Nokea
Which of these causes of gastroenteritis usually requires treatment with antibiotics?
- A. shigella
- B. salmonella
- C. e-coli
- D. giardia
Correct Answer: D
Rationale: Giardia flagellate needs metronidazole, not shigella, salmonella, E. coli, campy's self-run. Nurses dose this chronic gut bug.
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Damage control resuscitation:
- A. Is not indicated unless it is clear the patient's physiology has been deranged by severe injury.
- B. Is not indicated unless the patient is in the hospital.
- C. Is likely to involve restriction of fluid administration in a hypotensive, bleeding patient.
- D. Is likely is be assessed for adequacy by palpation of the radial pulse in patients with a head injury.
Correct Answer: C
Rationale: Damage control resuscitation (DCR) mitigates trauma's lethal triad (hypothermia, acidosis, coagulopathy). It's indicated preemptively in severe bleeding, not just post-derangement, to prevent physiologic collapse. It begins pre-hospital (e.g., paramedics), not only in-hospital, using blood products early. Fluid restriction in hypotensive bleeding limits dilutional coagulopathy, favoring permissive hypotension until haemostasis crucial in uncontrolled haemorrhage. Radial pulse palpation gauges perfusion broadly, but head injury patients need cerebral perfusion pressure prioritization, not DCR adequacy. ABC remains foundational. Fluid restriction's role balancing shock correction with bleeding exacerbation defines DCR's shift from crystalloid overload, improving survival in exsanguinating trauma.
The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?
- A. The UAP flushes the toilet once after emptying the patient's bedpan.
- B. The UAP stands by the patient's bed for 30 minutes talking with the patient.
- C. The UAP places the patient's bedding in the laundry container in the hallway.
- D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.
Correct Answer: B
Rationale: Cervical implant's radioactive 30 minutes bedside overshoots exposure limits (under 30's safe); flushing , laundry , and mouthwash don't radiate. Nurses in oncology intervene UAP need time caps to dodge radiation, a safety must.
A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement. Which of the following statements by the client indicates the clients correct understanding of the discharge teaching regarding warfarin anticoagulant therapy?
- A. I may need to modify my diet while on this medication
- B. I do not need to take my prescribed medication for the rest of my life
- C. Additional monitoring is not required while on the anticoagulant
- D. I can lead a normal life while on anticoagulants; no restrictions are required
Correct Answer: A
Rationale: Mechanical valves demand warfarin forever diet tweaks, like steady vitamin K, keep INR stable, a sign the client gets it. Lifelong meds, monitoring, and restrictions (e.g., bleeding risk) are non-negotiable. Nurses cheer this dietary nod, ensuring warfarin's tightrope walk succeeds, a smart grasp in this valve swap life.
With regards to adverse effects of first-line antihypertensive medications, angioedema has been associated with which ONE of the following classes of antihypertensives?
- A. Angiotensin receptor blockers
- B. Angiotensin-converting enzyme inhibitors
- C. Calcium channel blockers (dihydropyridine)
- D. Thiazide diuretics
Correct Answer: B
Rationale: Angioedema, a potentially life-threatening swelling of deep skin layers or mucous membranes, is a well-documented adverse effect of angiotensin-converting enzyme (ACE) inhibitors, occurring in about 0.1-0.7% of patients due to bradykinin accumulation from enzyme inhibition. This distinguishes ACE inhibitors from other first-line antihypertensives. Angiotensin receptor blockers (ARBs) rarely cause angioedema, as they don't affect bradykinin levels. Calcium channel blockers (e.g., dihydropyridines like amlodipine) may cause peripheral edema but not angioedema. Thiazide diuretics are linked to electrolyte imbalances or rashes, not angioedema. Family physicians must recognize this ACE inhibitor risk, ensuring prompt discontinuation and airway management if it occurs, critical for safe chronic disease management.
Which of the following is not associated with non-alcoholic fatty liver disease?
- A. Diabetes mellitus
- B. Lung cancer
- C. Pre-diabetes mellitus
- D. Hyperuricemia
Correct Answer: B
Rationale: NAFLD diabetes, pre-sugar, uric, colon tie; lung cancer's out. Nurses link this chronic fat net.