Nokea
Which of the following is not complication associated with NAFLD?
- A. Ischemic heart disease
- B. Cerebrovascular accident
- C. Colon cancer
- D. All of the above
Correct Answer: D
Rationale: NAFLD heart, stroke, colon, liver cancer all link; no outlier. Nurses track this chronic risk chain.
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Mr Yee, 45 years old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over his left elbow. He says that two years ago he took allopurinol 100 mg for one month followed by 200 mg OM for one month, but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago. He says he took it likely 'once or twice a week'. He states that he did not experience any rashes or other side effects to it then. He did not go back to see his previous GP as he has moved house and your clinic is nearer to his home. He does not drink alcohol except one glass of wine once or twice a year on special occasions. Two weeks ago, he was admitted to the hospital for a gout flare. He had blood tests done, which returned the results below. He is asking you to give him Arcoxia standby as it usually works for his gout flare. Uric acid 620 mmol/L, Creatinine 96 umol/L, eGFR >90 mL/min, BP 144/94 mmHg. He has HTN on HCTZ long-term. Which is incorrect advice?
- A. Offer to restart allopurinol and explain that it does not work immediately. You may wish to discuss HLA B5801 testing particularly as it is unclear how frequent and for how long he was taking allopurinol previously
- B. Advise that he will need stepwise up-titration of a urate lowering agent to reach uric acid target. Regular blood tests will allow this to be done safely
- C. Advice that colchicine prophylaxis is helpful to prevent gout attacks, as it takes time for a urate lowering agent to reach uric acid target
- D. Advise him that allopurinol is ineffective. Offer to initiate febuxostat or probenecid immediately
Correct Answer: D
Rationale: Tophus and 620 uric acid yell chronic gout allopurinol's not bunk; past spotty use tanked it, not the drug. Restarting with titration, colchicine cover, and allergy watch fits; HLA testing flags risk. Swapping to febuxostat or probenecid skips allopurinol's shot wrong call when adherence, not efficacy, flopped. Clinicians correct this, steering chronic control right.
An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells
- B. Malignant cells contain proteins called tumor-specific antigens
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells
- D. The nuclei of cancer cells are unusually large, but regularly shaped
Correct Answer: B
Rationale: Cancer cells sport tumor-specific antigens (e.g., CEA) proteins marking them as rogue, unlike normal cells. Fibronectin's less in malignant cells, aiding their slipperiness. Chromosomes are fragile and jumbled (aneuploidy), not stable. Nuclei are big and wonky (pleomorphic), not regular. Nurses in oncology education lean on this antigen trait it's why tests spot cancer and therapies target it, a clear line from normal to malignant.
The thickening of the glomerular basal membrane in an early stage of diabetes mellitus is a consequence of which mechanism?
- A. AGE deposition
- B. Proteinuria
- C. Inflammation
- D. All mechanisms mentioned above
Correct Answer: A
Rationale: Early diabetic kidney AGEs glue GBM thick, not protein spill or inflammation yet. Nurses catch this, a chronic sugar scar.
Which condition assessed by the nurse would be an early warning sign of childhood cancer?
- A. Difficulty swallowing
- B. Frequent cough or hoarseness
- C. Change in bowel and bladder habits
- D. Swellings, lumps or masses anywhere on the body
Correct Answer: D
Rationale: Childhood cancers often present with subtle, non-specific signs, but swellings, lumps, or masses anywhere on the body are a key early warning, indicating possible tumors like leukemia (lymphadenopathy), Wilms tumor, or sarcomas. Nurses must assess these palpable abnormalities, as they prompt urgent diagnostic workup imaging or biopsy to catch cancer early when treatment is most effective. Difficulty swallowing might suggest esophageal or brain tumors but isn't a common early childhood cancer sign. Frequent cough or hoarseness could indicate adult cancers (e.g., lung) or late-stage disease, not typical pediatric onset. Bowel and bladder changes are more adult-specific (e.g., colorectal cancer) or late effects in children. Lumps' prominence in pediatric guidelines underscores their priority, aligning with nursing's role in early detection to improve survival rates in young patients.
Which of the following is NOT part of the histology of non-alcoholic steatohepatitis?
- A. Fatty infiltration in liver
- B. Fibrosis of liver
- C. Inflammatory infiltrates in lobules
- D. Cirrhosis
Correct Answer: D
Rationale: NASH histology includes steatosis (fatty infiltration), lobular inflammation, and fibrosis, per pathology definitions. Mallory bodies (intracellular inclusions) are classic but not universal. Cirrhosis is an advanced NAFLD outcome, not a defining NASH feature progression, not initial histology. This distinction aids physicians in staging chronic liver disease accurately.