Nokea
Which of the following cancer patients could potentially be placed together as roommates?
- A. A patient with a neutrophil count of 1000/mm³
- B. A patient who underwent debulking of a tumor to relieve pressure
- C. A patient receiving high-dose chemotherapy after a bone marrow harvest
- D. A patient who is post-op laminectomy for spinal cord compression
Correct Answer: B
Rationale: Roommate pairing hinges on infection risk and care needs. The debulking patient tumor reduced for symptom relief and post-laminectomy patient spinal decompression both underwent palliative surgeries, not inherently immunocompromised, making them compatible. A neutrophil count of 1000/mm³ signals moderate neutropenia, needing isolation to dodge infections. High-dose chemotherapy post-bone marrow harvest obliterates immunity, demanding strict protection. The surgical pair's stability, lacking acute immune suppression, allows safe cohabitation, a nurse's practical call to optimize space and reduce cross-infection risks in cancer care settings.
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What is the result of bariatric surgery as a therapy for morbid obesity?
- A. Reduced insulin sensitivity
- B. Increased insulin sensitivity
- C. Reduced lipolysis
- D. Increased lipolysis
Correct Answer: B
Rationale: Bariatric fix insulin sensitivity jumps, fat shrinks, glucose flows, not lipolysis shifts. Nurses cheer this, a chronic reset win.
A 56 yo man presents with a penetrating wound to his leg from a wooden stake. The wound is contaminated with debris. His last tetanus booster was 12 years ago, but records reliably indicate he's had 3 doses of tetanus vaccine. The most appropriate anti-tetanus regimen for him is:
- A. ADT (Adult Diphtheria Tetanus) plus tetanus Ig (immunoglobulin)
- B. Tetanus Ig only
- C. ADT only
- D. Child diphtheria tetanus, as he is immunologically 'immature'
Correct Answer: C
Rationale: Dirty stake, 12 years off ADT boosts his three-dose base, no Ig for primed; kid shots, nothing's off. Nurses jab this chronic recall.
Which of the following nursing interventions would be appropriate for a client with sickle cell disease?
- A. Prepare the client for surgery
- B. Encourage fluid intake
- C. Provide a warm environment
- D. Keep the client strictly NPO
Correct Answer: B
Rationale: Sickle cell's sticky cells crave hydration fluids thin blood, easing vaso-occlusion, a top intervention to cut crisis. Surgery's rare, warmth helps pain, NPO starves. Nurses push intake, preventing sickling, a hydration win in this hemoglobin war.
Non modifiable risk factors for developing chronic illness include:
- A. Smoking and hypertension
- B. Sedentary lifestyle and diabetes
- C. Family history and socio-political factors
- D. Working/living conditions and stress
Correct Answer: C
Rationale: Non-modifiable risk factors are inherent traits or circumstances that cannot be changed, unlike modifiable factors tied to behavior or environment. Smoking and hypertension are modifiable through lifestyle changes or medical intervention, not fixed. Sedentary lifestyle is a choice, and diabetes, while influenced by genetics, is often manageable, making them modifiable. Family history, such as genetic predisposition to diseases like cancer or heart disease, is unalterable, and socio-political factors like access to healthcare shaped by policy or socioeconomic status are beyond individual control, fitting the non-modifiable category. Working and living conditions, plus stress, can be adjusted with resources or coping strategies, classifying them as modifiable. The distinction lies in control: family history and socio-political factors remain static, influencing chronic illness risk without personal alteration, as noted in foundational chronic disease literature like Farrell (2017), emphasizing genetics and societal context over mutable habits.
A 72 years old man is diagnosed to have Type 2 DM, hypertension and hyperlipidemia with stage 3 chronic kidney disease. He is otherwise well and asymptomatic. He is referred to you for follow-up care. His blood pressure is 142/70 mmHg with HbA1c 6.5%. You would continue his following medications EXCEPT
- A. Hydrochlorothiazide 12.5 mg OD
- B. Simvastatin 40 mg ON
- C. Aspirin 100 mg OD
- D. Glibenclamide 10 mg bid
Correct Answer: D
Rationale: Stage 3 CKD eGFR 30-59 means glibenclamide's out; it piles up, risking hypoglycemia in shaky kidneys. Thiazide holds BP, simvastatin guards lipids, aspirin shields heart, irbesartan protects kidneys all stay. Nurses swap sulphonylureas here, dodging chronic sugar crashes in fragile renal states.