Nokea
A 58 year old woman is known to have diabetes mellitus for 20 years. Her glycaemic control has deteriorated over the last three years. She is currently on Insulin and Metformin. Her serum creatinine is 140 μmol/L. Urinalysis performed over the last six months showed persistent proteinuria 1+. What should be the MOST appropriate target blood pressure for this lady?
- A. <125/75 mmHg
- B. <130/85 mmHg
- C. <130/80 mmHg
- D. <120/70 mmHg
Correct Answer: C
Rationale: Diabetes 20 years, proteinuria, creatinine 140 CKD stage 3 needs BP under 130/80 to shield kidneys, per guidelines. Tighter risks perfusion; looser misses protection. Insulin and metformin tag along, but BP's the chronic guard nurses enforce here.
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In caring for a patient with neutropenia, what tasks can be delegated to the nursing assistant?
- A. Take vital signs every 4 hours
- B. Report temperature elevation >100.4°F
- C. Assess for sore throat, cough, or burning with urination
- D. Gather the supplies to prepare the room for protective isolation
Correct Answer: A
Rationale: Neutropenia heightens infection risk, requiring team vigilance. Taking vital signs every 4 hours fits nursing assistants' scope routine monitoring flags fevers, key in neutropenia, without needing assessment skills. Reporting fever >100.4°F is their duty once detected, but assessing symptoms like sore throat or cough demands RN judgment to interpret infection signs. Gathering supplies for isolation is assistive, not evaluative, suiting their role. Handwashing's universal, not a task to delegate. Vital signs delegation ensures timely data collection, freeing nurses to analyze and act, a practical split in caring for this vulnerable patient.
A nurse is caring for a client who presented to the emergency department with complaints of fatigue, palpitations, and chest pains. Upon assessment, the provider notes an S3 and S4 gallop, weak peripheral pulses, and tachycardia. The provider orders a chest x-ray and echocardiogram, which reveals left ventricular dilation. Which of the following disorder is consistent with these findings?
- A. Cardiac tamponade
- B. Dilated cardiomyopathy
- C. Pericarditis
- D. Restrictive cardiomyopathy
Correct Answer: B
Rationale: Left ventricular dilation with S3, S4, weak pulses, and tachycardia paints dilated cardiomyopathy heart muscle stretches, weakening pump, causing fatigue and palpitations. Tamponade compresses, not dilates. Pericarditis inflames without dilation. Restrictive stiffens, resisting stretch. Nurses tie this to DCM's systolic flop, anticipating meds like ACE inhibitors, a fit for this stretched-out heart.
One of the features of type 2 diabetes mellitus is the abnormally increased blood glucose values after meals. Question: What causes this abnormal rise of postprandial blood glucose?
- A. Insufficient glucose uptake in the liver due a shortage of Glut-2 transporters
- B. Insufficient glucose uptake in muscle tissue due to a defect in the Glut-4 transporters
- C. Insufficient glucose uptake in adipose tissue due to a defect in the intracellular insulin signal cascade
- D. Insufficient glucose uptake in muscle tissue due to a defect in the intracellular insulin signal cascade
Correct Answer: D
Rationale: Type 2's post-meal spike muscle's insulin signal jams, Glut-4 stalls, glucose piles up. Liver's Glut-2's fine, fat's minor, muscle's the big miss nurses peg this resistance core, a chronic uptake bust.
The nurse receives an order to infuse heparin 1200 units/hr IV. The IV bag contains 25,000 units heparin in 500 mL D5W. Calculate the IV rate in mL/hr.
- A. 20
- B. 24
- C. 28
- D. 30
Correct Answer: B
Rationale: Heparin's drip: 1200 units/hr from 25,000 units in 500 mL 500 ÷ 25,000 = 0.02 mL/unit, times 1200 = 24 mL/hr, a nurse's calc to thin blood right. Off numbers (20, 28, 30) skew dosing. Precision keeps clots at bay, a steady flow in this IV dance.
Within the theory of planned behaviour, what is the term used to indicate the idea that a particular behaviour will either succeed or not?
- A. Attitude
- B. Implementation-intention
- C. Intention
- D. Perceived behavioural control
Correct Answer: D
Rationale: Planned behaviour control belief sways success odds, not liking, plans, or will. Nurses tap this, a chronic confidence key.