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.
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Pulmonary rehabilitation is one of the most effective interventions in the management of COPD. The primary goals of this program are to:
- A. Ensure the patient eats appropriately, takes their medication as prescribed and exercises every day
- B. Involve the patient in the multidisciplinary team and knows how to manage their condition
- C. Reduce symptoms, improved QOL, increase physical and emotional participation in everyday life
- D. Prevent deterioration, avoid hospitalisation and support the carers
Correct Answer: C
Rationale: Pulmonary rehab reclaims COPD life less wheeze, better QOL, more daily grit, physical and emotional. Diet-meds-exercise is narrow; team play's a means; prevention's a perk, not core. Nurses drive this, a chronic lift.
Triglycerides are absorbed in the intestines after a meal. Question: After being absorbed by intestinal cells, triglycerides are transported in the blood circulation by which lipid particle?
- A. Chylomicron particle
- B. HDL particle
- C. IDL particle
- D. VLDL particle
Correct Answer: A
Rationale: Post-meal triglycerides ride chylomicrons gut to blood, not HDL, IDL, or VLDL's liver gig. Nurses track this, a chronic fat ferry.
Which does not require post exposure prophylaxis for rabies?
- A. scratch
- B. bite on face
- C. bite on extremity
- D. skin contact with blood, urine or faeces
Correct Answer: D
Rationale: Rabies PEP bites, scratches, bat splashes trigger; blood, pee, poop on skin don't. Nurses skip this chronic non-risk.
The immediate nursing care to be provided to a patient presenting with a suspected ischaemic stroke include:
- A. Position on left lateral side, insert nasogastric tube, conduct an ECG and insert an IV line
- B. Primary/Secondary survey, give analgesia, 4th hourly neuro obs and vital signs, maintain oral intake
- C. Primary/Secondary survey, 4th hourly neuro obs and vital signs, monitor BGL and maintain nil by mouth
- D. 4th hourly neuro obs and vital signs, monitor BGL, insert an IV line and reduce intracranial pressure by positioning and reduced stimulation
Correct Answer: C
Rationale: Stroke hits fast surveys spot deficits, neuro obs track brain, vitals catch crashes, BGL rules out mimics, and nil by mouth preps for scans or clots, a tight first step. Lateral's for airways, not here; analgesia's late; IVs and ICP control follow. Nurses nail this, racing for tPA windows, a chronic precursor's acute kickoff.
Which of the following is FALSE regarding patient education for insulin therapy?
- A. It improves the patients experience and adherence to insulin therapy
- B. It requires time and preparation
- C. Different topics and focus can be covered at different stages of insulin therapy
- D. It can only be done by diabetes nurse educators
Correct Answer: D
Rationale: Patient education for insulin therapy enhances experience and adherence, requires time, and varies by stage e.g., injection skills at initiation, hypoglycemia management later all true per diabetes guidelines. However, stating it can only be done by diabetes nurse educators is false. While specialized educators excel, other healthcare professionals (physicians, pharmacists) can deliver effective education, especially in resource-limited settings. Multidisciplinary involvement ensures broader access and periodic understanding checks, vital for chronic disease management. This flexibility empowers diverse teams to support patients, debunking the exclusivity myth.