Nokea
Which statement, from a participant attending the class on AIDS prevention, indicates an understanding on how to reduce transmission of HIV?
- A. Mother's who are HIV positive should still be encouraged to breastfeed their babies because beast milk is superior to cow's milk
- B. I think a needle exchange program, where clean needles are exchanged for dirty needles, should be offered in every city
- C. Females taking birth control pills are protected from getting HIV
- D. It's okay to use natural skin condoms since they offer the same protection as the latex condoms
Correct Answer: B
Rationale: The correct answer is B because implementing a needle exchange program is an effective way to reduce transmission of HIV among intravenous drug users. By providing clean needles in exchange for dirty needles, the risk of sharing contaminated needles and spreading the virus is significantly reduced. This approach also helps prevent the transmission of other bloodborne diseases, such as Hepatitis C. The other statements do not demonstrate an understanding of how to reduce HIV transmission - for example, encouraging breastfeeding for HIV-positive mothers can transmit the virus to the baby, birth control pills do not protect against HIV, and natural skin condoms do not offer the same level of protection as latex condoms.
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Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following?
- A. Squatting posture
- B. Absent or diminished femoral pulses
- C. Severe cyanosis at birth
- D. Cyanotic ("tet") episodes 46
Correct Answer: B
Rationale: Coarctation of the aorta is a congenital heart defect where there is a narrowing of the aorta, usually near the insertion of the ductus arteriosus. This narrowing can lead to decreased blood flow to the lower body. A common finding in a child with coarctation of the aorta is absent or diminished femoral pulses due to the obstruction of blood flow through the narrowed aorta. Other symptoms may include high blood pressure in the arms, weak lower body pulses, and heart murmur. Squatting posture, severe cyanosis at birth, and cyanotic ("tet") episodes are not typically associated with coarctation of the aorta.
Children with secondary nocturnal enuresis may have
- A. UTI
- B. diabetes mellitus
- C. diabetes insipidus
- D. psychosocial stressor
Correct Answer: D
Rationale: Psychosocial stressors can trigger secondary nocturnal enuresis after a period of dryness.
You are assigned to evaluate the outcome of fecal occult blood test as a screening test for patients with bowel cancer. The total number of patients who underwent the test is 2030; in those whom the disease is confirmed are 30. The results of fecal occult blood test are as follows: in 20 patients who has a confirmed bowel cancer (truly positive), and in 180 patients who don't have the disease (falsely positive); in 10 patients who truly has the disease (falsely negative), and in 1820 patients who are not affected by the disease (truly negative). All the following statements are true EXCEPT
- A. the prevalence of the disease for those population is 1.48%
- B. the sensitivity of the test is 67%
- C. the specificity of the test is 91%
- D. the positive predictive value is 20%
Correct Answer: A
Rationale: Prevalence = (Total cases / Total population) * 100 = (30 / 2030) * 100 ≈ 1.48%. This statement is correct, so it is the exception as the question asks for the incorrect statement.
A client with serum glucose level of 618mg/dl is admitted to the facility. He's awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6F (38.1C), heart rate of 116 beats/min, and blood pressure of 108/70mHg. Based on these assessment findings, which nursing diagnosis take highest priority?
- A. Deficient volume related to osmotic diuresis
- B. Decreased cardiac output related to elevated heart rate
- C. Imbalanced nutrition: Less than body requirements related to insulin deficiency
- D. Ineffective thermoregulation related to dehydration
Correct Answer: A
Rationale: The client's serum glucose level of 618mg/dl is indicative of severe hyperglycemia, likely due to uncontrolled diabetes mellitus. The client's presentation with hot dry skin, elevated heart rate, and low blood pressure suggests dehydration as a result of osmotic diuresis, which occurs in an attempt to excrete excess glucose. With an elevated heart rate and low blood pressure, it is essential to address the deficient volume to prevent further complications such as hypovolemic shock. Rehydration and fluid replacement are crucial interventions to help restore the client's fluid balance and prevent hemodynamic instability. Addressing the deficient volume related to osmotic diuresis should take the highest priority in this case.
During a breast examination, which finding most strongly suggests that the client has breast cancer?
- A. Slight asymmetry of the breasts
- B. A fixed nodular mass with dimpling of the overlying skin
- C. Bloody discharge from the nipple
- D. Multiple firm, round, freely movable masses that change with the menstrual cycle
Correct Answer: B
Rationale: A fixed nodular mass with dimpling of the overlying skin is the finding that most strongly suggests breast cancer. This presentation is concerning for an invasive carcinoma that has invaded into the surrounding tissues, leading to the dimpling of the skin. Breast cancer typically presents as a painless, hard, irregularly shaped, non-mobile mass. Dimpling of the skin overlying the mass is a sign of advanced disease and is often associated with a poor prognosis. Therefore, this finding should raise suspicion for breast cancer and prompt further evaluation and workup.