Nokea
Which is the most common organism/s causing osteomyelitis in all age groups?
- A. streptococci
- B. staph aureus
- C. gm negatives
- D. hemophilus
Correct Answer: B
Rationale: Staph aureus reigns in osteomyelitis bone's bane across kids to geezers, sticking to marrow like glue. Streptococci hit less, gram-negatives tag trauma, hemophilus fades post-vaccine, fungi creep rare. Nurses bank on this staph stat, a chronic skeleton scourge needing targeted juice.
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Proven treatment for patients with noncirrhosis from NAFLD include the following except:
- A. Liver transplant
- B. Bariatric surgery
- C. Vitamin E
- D. Weight loss
Correct Answer: A
Rationale: Noncirrhotic NAFLD bends to weight loss, bariatric cuts, and Vitamin E's antioxidant punch proven aids. Transplant's endgame for cirrhosis, not here. Metformin flops for fat, despite diabetes use. Clinicians skip this organ swap, leaning on lifestyle and pills, a chronic fix before scars hit.
A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- A. Helping clients adjust to their appearance
- B. Reassuring clients that this change is temporary
- C. Referring clients to a reputable wig shop
- D. Teaching measures to prevent scalp injury
Correct Answer: D
Rationale: Alopecia, or hair loss, is a common chemotherapy side effect due to drugs targeting rapidly dividing cells, including hair follicles. While emotional support is vital, the priority is client safety. Teaching measures to prevent scalp injury such as avoiding harsh brushing or sun exposure takes precedence because the scalp becomes vulnerable without hair's protective barrier, risking cuts, infections, or burns. Helping clients adjust to appearance and reassuring them about regrowth address psychosocial needs but don't mitigate physical risk. Referring to a wig shop is practical but secondary to safety. In oncology nursing, prioritizing physical protection aligns with the hierarchy of needs, ensuring the client avoids complications like infection, especially if immunocompromised, before addressing emotional impacts.
A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.
With regards to starting drug therapy for arterial hypertension, at which level of diastolic pressure should treatment be considered?
- A. 60 to 69 mmHg
- B. 70 to 79 mmHg
- C. 80 to 89 mmHg
- D. 90 to 95 mmHg
Correct Answer: D
Rationale: Arterial hypertension management follows guidelines like those from the American College of Cardiology, where drug therapy is typically considered when blood pressure exceeds certain thresholds. Diastolic pressure of 90 mmHg or higher is a widely accepted level for initiating treatment in adults, especially if sustained or accompanied by risk factors like diabetes or organ damage, as it indicates stage 1 hypertension needing intervention to prevent cardiovascular complications. Levels below 90 mmHg (60-69, 70-79, 80-89 mmHg) may warrant lifestyle changes but not immediate drug therapy unless systolic pressure or other risks elevate the profile. The 90-95 mmHg range aligns with clinical practice to start antihypertensives, balancing benefit and risk, particularly in primary care settings where family physicians aim to reduce stroke and heart disease incidence effectively.
Which of the following is an example of multimorbidity?
- A. Chronic obstructive pulmonary disease and a urinary tract infection
- B. Lung cancer and pneumonia
- C. Chronic kidney disease and appendicitis
- D. Diabetes and exacerbation of rheumatoid arthritis
Correct Answer: D
Rationale: Multimorbidity means chronic twins diabetes and rheumatoid arthritis flare together, a dual load, not acute add-ons like UTIs, pneumonia, or appendicitis. Those flare fast and fade; chronic pairs grind on, tangled or not, a nurse's radar for complex care, a hallmark of long-haul illness overlap.