Nokea
The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer?
- A. Teach the patient about the seven warning signs of cancer.
- B. Plan to monitor the patient's carcinoembryonic antigen (CEA) level.
- C. Teach the patient about annual chest x-rays for lung cancer screening.
- D. Discuss risks associated with cigarette smoking during each patient encounter.
Correct Answer: D
Rationale: Smoking's the lung cancer kingpin two packs a day screams risk. Hitting the patient with smoking's dangers every visit pushes primary prevention, aiming to cut exposure to tar and carcinogens fueling 85% of cases. Warning signs (CAUTION) and chest x-rays are secondary catching cancer, not stopping it. CEA's a tumor marker for tracking, not prevention. Nurses in oncology know preaching cessation at every chance leverages behavior change, the gold standard to slash lung cancer odds, trumping screening or monitoring in a heavy smoker like this.
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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.
Appropriate statements regarding markers of outcome after major surgery in England in 2014 include:
- A. Data about each hospital's complication rates after surgery are readily available.
- B. Data about each hospital's 30-day mortality after surgery are readily available.
- C. For most procedures, 90-day mortality rate are similar to 30-day mortality rates.
- D. National Hospital Episode Statistics (HES) data are useful for monitoring the performance of units.
Correct Answer: B
Rationale: In 2014 England, surgical outcome transparency increased. Complication rates weren't universally published per hospital, varying by procedure and trust. However, 30-day mortality data were widely available, notably via NHS initiatives and specialty audits (e.g., National Joint Registry), reflecting short-term success. Ninety-day mortality often exceeds 30-day rates (e.g., in vascular surgery), capturing delayed deaths, so they're not typically similar. HES data, capturing inpatient episodes, help monitor trends and performance, though coding accuracy limits granularity. Weekend admission mortality was higher, per studies like 2015 BMJ, due to staffing and care differences. The availability of 30-day mortality data was a key quality metric, driving accountability and improvement in surgical care.
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
The blood glucose level rises after meals. This glucose is stored in various organs under the influence of insulin. Question: During the postprandial period, most glucose is stored in which tissue?
- A. Intestinal tissue
- B. Liver tissue
- C. Muscle tissue
- D. Fat tissue
Correct Answer: C
Rationale: Post-meal glucose floods muscle insulin shoves it there, 60% of the haul, a chronic storehouse. Liver grabs next, fat lags, intestines pass nurses track this, a bulk uptake king.
Which of the following interventions should be included in the nutrition care plan of the client with atherosclerosis?
- A. Limit sodium intake to 6 g per day
- B. Increase full-fat dairy products
- C. Increase saturated fats
- D. Increase daily intake of vegetables, fruits, and whole grains
Correct Answer: D
Rationale: Atherosclerosis plaque-laden arteries thrives on poor diet. Boosting vegetables, fruits, and whole grains slashes cholesterol and inflammation, slowing plaque via fiber and antioxidants, a cornerstone of cardiac nutrition. Sodium limits help hypertension, but 6 g exceeds heart-healthy goals (2.3 g). Full-fat dairy and saturated fats fuel plaque, worsening disease. Nurses push plant-based eating, aligning with evidence to reverse atherosclerosis's march, a proactive step over mere restriction in this vascular battle.