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.
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What is the cut-off of blood pressure for the diagnosis of hypertension that is recommended by MOH Clinical Practice Guideline?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/70 mmHg
- D. 140/90 mmHg
Correct Answer: D
Rationale: MOH guidelines hold hypertension at 140/90 mmHg, a conventional cutoff balancing sensitivity and specificity for diagnosis in primary care, aligning with global norms like WHO. Lower thresholds 120/70, 125/75, 130/70, 135/80 catch prehypertension or align with newer AHA standards, but MOH sticks to 140/90 for actionable clarity, triggering treatment to curb stroke or heart risks. This higher bar avoids overdiagnosis in resource-stretched settings, ensuring focus on clear disease, a practical call for managing chronic vascular load.
The nurse is assessing a 3-year-old child whose mother complains that he is listless and has been having trouble swallowing. Which of the following findings would suggest the child has a brain tumor?
- A. Observation reveals nystagmus and head tilt
- B. Vital signs show blood pressure measures 120/80
- C. Examination shows temperature of 38.5°C and headache
- D. Observation reveals a cough and labored breathing
Correct Answer: A
Rationale: Brain tumors in young children often cause neurological signs from mass effect or increased intracranial pressure (ICP). Nystagmus (involuntary eye movement) and head tilt suggest cerebellar or brainstem involvement, common in pediatric brain tumors like medulloblastoma, disrupting coordination and posture key findings in a listless child with swallowing issues (possibly cranial nerve dysfunction). Blood pressure of 120/80 is elevated but lacks widened pulse pressure typical of ICP; it's non-specific without context. Fever and headache might indicate meningitis, not a tumor, unless paired with focal signs. Cough and labored breathing point to respiratory issues, not neurological ones. Nurses noting nystagmus and tilt prompt urgent imaging, critical in pediatric oncology for diagnosing brain tumors early and preventing further deterioration.
Strategies to overcome barriers and challenges faced in insulin therapy include the following EXCEPT:
- A. Close supervision for the patient's first jab
- B. Threaten patient into adherence with insulin therapy
- C. Engage patient from the start
- D. Offer the least painful options currently available in the market
Correct Answer: B
Rationale: Insulin wins guide first shots, engage early, ease pain, set sharp goals; threats flop, breed resentment. Nurses coach this chronic game, not bully.
According to the World Health Organization's ICF Bio-Psycho-Social Model, which of the following factors is an environmental contextual factor?
- A. Social background
- B. Behaviour pattern
- C. Social attitudes
- D. Coping style
Correct Answer: C
Rationale: ICF's environment slot social attitudes shape disability's feel, a nurse's external lens. Background, behavior, coping are personal, not outer. It's a chronic context key, world over self.
Which of the following is not complication associated with NAFLD?
- A. Ischemic heart disease
- B. Cerebrovascular accident
- C. Colon cancer
- D. All of the above
Correct Answer: D
Rationale: NAFLD heart, stroke, colon, liver cancer all link; no outlier. Nurses track this chronic risk chain.