Nokea
You have just received the morning report from the night shift nurses. List the order of priority for assessing and caring for these patients.
- A. A patient who developed tumor lysis syndrome around 5:00 AM
- B. A patient with frequent reports of break-through pain over the past 24 hours
- C. A patient scheduled for exploratory laparotomy this morning
- D. A patient with anticipatory nausea and vomiting for the past 24 hours
Correct Answer: A
Rationale: Tumor lysis syndrome, an oncologic emergency from rapid cell breakdown, spikes electrolytes and risks renal failure its 5:00 AM onset demands immediate assessment for stability, trumping others. Surgery prep follows laparotomy needs readiness checks like NPO status, time-sensitive but stable. Breakthrough pain, chronic over 24 hours, requires analgesia adjustment, urgent but not life-threatening. Anticipatory nausea, psychogenic, needs comfort and antiemetics, least acute. Prioritizing tumor lysis aligns with ABCs circulation and organ function ensuring rapid intervention like fluids or dialysis, a nurse's critical triage call in this lineup.
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During the teaching session for a patient who has a new diagnosis of acute leukemia, the patient is restless and looks away without making eye contact. The patient asks the nurse to repeat the information about the complications associated with chemotherapy. Based on this assessment, which nursing diagnosis is appropriate for the patient?
- A. Risk for ineffective adherence to treatment related to denial of need for chemotherapy
- B. Acute confusion related to infiltration of leukemia cells into the central nervous system
- C. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment
- D. Risk for ineffective health maintenance related to possible anxiety about leukemia diagnosis
Correct Answer: D
Rationale: New leukemia diagnosis plus restlessness and repeat requests scream anxiety risk for ineffective health maintenance' fits, as it ties to coping, not denial , brain infiltration , or disinterest . Nurses in oncology spot this fear fogs learning, needing slower, calmer teaching to stick.
The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
Mr Xavier, a 60-year-old accountant, was recently started on allopurinol 100 mg two months ago. This was increased to 200 mg three weeks ago in your clinic. He informed you that he was diagnosed with UTI and started on ciprofloxacin. Today, he returns to your clinic with maculopapular rashes on his trunk and abdomen. He has a low-grade fever of 37.5°C. Which is the most appropriate next step?
- A. Stop Ciprofloxacin and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to Moxifloxacin 500 mg bd instead
- C. Continue medications and check for Dengue serology
- D. Stop Allopurinol
Correct Answer: D
Rationale: Rashes and fever post-allopurinol hike scream drug reaction stopping it nips hypersensitivity, like SJS risk, tied to uric acid meds over cipro's rarer skin hit. Quitting cipro alone misses the likely culprit; swapping antibiotics or dengue checks dodge the drug link; full stop's overkill. Clinicians halt allopurinol, watching this chronic fix's nasty turn, a swift call.
Which of the following countries has the highest percentage of diabetes patients?
- A. USA
- B. Britain
- C. India
- D. Saudi Arabia
Correct Answer: D
Rationale: Saudi Arabia's diabetes rate soars wealth, sedentary shifts, and diet spike it past USA's obesity-driven numbers, Britain's milder load, and India's vast but diluted count. Over 20% prevalence there trumps others' teens, a chronic epidemic nurses track in Gulf states, tied to rapid modernization.
The following are major causes of death among patients with NAFLD over the long term, except:
- A. Pancreatic cancer
- B. Acute myocardial infarct
- C. Road traffic accident
- D. Colon cancer
Correct Answer: C
Rationale: NAFLD's long haul kills via heart attacks, pancreatic, colon, or breast cancers metabolic and inflammation's toll. Road accidents? Random, not tied to fat liver's chronic grind. Clinicians watch these big hitters, not crash stats, in NAFLD's mortal map.