Nokea
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.
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The glycaemic profiles of people living with diabetes is affected by the following EXCEPT:
- A. Monitoring of blood glucose
- B. Dietary intake
- C. Exercise
- D. Stress
Correct Answer: A
Rationale: Diabetes' sugar swings dance to diet, exercise, stress, and meds intake, burn, cortisol, and pills all tug levels. Monitoring tracks, not tweaks, the profile; it's a mirror, not a mover. Clinicians lean on this quintet's interplay, adjusting levers, not the gauge, a chronic puzzle where tools shape, not tally, the game.
Which is not a common cause of respiratory symptoms in HIV/AIDS patients?
- A. community acquired bacterial pneumonia
- B. non hodgkins lymphoma
- C. Pulmonary Embolus
- D. CMV
Correct Answer: C
Rationale: Pulmonary embolus isn't HIV's lung usual clots tie to beds, not AIDS' immune dive. Pneumonia, lymphoma, CMV, PCP thrive in CD4's fall; emboli don't care. Nurses chase opportunists first, a chronic breath thief lineup skipping this oddball.
A community health center is preparing a presentation on the prevention and detection of cancer. Which health care professional should be assigned to address the topic: Explain screening exams and diagnostic testing for common cancers?
- A. RN
- B. LPN/LVN
- C. Nurse Practitioner
- D. Nutritionist
Correct Answer: C
Rationale: Explaining screening exams and diagnostic testing for cancers like mammograms or colonoscopies requires advanced knowledge of procedures, interpretation, and patient counseling, fitting the nurse practitioner's role. NPs perform exams, order diagnostics, and educate on results, bridging clinical and teaching skills in community settings. RNs focus on care coordination and basic education, not diagnostics. LPN/LVNs handle practical tasks, lacking authority for in-depth screening discussions. Nutritionists address diet, not testing protocols. NPs' expertise ensures accurate, authoritative delivery, critical for empowering attendees with prevention knowledge, aligning with their scope in primary care and health promotion initiatives.
A 7-year-old child with osteosarcoma is being treated with chemotherapy. Which medication would the nurse expect the physician to order most commonly as a prophylaxis against Pneumocystis jirovecii?
- A. Trimethoprim-sulfamethoxazole
- B. Ketoconazole
- C. Filgastim
- D. Prednisone
Correct Answer: A
Rationale: Osteosarcoma chemotherapy compromises the immune system, increasing susceptibility to opportunistic infections like Pneumocystis jirovecii pneumonia (PCP), a serious risk in immunocompromised children. Trimethoprim-sulfamethoxazole (TMP-SMX) is the most common prophylactic antibiotic for PCP, effectively preventing this lung infection by targeting its causative organism. Ketoconazole treats fungal infections but not PCP, which is caused by a fungus-like organism requiring specific therapy. Filgrastim stimulates neutrophil production to combat neutropenia, not PCP directly. Prednisone, a corticosteroid, suppresses immunity and reduces tumor-related edema but doesn't prevent infections and may increase risk. The nurse anticipates TMP-SMX due to its established role in pediatric oncology protocols, ensuring protection against a preventable, potentially fatal complication during chemotherapy.
When conventional routes of analgesia have been unsuccessful or are contraindicated for chronic pain syndromes, intrathecal drug delivery systems may be considered. Appropriate indications are likely to include:
- A. Patients with cancer-related pain in whom life expectancy is estimated to be >3 months.
- B. Chronic pancreatitis.
- C. Haematuria loin pain syndrome.
- D. Chronic low back pain.
Correct Answer: A
Rationale: Intrathecal drug delivery systems (IDDS) treat severe, refractory pain. Cancer pain with >3 months life expectancy justifies IDDS, balancing implantation risks with prolonged benefit shorter expectancy favors simpler methods. Chronic pancreatitis may respond, but evidence is weaker; it's not a primary indication. Haematuria loin pain syndrome (loin pain haematuria syndrome) is niche, rarely managed with IDDS due to limited data. Chronic low back pain often fails conservative treatment, but IDDS is reserved for extreme cases (e.g., failed back surgery syndrome), not routine. Chronic refractory angina is cardiac, not typically IDDS-eligible. Cancer pain's prevalence, severity, and responsiveness to intrathecal opioids/ziconotide make it the clearest indication, optimizing quality of life in palliative care.