Nokea
Which stage of liver damage is irreversible?
- A. Cirrhosis
- B. Fibrosis
- C. Inflammation
- D. Steatosis
Correct Answer: A
Rationale: Cirrhosis scars for keeps fibrosis might bend, inflammation fades, steatosis lifts, but end-stage knots stay. Nurses mark this, a chronic liver lock.
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Which is not true of gangrene?
- A. it is usually caused by clostridium perfringens
- B. pain is out of proportion to the soft tissue injury
- C. hyperbaric oxygen is recommended
- D. gas must be seen on a plain xray
Correct Answer: D
Rationale: Gangrene Clostridium leads, pain screams, oxygen helps, surgery rules; gas isn't must-see. Nurses cut this chronic myth.
The disease progress of cancers, such as cervical or Hodgkin's, can be classified according to a clinical staging system. Place the description of stages 0-IV in the correct order.
- A. Metastasis
- B. Limited local spread
- C. Cancer in situ
- D. Tumor limited to tissue of origin
Correct Answer: C
Rationale: Clinical staging tracks cancer progression: starting with cancer in situ, where abnormal cells stay confined, non-invasive stage 0. Next, tumor limited to tissue of origin marks stage I, with localized growth but no spread. Limited local spread, stage II, shows slight extension beyond the origin. Extensive local and regional spread, stage III, involves nearby tissues or nodes. Metastasis, stage IV, indicates distant spread, the most advanced. The sequence cancer in situ, tumor limited to origin, limited spread, extensive spread, metastasis reflects increasing severity, guiding treatment from surveillance to aggressive therapy. Nurses use this to educate patients, aligning interventions with disease extent, critical for prognosis in cancers like cervical or Hodgkin's.
Mr Soh, a 40-year-old accountant on allopurinol 200 mg OM for the past eight months, reports two recent gout attacks in the last year. He has no other known past medical history. When you probe, he is adherent to allopurinol except for missing it perhaps once or twice a month. His BMI is 25 kg/m², BP 144/94 mmHg. His last uric acid was one month ago, which was 405 mmol/L. He is having a gout attack now. He tells you that his gout attacks are usually aborted with colchicine TDS for two days. Whilst on colchicine, he does not experience diarrhoea except perhaps one episode of loose stools after which he stops colchicine. Which is the most appropriate next step?
- A. Start Hydrochlorothiazide for hypertension
- B. Start Losartan for hypertension
- C. Stop Allopurinol during this acute gout attack and start colchicine
- D. Continue allopurinol at 100 mg OM despite the attack and start colchicine
Correct Answer: B
Rationale: Current gout attack with uric acid 405 mmol/L (above target <360) on allopurinol 200 mg suggests undertreatment. Continue allopurinol (not stop) during flares, add colchicine TDS for acute relief, and address BP 144/94 with Losartan urate-lowering and cardioprotective, unlike HCTZ, which raises urate. Check creatinine and up-titrate allopurinol later. This balances acute and chronic management effectively.
A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
- A. Interrupted sleep pattern
- B. Hot flashes
- C. Epistaxis (nose bleed)
- D. Increased weight
Correct Answer: C
Rationale: Carmustine, a nitrosourea, slams bone marrow, dropping platelets and causing thrombocytopenia low counts mean bleeding risks soar. Epistaxis (nosebleeds) is a classic sign, as mucosal vessels lack clotting support, especially with counts below 50,000/µL. Sleep issues might tie to discomfort but aren't direct. Hot flashes link to hormonal therapies, not this. Weight gain's unrelated cancer often causes loss. Nurses zero in on bleeding like epistaxis, bruising, or petechiae checking daily for these red flags, vital in oncology to catch and manage this life-threatening chemo fallout early.
Insulin is an anabolic hormone. Question: A catabolic state induced by insulin deficiency has an effect on which metabolism?
- A. Protein metabolism
- B. Glucose metabolism
- C. Fat metabolism
- D. A+B+C
Correct Answer: D
Rationale: Insulin gone, catabolism rages proteins break, glucose spikes, fats burn all unravel. No picking one; it's a full-body crash nurses see this in type 1's ketosis, a chronic fuel flip.