Nokea
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient's subsequent plan of care?
- A. Limit the time that visitors spend at the patient's bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patient's care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: HDR implants (brachytherapy) emit radiation limiting visitor time (e.g., 30 min) cuts exposure risk. Self-care's nice but not safety-driven. Gender's irrelevant pregnant staff avoid, not males. Shared rooms up exposure, not safety. Nurses in oncology enforce this, shielding others while the source's active, a radiation rule of thumb.
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The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
Which of the following is the priority nursing intervention for a client experiencing a transfusion reaction?
- A. Stop transfusion immediately
- B. Check vital signs
- C. Notify the provider
- D. Flush the intravenous line
Correct Answer: A
Rationale: Transfusion reactions hemolytic or allergic kill fast; stopping the infusion halts antigen flood, the priority per ABCs to save life. Vitals, notifying, or flushing follow stopping's first. Nurses act swift, cutting the culprit, a non-negotiable step in this blood-borne crisis, trumping all else.
The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Engage the patient in shared decision making
- B. Threaten the patient into adherence with insulin therapy
- C. Provide close supervision and follow-up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLPIRA
Correct Answer: B
Rationale: Insulin's hurdles yield to shared decisions, close watch, weight tricks, and goal setting empowering, not bullying. Threats tank trust and adherence, backfiring in chronic care where buy-in's king. Support beats scare tactics, aligning with diabetes' need for partnership, a strategy flop amid solid aids.
Appropriate statements regarding markers of outcome after major surgery in England in 2014 include:
- A. Data about each hospital's complication rates after surgery are readily available.
- B. Data about each hospital's 30-day mortality after surgery are readily available.
- C. For most procedures, 90-day mortality rate are similar to 30-day mortality rates.
- D. National Hospital Episode Statistics (HES) data are useful for monitoring the performance of units.
Correct Answer: B
Rationale: In 2014 England, surgical outcome transparency increased. Complication rates weren't universally published per hospital, varying by procedure and trust. However, 30-day mortality data were widely available, notably via NHS initiatives and specialty audits (e.g., National Joint Registry), reflecting short-term success. Ninety-day mortality often exceeds 30-day rates (e.g., in vascular surgery), capturing delayed deaths, so they're not typically similar. HES data, capturing inpatient episodes, help monitor trends and performance, though coding accuracy limits granularity. Weekend admission mortality was higher, per studies like 2015 BMJ, due to staffing and care differences. The availability of 30-day mortality data was a key quality metric, driving accountability and improvement in surgical care.
The blood glucose level rises after meals. This glucose is stored in various organs under the influence of insulin. Question: During the postprandial period, most glucose is stored in which tissue?
- A. Intestinal tissue
- B. Liver tissue
- C. Muscle tissue
- D. Fat tissue
Correct Answer: C
Rationale: Post-meal glucose floods muscle insulin shoves it there, 60% of the haul, a chronic storehouse. Liver grabs next, fat lags, intestines pass nurses track this, a bulk uptake king.