CLINICAL KNOWLEDGE NEWEST VERSION
ACTUAL 140 2026 NURSING AND HEALTH
SCIENCES TEST PAPER QUESTIONS AND
SOLUTIONS GRADED A+
◉ Actinic Keratoses. Answer: -slightly rough, pink or flesh-colored
lesion in sun-exposed area
-pharmacological treatment: 5-fluorouracil (topical chemotherapy)
-non-pharmacological treatment: chemical peel, cryotherapy, laser
resurfacing
◉ Tuberculosis. Answer: I. Transmission
A. Mycobacterium tuberculosis carried in airborne droplets
B. Active Pulmonary or Laryngeal Tuberculosis transmitted
1. Sneeze, cough, speak, or sing
II. Symptoms
A. Latent Tuberculosis is asymptomatic
B. Active Tuberculosis presentation often mimics cancer
presentation
1. Non-specific presentation (most common)
a. Fatigue
,b. Weight loss
c. Cachexia
d. Night Sweats
C. Pulmonary Tuberculosis symptoms
1. Productive cough (typically 2-3 weeks)
2. Hemoptysis (uncommon)
3. Pleuritic Chest Pain
4. Dyspnea
III. Signs
A. Sites of Involvement
1. Primary infection: lung involvement
B. Disseminated Disease
IV. Management
A. Latent Tuberculosis
1. Positive PPD without signs of Active Tb
2. Treatment indicated if risk of Tb Progression from latent to active
disease
B. Active Tuberculosis
◉ Gout. Answer: I. Pathophysiology
,A. *Gout occurs when Uric Acid levels exceed solubility limits*
1. Monosodium urate crystals deposit in joints, Kidney, and soft
tissues
2. Crystal deposition triggers a inflammatory response from
cytokines and Neutrophils
3. Joint space is irreversibly injured with ongoing attacks
II. Risk Factors
A. Most common
1. Obesity
2. Alcohol use (especially beer)
3. High purine diet (red meats, turkey and wild game, organ meats,
seafood)
4. Drinks sweetened with high fructose corn syrup
5. Diuretic therapy including Thiazide Diuretics
6. Other risks
a. Diabetes Mellitus
b. Hyperlipidemia
c. Hypertension
d. Atherosclerosis
e. Renal Insufficiency
f. Myeloproliferative disease
, III. Symptoms
A. Associated Symptoms
1. Chills
2. Fever as high as 104 F (40 C)
3. Severity: Very severe pain
a. Unable to bear weight
b. Too painful to put on socks
c. Intollerant to light touch from blankets
B. Regions Lower extremities
1. *First Metatarsophalangeal joint of great toe* (most common)
a. Known as *Podagra*
i. Affected in 50% of first gout attacks
Mid-tarsal joints
2. Ankle Joints
3. Knee Joints
C. Regions upper extremities
1. Fingers
2. Wrists
3. Elbows
D. Characteristics: Joint Pain
1. Excruciating, crushing type pain
ACTUAL 140 2026 NURSING AND HEALTH
SCIENCES TEST PAPER QUESTIONS AND
SOLUTIONS GRADED A+
◉ Actinic Keratoses. Answer: -slightly rough, pink or flesh-colored
lesion in sun-exposed area
-pharmacological treatment: 5-fluorouracil (topical chemotherapy)
-non-pharmacological treatment: chemical peel, cryotherapy, laser
resurfacing
◉ Tuberculosis. Answer: I. Transmission
A. Mycobacterium tuberculosis carried in airborne droplets
B. Active Pulmonary or Laryngeal Tuberculosis transmitted
1. Sneeze, cough, speak, or sing
II. Symptoms
A. Latent Tuberculosis is asymptomatic
B. Active Tuberculosis presentation often mimics cancer
presentation
1. Non-specific presentation (most common)
a. Fatigue
,b. Weight loss
c. Cachexia
d. Night Sweats
C. Pulmonary Tuberculosis symptoms
1. Productive cough (typically 2-3 weeks)
2. Hemoptysis (uncommon)
3. Pleuritic Chest Pain
4. Dyspnea
III. Signs
A. Sites of Involvement
1. Primary infection: lung involvement
B. Disseminated Disease
IV. Management
A. Latent Tuberculosis
1. Positive PPD without signs of Active Tb
2. Treatment indicated if risk of Tb Progression from latent to active
disease
B. Active Tuberculosis
◉ Gout. Answer: I. Pathophysiology
,A. *Gout occurs when Uric Acid levels exceed solubility limits*
1. Monosodium urate crystals deposit in joints, Kidney, and soft
tissues
2. Crystal deposition triggers a inflammatory response from
cytokines and Neutrophils
3. Joint space is irreversibly injured with ongoing attacks
II. Risk Factors
A. Most common
1. Obesity
2. Alcohol use (especially beer)
3. High purine diet (red meats, turkey and wild game, organ meats,
seafood)
4. Drinks sweetened with high fructose corn syrup
5. Diuretic therapy including Thiazide Diuretics
6. Other risks
a. Diabetes Mellitus
b. Hyperlipidemia
c. Hypertension
d. Atherosclerosis
e. Renal Insufficiency
f. Myeloproliferative disease
, III. Symptoms
A. Associated Symptoms
1. Chills
2. Fever as high as 104 F (40 C)
3. Severity: Very severe pain
a. Unable to bear weight
b. Too painful to put on socks
c. Intollerant to light touch from blankets
B. Regions Lower extremities
1. *First Metatarsophalangeal joint of great toe* (most common)
a. Known as *Podagra*
i. Affected in 50% of first gout attacks
Mid-tarsal joints
2. Ankle Joints
3. Knee Joints
C. Regions upper extremities
1. Fingers
2. Wrists
3. Elbows
D. Characteristics: Joint Pain
1. Excruciating, crushing type pain
