures accurate, authoritative delivery, critical for empowering attendees with prevention knowledge, aligning with their scope in primary care and health promotion initiatives.
A 58 year old woman is known to have diabetes mellitus for 20 years. Her glycaemic control has deteriorated over the last three years. She is currently on Insulin and Metformin. Her serum creatinine is 140 μmol/L. Urinalysis performed over the last six months showed persistent proteinuria 1+. What should be the MOST appropriate target blood pressure for this lady?
- A. <125/75 mmHg
- B. <130/85 mmHg
- C. <130/80 mmHg
- D. <120/70 mmHg
Correct Answer: C
Rationale: Diabetes 20 years, proteinuria, creatinine 140 CKD stage 3 needs BP under 130/80 to shield kidneys, per guidelines. Tighter risks perfusion; looser misses protection. Insulin and metformin tag along, but BP's the chronic guard nurses enforce here.
In the UK, orthognathic surgery is likely to:
- A. Be undertaken in specialist craniofacial surgery units rather than in maxillofacial surgery units.
- B. Be associated with a high incidence of postoperative nausea and vomiting.
- C. Require a nasal rather than an oral tracheal tube when a Le Fort I osteotomy is performed.
- D. Require admission of the patient to a high-dependency unit.
Correct Answer: B
Rationale: Orthognathic surgery corrects jaw deformities in the UK, typically by maxillofacial surgeons, not solely craniofacial units (reserved for complex congenital cases). Postoperative nausea and vomiting (PONV) are common due to blood swallowing, prolonged surgery, and opioids risk factors per Apfel criteria. Le Fort I osteotomy (maxillary) often uses oral intubation; nasal tubes suit mandibular focus or surgeon preference, not a requirement. High-dependency unit (HDU) admission isn't routine most recover in general wards unless complications (e.g., airway) arise. Cleft palate repair precedes, not follows, orthognathic work. PONV's prevalence reflects surgical and anaesthetic challenges, necessitating robust antiemetic prophylaxis.
Mr XYZ, a 60-year-old, smoker with DM, hypertension and CKD Stage 3 sees you for routine chronic review. He reports recurrent gout flares past five weeks of increasing intensity and duration which he assumes is due to frequent travel and lack of exercise. His current laboratory results are creatinine 106, eGFR 56, uric acid 400, HbA1c 7.3%, random hypocount 8.5 mmol/L. He is currently taking glipizide 5 mg BD, Metformin 250 mg BD, Amlodipine 5 mg OM. What is the most appropriate management in this patient?
- A. Offer dietary advice
- B. Prescribe NSAIDs and medical certificate (MC)
- C. Increased exercise frequency (e.g. jogging at least 3 times per week)
- D. Initiate urate lowering therapy using allopurinol with colchicine prophylaxis
Correct Answer: D
Rationale: Gout flares, uric acid 400, CKD 3 allopurinol with colchicine tames crystals, not just diet, NSAIDs, jogging, or smoke quit. Nurses start this chronic uric brake.
You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?
- A. Palliative
- B. Reconstructive
- C. Salvage
- D. Prophylactic
Correct Answer: A
Rationale: Stage IV colon cancer with liver mets is endgame surgery here's palliative, easing pain, obstruction, or bleeding, not curing. Reconstructive fixes form post-cure, irrelevant now. Salvage hits recurrence after lighter tries, not this late stage. Prophylactic's preemptive, not reactive. Palliative's about comfort, aligning with oncology's shift to quality of life when cure's off the table, a tough but real talk nurses navigate.