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A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
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A nurse is caring for a client diagnosed with peripheral artery disease. Which of the following is a common assessment finding?
- A. 4+ pedal pulses
- B. 3+ pedal pulses
- C. Bounding pulses in all 4 extremities
- D. 1+ pedal pulses
Correct Answer: D
Rationale: Peripheral artery disease (PAD) clogs arteries, slashing flow 1+ pedal pulses (weak, thready) are typical, reflecting ischemia below blockages. 4+ or 3+ pulses (strong) contradict PAD's hypoperfusion; bounding pulses suggest hyperdynamic states, not occlusion. Nurses expect weak pulses, checking for pain or pallor, key to tracking PAD's limb-threatening march, guiding interventions like revascularization.
Which complications are the three main consequences of leukemia?
- A. Bone deformities, spherocytosis and infection.
- B. Anemia, infection, and bleeding tendencies.
- C. Lymphocytopoiesis, growth delays, and hirsutism.
- D. Polycythemia, decreased clotting time, and infection.
Correct Answer: B
Rationale: Leukemia, a bone marrow cancer, replaces normal marrow elements with immature, dysfunctional white blood cells (lymphoblasts), leading to three primary complications: anemia, infection, and bleeding tendencies. Anemia results from reduced red blood cell production, causing fatigue and pallor. Infection risk rises due to neutropenia immature lymphoblasts lack infection-fighting ability making children prone to severe illnesses. Bleeding tendencies occur from thrombocytopenia, low platelet counts causing bruising or petechiae. Bone deformities and spherocytosis aren't leukemia hallmarks; the former might occur in bone cancers like osteosarcoma, and the latter is a red cell disorder. Lymphocytopoiesis is a process, not a complication, while growth delays and hirsutism aren't primary leukemia effects. Polycythemia (high red cells) and decreased clotting time oppose leukemia's anemia and bleeding risks. Nurses must monitor these complications, as they guide interventions like transfusions or antibiotics, critical for supporting children through leukemia treatment.
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.
A client suffering from a narcotic overdose is seen in the Emergency Department. The client is confused, with warm, flushed skin, headache, and weakness. Vital signs of noted are temperature 102.6 F, heart rate 128 beats/minute, respirations 24 breaths/minute, and blood pressure 130/86 mm Hg. A blood gas analysis sample was drawn on room air, and the results are as follows: pH 7.33 PaCO2 53 mm Hg, PaO2 72 mm Hg, HCO3 24 mEq/L. This client is at risk for which of the following?
- A. Metabolic alkalosis
- B. Respiratory alkalosis
- C. Respiratory acidosis
- D. Metabolic acidosis
Correct Answer: C
Rationale: Narcotics depress breathing pH 7.33 (low), PaCO2 53 mm Hg (high) signal respiratory acidosis, as CO2 piles up from hypoventilation, a classic overdose trap. PaO2 72 mm Hg shows mild hypoxia; HCO3 24 mEq/L hasn't compensated yet. Alkalosis needs low CO2 or high HCO3; metabolic acidosis drops HCO3. Nurses spot this, anticipating oxygen or reversal, a breath-stifled risk in this opioid haze.
Which of the following is an example of multimorbidity?
- A. Chronic obstructive pulmonary disease and a urinary tract infection
- B. Lung cancer and pneumonia
- C. Chronic kidney disease and appendicitis
- D. Diabetes and exacerbation of rheumatoid arthritis
Correct Answer: D
Rationale: Multimorbidity means chronic twins diabetes and rheumatoid arthritis flare together, a dual load, not acute add-ons like UTIs, pneumonia, or appendicitis. Those flare fast and fade; chronic pairs grind on, tangled or not, a nurse's radar for complex care, a hallmark of long-haul illness overlap.