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Symptoms of acute human immunodeficiency virus (HIV) typically occur within how long after infection?
Symptoms of acute HIV generally occur 2-4 weeks after infection. A vast array of symptoms may be present such as fever, rash, generalized fatigue, nausea, vomiting, diarrhea, and a sore throat.
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Eye lubricants are used for all but the following:
Eye lubricants are not used to achieve miosis during eye surgery. Eye lubricants are frequently used to treat dry eyes in cases where tears need to be replaced, to moisten contact lenses, or to protect eyes during surgery.
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Which of the following is part of a standard treatment plan for a diagnosis of stage I Lyme disease?
Stage 1 is called early localized Lyme disease. The infection is not yet widespread throughout the body. This is treated with a topical antihistamine to reduce symptoms.
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Which of the following is considered to be a normal age-related ocular degeneration?
Presbyopia, or farsightedness, is caused by a loss of elasticity in the lens of the eye, and is considered a normal change with aging.
Glaucoma, blepharitis, and cataracts all carry increased risk with advanced age, but are considered to be abnormal and/or pathological changes.
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Which of the following is not a risk factor for infertility in men?
Cigarette smoking and other poor lifestyle choices have been shown to cause decreased fertility in men. Surgeries such as hernia repair can also have a negative effect on male fertility. Sexually transmitted infection can cause fertility problems, especially if left untreated, in males and females. Frequent hot tub or spa use has also not recommended. Mild levels of sun exposure are the least likely of the above to cause infertility in men.
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The nurse is educating a 19-year-old female on contraceptive methods. The nurse describes which of these as the most effective?
The male condom is the most effective when used correctly. However, if used incorrectly, carries a much higher risk of failure. The male condom is also the only method of the answer choices that also carries protection against sexually transmitted diseases.
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The nurse is educating a 23-year-old woman on contraceptive options. She describes which of these as the most effective?
Medroxyprogesterone acetate injection is the most effective of the listed methods. Other methods of the above carry the risk for displacement or incorrect use. The nurse should inform the client that the medroxyprogesterone acetate injection is not effective against sexually transmitted diseases.
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The nurse is educating families in northern Wisconsin on the subject of tick removal. The nurse knows that teaching has been effective when they state all but which of the following?
Never twist, jerk, or rip the tick when attempting to remove them from the skin. Wear gloves or use a paper towel if they are not available. Seal the tick within a plastic bag and keep it in the freezer. If illness occurs, the tick may be useful for further testing.
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Which of the following is a bacterium frequently responsible for causing urinary tract infections?
Escherichia coli is a bacteria that lives in the normal flora of the intestines. However, it is also a frequent cause of urinary tract infections. Candida albicans is a fungus that frequently causes thrush and vaginitis. Mycobacterium leprae is responsible for leprosy or Hansen's disease. Treponema pallidum is a spirochete responsible for syphilis. Lastly, Clostridium botulinum is responsible for botulism as a result of it's secretion of a neurotoxin.
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Which of the following bodily fluids does not transmit human immunodeficiency virus (HIV)?
HIV is easily spread through all of the listed body fluids with the exception of saliva. A person may not contract HIV through exchange of saliva during activities such as kissing or sharing eating utensils.
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Which of the following regarding human immunodeficiency virus (HIV) is false?
HIV may be contagious just days after the host is infected. Women in heterosexual relationships may become infected more easily than men due to prolonged exposure to bodily fluids. It is however, possible for men to contract HIV from an infected woman. HIV is not frequently transmitted to health care professionals. Even for those who suffer from needle-stick injuries, transmission is unlikely.
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The nurse prepares to insert a peripheral venous catheter (PVC). Which of the following is an incorrect step in this process?
The catheter needle must be inserted bevel up at an angle between 10 to 30 degrees. The correct steps for inserting an peripheral venous catheter (PVC) are: 1) explain procedure and check identity, 2) prepare equipment at the bedside on clean surface, 3) apply appropriate personal protective equipment as needed, 4) distend veins by applying tourniquet 4-6 inches above site, 5) clean site with facility-approved cleaning solution, 6) hold skin taut to stabilize vein, 7) insert catheter bevel up at an angle between 10 and 30 degrees, 8) pierce skin and vessel to enter vein, 9) advance catheter until blood return observed, then remove tourniquet, 10) withdraw needle from catheter and advance catheter to hub, 11) secure catheter with tape or facility-approved dressing, 12) attach IV tubing and begin infusion, 13) assess for complications including infiltration or hematoma.
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The surgical nurse cares for a patient status post umbilical herniorraphy. Which of the following nursing interventions is a priority for the nurse?
All of these are important nursing interventions for a post-op herniorraphy patient. The priority is to prevent increasing intraabdominal pressure. Relieving urinary retention and avoiding coughing are the most important considerations to achieve this priority, but it is most important for the nurse to remember to avoid coughing, as it is most likely to increase intraabdominal pressure. It is also important to remember because it is often promoted for other post-operative procedures, and this is one case where it is not.
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The community health nurse educates a group of young boys who are learning about hiking safety. Which of the following statements made by the nurse is not effective for preventing Lyme disease?
Prophylactic antibiotics are not indicated for the prevention of Lyme disease. Antibiotics will be used after a tick bite when symptoms develop and an infection is suspected. The community health nurse should teach rules of prevention, including 1) knowing where Lyme disease is prevalent (New England, upper Midwest, mid-Atlantic states), 2) wearing long sleeves and long pants, covering as much skin as possible with clothing, 3) using insect repellant such as sprays over the whole body, and 4) checking for tick bites especially after exposure is anticipated, so you may receive care as quickly as possible if needed.
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Which of the following should be restricted in a patient with end-stage renal failure?
A patient with end-stage renal failure should be kept on a low-protein, low potassium diet. Fluid restriction is also an important part of management of patients with end-stage renal failure and patients on dialysis.
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A 75 year old female with end-stage renal failure asks her nurse for advice about her diet. Knowing that this patient must adhere to a low-potassium diet, the nurse cautions her against which of the following foods?
Orange juice is very high in potassium. One 12oz glass of orange juice contains 705mg of potassium. This could easily increase blood potassium to dangerous levels. The other fruits and vegetables listed are all low-potassium foods suitable for consumption by individuals needing to follow a low potassium diet.
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A nurse is looking over a basic metabolic panel for a 69 year old male. She notices that his BUN is . This value is __________.
BUN, or blood urea nitrogen, is a measurement of the kidney's ability to excrete urea, which is a byproduct of protein metabolism. This patient's BUN is within normal range: the reference range for BUN is .
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You are the nurse taking care of a 15-year old male wrestler at a primary care clinic who complains of a raised, red, ring-like rash with central clearing on his lower back that he states is very itchy. Which of the following is the most likely diagnosis?
The correct answer is "Tinea corporis," which is also known colloquially as "ringworm."
The described case is a classic case for tinea corporis, in which the patient is a young athlete, often a wrestler (due to the frequent skin-to-skin or skin-to-mat contact in damp, sweaty environments), who presents with an itchy, red, ring-like rash that exhibits central clearing. The word "corporis" qualifies that the fungal dermatophyte infection ("tinea") is specifically located on the body/torso/back region.
The other choices are incorrect as tinea capitis is a fungal infection of the scalp, tinea pedis is a fungal infection of the feet, tinea cruris is a fungal infection of the groin ("jock itch"), and tinea manuum is a fungal infection of the hands.
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You are the nurse taking care of an elderly patient with severe dementia and limited mobility who is at a high risk for developing a pressure ulcer. Which of the following options is the best first-line approach to preventing development of a pressure ulcer in this patient?
The correct answer is "Turning the patient multiple times per day." This is the correct answer because in the preventive stage for pressure ulcer management, there is no need to perform any invasive procedures, administer antibiotics in a patient who may be at high-risk for needing broad-spectrum antibiotics in the future (hence fostering antibiotic resistance), or consult subspecialty services (as there is no dermatological condition to be treated at the moment). The best option to prevent a pressure ulcer in a patient who is at high risk for developing a pressure ulcer is to turn the patient regularly while they are in bed, if they are bed-bound. By turning the patient, the high-pressure areas that would be at the highest risk for development of a pressure ulcer are able to have relief from pressure for a greater proportion of the day/night, and as such, can have blood flow restored while the patient is turned. By allowing for maximal blood flow to these regions, the risk of ischemia and subsequent infection and/or ulcer development is decreased. Without the actual development of an ulcer or infection, administering antibiotics, either topically, intramuscularly, or intravenously is inappropriate.
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You are a nurse in an emergency department and a patient presents with a 5 cm by 6 cm abscess on the dorsal aspect of his left hand. The hand is very painful, but he has full range of motion, and no sensory deficits. He is afebrile and has no systemic or localized symptoms aside from the abscess. Which of the following is the most appropriate next step in management?
The correct answer is "incision and drainage of the abscess." This is the correct answer, because an abscess, by definition, is a walled off collection of pus and bacteria, that is typically impenetrable to topical or systemic antibiotics. The only way to truly resolve an abscess is to incise and drain it, such that the walled off material can be expelled, and the pressure and pain can be relieved. Further, the material should be sent for culture so that the patient can be placed on appropriate antibiotics if the physician deems it necessary for post-drainage care.
The other choices are incorrect. Surgical amputation of the affected hand would be a drastic measure for a localized abscess that is not otherwise causing limb ischemia or necrosis. Incision and drainage is a much more reasonable first step. Injecting a steroid into the abscess would be a potentially dangerous intervention as steroids decrease the body's immune response to infection, and as such, could increase the bacterial load within the abscess, allowing it to expand and become more serious. As mentioned earlier, topical and oral antibiotics would likely be impenetrable to the abscess and would be inappropriate first steps when the option of incision and drainage exists.
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