Nokea
Which of the following health determinants is NOT a component of Lalonde's model?
- A. Biological factors
- B. Physical environment
- C. Health care
- D. Attitude to life
Correct Answer: D
Rationale: Lalonde's grid biology, environment, care, not attitude shapes health, not mindsets. Nurses map this, a chronic model cut.
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An oncology patient has just returned from the postanesthesia care unit after an open hemicolectomy. This patient's plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome
- B. Assess the patient's fine motor skills once per shift
- C. Assess the patient's wound for dehiscence every 4 hours
- D. Maintain the patient's head of bed at 45 degrees or more at all times
Correct Answer: C
Rationale: Post-hemicolectomy, wound dehiscence splitting open is a killer risk, tied to infection or poor healing, needing checks every 4 hours. Compartment syndrome's a fracture thing, not gut surgery. Fine motor's irrelevant here neuro's not the issue. High head-of-bed helps breathing but isn't universal post-op. Nurses in oncology prioritize this, catching leaks or redness early, critical after cancer gut surgery.
An HIV-positive patient presents to the ED complaining of shortness of breath and non-productive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85% on room air. All of the following statements regarding this patient's probable diagnosis are TRUE, EXCEPT
- A. Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients
- B. Pentamidine isothionate is an effective alternate therapy to TMP-SMX
- C. A normal chest x-ray rules out acute PCP infection
- D. 65% of patients relapse within 18 months
Correct Answer: H
Rationale: PCP top AIDS bug, pentamidine swaps TMP-SMX, relapse hits, steroids for hypoxia; normal CXR misses 20%. Nurses nix this chronic x-ray lie.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
Which complications are the three main consequences of leukemia?
- A. Bone deformities, spherocytosis and infection.
- B. Anemia, infection, and bleeding tendencies.
- C. Lymphocytopoiesis, growth delays, and hirsutism.
- D. Polycythemia, decreased clotting time, and infection.
Correct Answer: B
Rationale: Leukemia, a bone marrow cancer, replaces normal marrow elements with immature, dysfunctional white blood cells (lymphoblasts), leading to three primary complications: anemia, infection, and bleeding tendencies. Anemia results from reduced red blood cell production, causing fatigue and pallor. Infection risk rises due to neutropenia immature lymphoblasts lack infection-fighting ability making children prone to severe illnesses. Bleeding tendencies occur from thrombocytopenia, low platelet counts causing bruising or petechiae. Bone deformities and spherocytosis aren't leukemia hallmarks; the former might occur in bone cancers like osteosarcoma, and the latter is a red cell disorder. Lymphocytopoiesis is a process, not a complication, while growth delays and hirsutism aren't primary leukemia effects. Polycythemia (high red cells) and decreased clotting time oppose leukemia's anemia and bleeding risks. Nurses must monitor these complications, as they guide interventions like transfusions or antibiotics, critical for supporting children through leukemia treatment.
Which does not cause genital ulceration?
- A. syphilis
- B. herpes simplex infection
- C. HIV
- D. lymphogranuloma venereum
Correct Answer: C
Rationale: HIV no direct ulcers; syphilis, herpes, LGV, chancroid carve sores. Nurses rule this chronic outlier.