Author: Anonymous

A client in a hypertensive emergency is admitted to the critical care unit. In the emergency room the vital signs are: Temperature: 97.9°Farenheit, Pulse: 88 beats/min, Respirations: 20, Blood pressure: 230/108, O2 Saturation: 95%.  At 1000 the client is started on prescribed intravenous nitroprusside at 5 mcg/kg/min.  The nurse applies evidence based practice guidelines and determines the intervention was effective, if at 1100am the reassessment reveals which of the following objective findings?  

The nurse is caring for a client complaining of severe back pain, on assessment an abdominal bruit is detected and pulsation in the LLQ is observed. What is the priority action by the nurse?  

A nurse is recovering a client in the post anesthesia care unit after an open surgical repair of an abdominal aortic aneurysm. The client is awake and follows commands. Which assessment finding requires immediate intervention?

The nurse obtains an ankle-brachial index (ABI) of 0.40 in a client’s right leg. Which interpretation of this finding is most appropriate?

A client presents to the emergency department status post animal bite from a cat X 1 day. The nurse observes the area is warm, swollen, red and painful. After assessing the wound, the nurse inquires as to the status of the animal and the client states the animal was walking on street and does not know owner or health status of cat. The nurse should implement which priority intervention?   

A client with end-stage kidney disease received continuous ambulatory peritoneal dialysis. The nurse reviews the client’s chart, and noticed the client has elevated lipid levels. What collaborative intervention should the nurse include in the client’s plan of care?    

 A client with advanced CKD has worsening nausea, poor appetite, and fluid overload despite treatment. Potassium remains elevated after prescribed therapy. Which finding best supports the need to discuss initiation of dialysis?  

7.1. Compare cementoblastoma and focal cemento-osseous dysplasia with reference to their pathological nature, radiographic features and management.                                           (3)7.2. Write short notes on Adenomatoid Odontogenic tumour under the following headings:a) Demographic profile                                     (1)b) Clinical presentation                                     (1)c) Radiological features and two differential diagnosis (3)d) Molecular profile                                         (2)

6.1. A 38-year-old woman is found to have a well-defined periapical radiolucency associated with all mandibular anterior teeth during routine radiographic examination. The tooth is asymptomatic and responds positively to vitality testing.a) What is the most likely diagnosis? (1)b) State one (1) important differential diagnosis. (1)c) Explain three (3) features that would help distinguish the two lesions. (3)6.2. Compare familial florid cemento-osseous dysplasia and familial gigantiform cementoma with respect to their clinical presentation, radiographic features, biological behaviour and genetic basis. (4)6.3. A patient presents with multiple osteomas involving the jaws.a) Which inherited syndrome should be considered? (1)b) What major gastrointestinal manifestation is associated with this syndrome? (1)c) What is the significance of this manifestation in terms of cancer risk? (1)

1.1  A 59-year-old man with a history of oropharyngeal squamous cell carcinoma treated with radiotherapy four years earlier and the posterior mandible included in the radiation field. He presents with persistent pain, swelling and purulent discharge in the right posterior mandible following endodontic treatment of a mandibular first molar three months ago. Clinical examination reveals exposed bone, while panoramic radiography demonstrates mixed radiolucent–radiopaque changes and cortical disruption in the previously irradiated mandible.a) State the most likely diagnosis. (1)b) Describe three (3) clinical or radiological findings in this case that support a diagnosis. (3)c) Identify two (2) factors in the clinical scenario that predispose the patient to condition. (2)d) List three (3) important differential diagnoses for the mandibular lesion in this patient for the lesion and state one (1) feature that would help distinguish each from the most likely diagnosis. (6). 1.2 A 27-year-old woman is referred for assessment of an incidental radiopaque lesion in the mandibular premolar–molar region, identified during routine panoramic radiography. The adjacent teeth are vital, caries-free and asymptomatic. Clinical examination reveals no swelling, tenderness or cortical expansion. The radiograph shows a homogeneous radiopaque focus within the mandibular trabecular bone, with well-defined margins. The lesion is not fused to the roots, and the periodontal ligament spaces and lamina dura of the adjacent teeth are preserved.                                                                                                                                                                  [10]a) State the most likely diagnosis. (1)b) List two (2) important differential diagnoses for this localised radiopaque lesion. (2)c) For each differential diagnosis identified in Question (c), state one (1) clinical or radiological features that would help distinguish it from the suspected diagnosis. (2)d) Recommend three (3) clinical or radiographic assessments that would help confirm the working diagnosis and exclude relevant alternatives. (3)e) Describe the appropriate management of the lesion in this patient. (2)