Nokea
A 30yr NZ man goes to PNG, takes 300 mg chloroquine weekly for 2 weeks prior and 4 weeks post his trip. 3/12 later gets febrile/sweats/maleana with malaria parasites on film. The following is true
- A. He took 1/2 the normal dose of chloroquine
- B. If he took primaquine for 2/52 this wouldn't have happened
- C. Assume chloroquine resistance and treat accordingly
- D. This is probably p. falciparum
Correct Answer: C
Rationale: PNG malaria chloroquine's 250 mg norm, resistance rife, not dose, primaquine, or falciparum lock. Nurses switch this chronic resistant fix.
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A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary modifications are generally not sustainable and hence dietary approaches are not as important as pharmacological approaches
- B. There is no Randomised Controlled Trial (RCT) level of evidence regarding decreasing sugar sweetened beverages
- C. Dietary approaches can be broadly categorised into energy-focused, macronutrient-focused, dietary pattern-focused, and dietary timing-focused
- D. Long-term diet trials have shown intermittent fasting to be superior to continuous energy restriction with respect to average weight loss
Correct Answer: C
Rationale: Diet's obesity fight splits smart energy, macros, patterns, and timing frame approaches, a true lens on options like low-carb or fasting. Sustainability varies, RCTs back sugar cuts, fasting ties (not tops) restriction, and proteins sate more than carbs. Clinicians wield this quartet, tailoring chronic plans, a broad truth in food's fat battle.
Officially approved blood glucose meters used for self-testing and point-of-care diagnostics are not always suitable to measure the blood glucose values in neonates. Question: What is the main cause for this?
- A. Some meters are calibrated to plasma glucose and other meters to blood glucose
- B. Some measurement methods are sensitive to high levels of ascorbic acid (vitamin C)
- C. The measurement variation of some meters is too large
- D. Some meters are sensitive to abnormal haematocrit values
Correct Answer: D
Rationale: Neonate glucose flubs haematocrit swings throw meters off, not calibration, vitamin C, or variance. Nurses adjust for this, a chronic baby glitch.
There are several different transmembranous glucose transporters (Gluts). Question: Which Gluts occur most frequently in the liver and which in the pancreas?
- A. Glut 1 in the liver and Glut 2 in the pancreas
- B. Glut 2 in the liver and Glut 2 in the pancreas
- C. Glut 2 in the liver and Glut 1 in the pancreas
- D. Glut 4 in the liver and Glut 2 in the pancreas
Correct Answer: B
Rationale: Liver slurps glucose with Glut 2, pancreas senses it the same both lean on this transporter's flow. Glut 1's elsewhere, Glut 4's muscle-fat turf nurses know this, a chronic glucose gate map.
Nursing considerations that should be applied in the management of people with type 2 diabetes mellitus include:
- A. Blood glucose level monitoring before and after meals.
- B. Preventing the consumption of all high carbohydrate foods.
- C. Skin, foot, and pressure area care when hospitalised.
- D. Minimising exercise to prevent fatigue and foot ulcers.
Correct Answer: C
Rationale: Nursing care for type 2 diabetes balances monitoring, prevention, and education. Blood glucose monitoring pre/post-meals informs insulin adjustments but isn't universally required frequency varies. Banning all high-carb foods is unrealistic; moderation via glycemic index guides diet, not prohibition. Skin, foot, and pressure area care is critical in hospital peripheral neuropathy and poor healing (e.g., Bob's case) risk ulcers and infections, needing daily inspection and protection, per standards in chronic care texts. Minimizing exercise contradicts management; activity improves insulin sensitivity and glucose uptake ulcer risk is mitigated with proper footwear, not inactivity. Foot care addresses diabetes' microvascular damage (neuropathy, angiopathy), preventing amputation, a leading morbidity, making it a priority intervention in acute settings.