Nokea
A 50-year-old patient, body weight 98 kg and height 1.82 m, has been diagnosed with type 2 diabetes based on increased fasting blood glucose levels (8.2 and 7.9 mmol/L). This gave the patient such a shock that he started a strict calorie-restricted diet. Two weeks later, his fasting blood glucose is 6.8 mmol/L and he has lost 1 kg. Question: What is the most likely explanation for the sharp reduction of the blood glucose level and the limited reduction in weight of only ±1%?
- A. The insulin-stimulated glucose uptake in muscle tissue has increased
- B. The insulin-stimulated inhibition of hepatic glucose production has increased
- C. The insulin-stimulated uptake of free fatty acids in muscle tissue has increased
- D. The insulin-stimulated inhibition of glycerol production in the liver has increased
Correct Answer: B
Rationale: Type 2's glucose drop calorie cut reins in liver's sugar spill, insulin works better there. Muscle uptake helps, fat shifts less, glycerol's minor liver's the quick fix, weight lags nurses see this, a chronic tweak.
You may also like to solve these questions
Which of the following client statements reflect an outcome expectancy statement?
- A. I am not able to exercise
- B. Exercise helps people lose weight
- C. Exercise is too hard on my arthritis
- D. Dietary restrictions work better than exercise to lose weight
Correct Answer: B
Rationale: Outcome expectancy ties behavior to results exercise shedding pounds nails it, a belief nurses tap for motivation. Can't-do's, pain gripes, or diet bets miss that link, just vent or compare. It's a chronic nudge, faith in action's payoff.
A 66 year old man has recently been diagnosed with hypertension. He has no history of heart disease and diabetes mellitus. His average blood pressure is recorded as 154/82 mmHg. What is the MOST appropriate first line pharmacological therapy?
- A. Angiotensin converting enzyme-inhibitors
- B. Angiotensin receptor blockers
- C. Thiazide diuretics
- D. Calcium channel blockers
Correct Answer: C
Rationale: New hypertension at 66, 154/82 no heart or sugar issues thiazide diuretics kick off gentle, effective control, especially in older adults. ACE inhibitors or ARBs fit if kidneys or diabetes pop up; calcium blockers work but aren't first; beta blockers lag unless heart history. Nurses lean on thiazides cheap, proven for this chronic pressure nudge, keeping it simple and safe.
Regarding PID
- A. Trichomonas and Gardnerella are commonest organisms
- B. Associated with irregular menstruation
- C. Absence of fever and cervical excitation excludes diagnosis
Correct Answer: B
Rationale: PID chlamydia, gonorrhea lead, irregular menses tie, fever and motion can hide. Nurses link this chronic pelvic thread.
The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment?
- A. I have frequent muscle aches and pains.'
- B. I rarely have the energy to get out of bed.'
- C. I experience chills after I inject the interferon.'
- D. I take acetaminophen (Tylenol) every 4 hours.'
Correct Answer: B
Rationale: Interferon's flu-like hell aches , chills , and Tylenol use are par but crushing fatigue flags dose-limiting toxicity, hinting at overdose or depression. Nurses in oncology dig deeper here rarely out of bed' could mean more than side effects, needing med tweaks or psych consult, critical for home care balance.
A government initiative to reduce the effects of fatigue in the workforce has recently been rolled out. As anaesthetic lead, you are asked by the chief executive of your institution to develop strategies to reduce fatigue in your department. Appropriate strategies are likely to include:
- A. Changing the frequency of night shifts on the on-call rota from every 3 days to every 2 weeks.
- B. Including a section in the trainee's handbook on the signs of fatigue, along with prevention and management strategies.
- C. Acquiring a departmental exercise bike.
- D. Reducing the number of night shifts worked by colleagues over 55 years of age.
Correct Answer: A
Rationale: Fatigue mitigation in anaesthesia enhances safety. Reducing night shift frequency from every 3 days to every 2 weeks allows recovery (per sleep science, 48-72 hours post-night shift), significantly cutting cumulative fatigue versus less impactful measures. A handbook educates on fatigue signs (e.g., yawning, errors) and strategies (naps, caffeine), but it's passive. An exercise bike offers minor alertness boosts but not sustained relief. Age-based shift reduction addresses older workers' recovery needs, yet evidence favors roster spacing for all. Refreshments help minimally. Frequent night shifts disrupt circadian rhythms and sleep homeostasis, amplifying error risk (e.g., medication misdosing); a 2-week gap aligns with occupational health guidelines for sustained performance.