Nokea
Which atypical pneumonia can be vaccinated against?
- A. coxiella burnetii
- B. mycoplasma pneumoniae
- C. chlamydia pneumoniae
- D. legionella
Correct Answer: A
Rationale: Coxiella Q fever has a vaccine, not mycoplasma, chlamydia duo, or legionella. Nurses jab this chronic farm bug shield.
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The BMI that does NOT INCREASE the risk of renal disease and CKD is X. What is X?
- A. 25 or more
- B. 30 or more
- C. 35 or more
- D. 40 or more
Correct Answer: A
Rationale: Body Mass Index (BMI) correlates with chronic kidney disease (CKD) risk, with higher values linked to increased incidence due to obesity-related glomerular hypertension and inflammation. A BMI of 25 or more defines overweight and obesity, elevating CKD risk, though 18.5-24.9 is the range typically not increasing risk. The question's phrasing implies the threshold where risk begins, making 25 or more the level where renal disease risk rises, per studies like the Framingham Heart Study. Higher BMIs (30+, 35+, 40+) progressively worsen risk, with 30 marking obesity. Thus, 25 or more is the correct cutoff, guiding family physicians in counseling patients on weight management to prevent CKD onset.
In caring for a patient with neutropenia, what tasks can be delegated to the nursing assistant?
- A. Take vital signs every 4 hours
- B. Report temperature elevation >100.4°F
- C. Assess for sore throat, cough, or burning with urination
- D. Gather the supplies to prepare the room for protective isolation
Correct Answer: A
Rationale: Neutropenia heightens infection risk, requiring team vigilance. Taking vital signs every 4 hours fits nursing assistants' scope routine monitoring flags fevers, key in neutropenia, without needing assessment skills. Reporting fever >100.4°F is their duty once detected, but assessing symptoms like sore throat or cough demands RN judgment to interpret infection signs. Gathering supplies for isolation is assistive, not evaluative, suiting their role. Handwashing's universal, not a task to delegate. Vital signs delegation ensures timely data collection, freeing nurses to analyze and act, a practical split in caring for this vulnerable patient.
How many times more likely is a patient with diabetes to die from a cardiovascular condition compared with a patient without diabetes?
- A. 2-4x
- B. 8-10x
- C. 20-25x
- D. 40-50x
Correct Answer: A
Rationale: Diabetes doubles, quadruples CV death vessels rot, not wild leaps. Nurses brace for this, a chronic heart toll.
A nurse is assessing a female client who is taking progestins. What assessment finding requires the nurse to notify the provider immediately?
- A. Irregular menses
- B. Edema in the lower extremities
- C. Ongoing breast tenderness
- D. Red, warm, swollen calf
Correct Answer: D
Rationale: Progestins, used in some cancer treatments (e.g., endometrial cancer), increase thromboembolism risk due to their hormonal effects on clotting factors. A red, warm, swollen calf suggests deep vein thrombosis (DVT), a medical emergency requiring immediate provider notification to prevent pulmonary embolism. Irregular menses, edema, and breast tenderness are common side effects of progestins, manageable with monitoring or symptomatic relief, and don't pose the same urgency. DVT's potential to escalate rapidly into a life-threatening condition prioritizes it over other findings. The nurse's prompt reporting ensures timely imaging (e.g., ultrasound) and anticoagulation therapy, aligning with oncology nursing's focus on vigilant complication detection in hormonally treated clients.
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.