Nokea
Which organism is most commonly responsible for travelers diarrhea?
- A. toxigenic strain of e coli
- B. clostridium difficile
- C. salmonella
- D. rotavirus
Correct Answer: A
Rationale: Travelers' trots E. coli's toxigenic strain leads, not C. diff, salmonella, rotavirus, or cholera's flood. Nurses peg this chronic globe-trotter.
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Which of the following has been shown to be useful in managing fatty liver?
- A. Insulin injection
- B. Metformin
- C. Vitamin E
- D. Exercises
Correct Answer: C
Rationale: Vitamin E, an antioxidant, reduces hepatic inflammation in non-alcoholic steatohepatitis (NASH), per AASLD guidelines, aiding NAFLD management. Insulin treats diabetes, not NAFLD directly. Metformin improves insulin sensitivity but lacks strong evidence for NAFLD reversal. Exercise and diet are key but split here; exercise aids weight loss, indirectly helping. Vitamin E's specific benefit makes it notable in chronic liver disease care.
Which nursing action should be included in the plan of care for a client returning to the surgical unit following a left modified radical mastectomy with dissection of axillary lymph nodes?
- A. Obtain permanent breast prosthesis before the patient is discharged from the hospital
- B. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes
- C. Place a pink bracelet on the client warning against venipunctures or blood pressures in the left arm
- D. Insist that the patient examine the surgical incision when the initial dressings are removed
Correct Answer: C
Rationale: Mastectomy with axillary dissection risks lymphedema a pink bracelet flags the left arm, barring venipuncture or BP cuffs to prevent swelling, a priority in post-op care. Prosthesis comes later, post-healing. PCA teaching avoids rigid timing PRN's key. Forcing incision checks risks distress, not healing. Nurses lock in this bracelet, safeguarding lymph flow, a must-do in this surgical aftermath to dodge chronic arm woes.
Mr XYZ, a 60-year-old, smoker with DM, hypertension and CKD Stage 3 sees you for routine chronic review. He reports recurrent gout flares past five weeks of increasing intensity and duration which he assumes is due to frequent travel and lack of exercise. His current laboratory results are creatinine 106, eGFR 56, uric acid 400, HbA1c 7.3%, random hypocount 8.5 mmol/L. He is currently taking glipizide 5 mg BD, Metformin 250 mg BD, Amlodipine 5 mg OM. What is the most appropriate management in this patient?
- A. Offer dietary advice
- B. Prescribe NSAIDs and medical certificate (MC)
- C. Increased exercise frequency (e.g. jogging at least 3 times per week)
- D. Initiate urate lowering therapy using allopurinol with colchicine prophylaxis
Correct Answer: D
Rationale: Gout flares, uric acid 400, CKD 3 allopurinol with colchicine tames crystals, not just diet, NSAIDs, jogging, or smoke quit. Nurses start this chronic uric brake.
A nurse is assessing a female client who is taking progestins. What assessment finding requires the nurse to notify the provider immediately?
- A. Irregular menses
- B. Edema in the lower extremities
- C. Ongoing breast tenderness
- D. Red, warm, swollen calf
Correct Answer: D
Rationale: Progestins, used in some cancer treatments (e.g., endometrial cancer), increase thromboembolism risk due to their hormonal effects on clotting factors. A red, warm, swollen calf suggests deep vein thrombosis (DVT), a medical emergency requiring immediate provider notification to prevent pulmonary embolism. Irregular menses, edema, and breast tenderness are common side effects of progestins, manageable with monitoring or symptomatic relief, and don't pose the same urgency. DVT's potential to escalate rapidly into a life-threatening condition prioritizes it over other findings. The nurse's prompt reporting ensures timely imaging (e.g., ultrasound) and anticoagulation therapy, aligning with oncology nursing's focus on vigilant complication detection in hormonally treated clients.
You measure the abdominal circumference and the hip circumference of a male patient with hypertension, overweight and recently-diagnosed type 2 diabetes mellitus. Question: Which values are most likely to be found in this patient?
- A. Abdomen: 78 cm, hip: 78 cm
- B. Abdomen: 78 cm, hip: 86 cm
- C. Abdomen: 102 cm, hip: 90 cm
- D. Abdomen: 90 cm, hip: 102 cm
Correct Answer: C
Rationale: Type 2, hypertension, overweight belly bulges past hips, 102 cm to 90 cm fits metabolic syndrome's apple shape, not slim or reverse. Nurses measure this, a chronic girth clue.