Nokea
Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.
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The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?
- A. Salvage surgery
- B. Palliative surgery
- C. Prophylactic surgery
- D. Reconstructive surgery
Correct Answer: C
Rationale: A bilateral mastectomy here is prophylactic removing nonvital breasts to prevent cancer in a high-risk patient with a positive tumor marker and family history. It's about risk reduction, not treatment of existing disease. Salvage surgery tackles recurrence after a less aggressive initial approach, like resecting a regrown tumor. Palliative surgery eases symptoms (e.g., pain from obstruction) in advanced cases, not prevention. Reconstructive surgery restores form or function post-treatment, like breast reconstruction after curative mastectomy. Prophylactic fits this preemptive strike, driven by genetic or familial risk (e.g., BRCA mutations), a growing trend in oncology to outpace cancer's onset, guided by nurses supporting informed, tough choices.
Which of the following should be not be routinely performed for patients with suspected non-alcoholic fatty liver disease?
- A. Liver biopsy
- B. Imaging studies like US scan
- C. Fasting lipids
- D. Fasting glucose
Correct Answer: A
Rationale: Liver biopsy, while diagnostic for NAFLD/NASH, isn't routine due to invasiveness and risks, reserved for unclear cases or staging needs, per AASLD. Ultrasound (fatty liver detection), fasting lipids, glucose, and liver function tests are non-invasive, routine screens for metabolic risk and diagnosis confirmation. This approach optimizes chronic disease evaluation safely.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Stopping all oral hypoglycaemic agents
- C. Recognition and self-management of hypoglycaemia
- D. Sick day management
Correct Answer: B
Rationale: Insulin therapy education for diabetes patients covers injection technique, hypoglycemia recognition and management, sick day rules, and safe driving, per diabetes care standards. However, stopping all oral hypoglycemic agents isn't universally essential many patients continue agents like metformin or SGLT-2 inhibitors alongside insulin for synergistic effects, depending on glycemic control needs. Assuming cessation oversimplifies treatment plans, potentially reducing efficacy. Education must tailor to individual regimens, not mandate stopping orals, making this the exception. Physicians ensure comprehensive teaching to enhance adherence and safety, critical in chronic disease management.
Which set of classification values indicates the most extensive and progressed cancer?
- A. T1 N0 M0
- B. T10 N0 M0
- C. T1 N1 M0
- D. T4 N3 M1
Correct Answer: D
Rationale: TNM staging gauges cancer extent: T (tumor size), N (node involvement), M (metastasis). T4 N3 M1 marks the worst T4 signals a large, invasive tumor, N3 extensive nodal spread, M1 distant metastases, painting a picture of widespread, advanced disease. T1 N0 M0 is small, localized, no spread early stage. T10 isn't standard (likely T1), still less severe. T1 N1 M0 has minor nodal involvement, not extensive. T4 N3 M1's combination screams progression, guiding nurses to expect aggressive care or palliation, a stark contrast to earlier stages' hopeful prognosis, critical for planning in advanced cancer.
The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical-surgical unit. Which client should the nurse see first?
- A. A client with pain that is two days post-operative from a prostatectomy
- B. A client ready for discharge education after treatment of an acute kidney injury
- C. A client with hypertension with a blood pressure of 172/92 mm Hg
- D. A client with a history of asthma complaining of increased dyspnea
Correct Answer: D
Rationale: Asthma's increased dyspnea flags airway risk ABCs prioritize breathing, as bronchospasm could crash fast, needing nebulizers or oxygen. Post-op pain's manageable, discharge education waits, hypertension's high but stable. Nurses hit dyspnea first, ensuring airflow, a life-first call in this shift-start triage.