A 75-year-old female presented to the emergency department with shortness of breath. The client's daughter is at the bedside and shares that the client has a history of heart failure. The nurse places the client on the cardiac monitor and finds that the client is in atrial fibrillation at a rate of 180 beats per minute. Which is a likely finding?
- A. Bounding pulses
- B. Lethargy
- C. Hypotension
- D. Edema
Correct Answer: C
Rationale: Atrial fibrillation at 180 beats/minute in heart failure loses atrial kick, slashing output hypotension follows as rapid, erratic beats fail to fill ventricles, a likely finding with this tachycardic chaos. Bounding pulses need strong ejection, not here. Lethargy or edema might emerge, but BP drop's immediate, tied to poor perfusion. Nurses expect this, anticipating rate control or fluids, a critical catch in this acute decompensation.
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Which condition assessed by the nurse would be an early warning sign of childhood cancer?
- A. Difficulty swallowing
- B. Frequent cough or hoarseness
- C. Change in bowel and bladder habits
- D. Swellings, lumps or masses anywhere on the body
Correct Answer: D
Rationale: Childhood cancers often present with subtle, non-specific signs, but swellings, lumps, or masses anywhere on the body are a key early warning, indicating possible tumors like leukemia (lymphadenopathy), Wilms tumor, or sarcomas. Nurses must assess these palpable abnormalities, as they prompt urgent diagnostic workup imaging or biopsy to catch cancer early when treatment is most effective. Difficulty swallowing might suggest esophageal or brain tumors but isn't a common early childhood cancer sign. Frequent cough or hoarseness could indicate adult cancers (e.g., lung) or late-stage disease, not typical pediatric onset. Bowel and bladder changes are more adult-specific (e.g., colorectal cancer) or late effects in children. Lumps' prominence in pediatric guidelines underscores their priority, aligning with nursing's role in early detection to improve survival rates in young patients.
The movement patterns of 80 students who participated in a training programme have been measured. One of the measurement variables is the number of hours the student plays sports per week. This variable is measured both after and before the training programme. Subsequently, the average number of hours the student played sports before the training programme is compared with the number of hours the student plays sports after the training programme. Question: Which test is suitable to compare these two average values?
- A. Chi-square test
- B. Fisher's exact test
- C. Two-sample t-test
- D. Paired t-test
Correct Answer: D
Rationale: Same kids, before-after sports hours paired t-test ties each shift, not chi-square's counts, Fisher's tables, or two-sample splits. Nurses stat this, a chronic match check.
About the mineralocorticoid antagonists (MRAs) which of the following is correct?
- A. Patiromer is a new MRA
- B. Losartan is a MRA
- C. MRAs can cause hypokalemia
- D. Finerenone is a novel nonsteroidal MRA
Correct Answer: D
Rationale: MRAs finerenone's new, not patiromer, losartan; hyperkalemia, albumin cuts fit. Nurses tap this chronic kidney tweak.
On a population level, differences can be observed between the body composition of people with and people without a disturbed glucose tolerance. Question: Which of the following options describes the body composition of overweight people with a disturbed glucose tolerance compared to that of healthy people without overweight?
- A. More adipose tissue and similar muscle mass
- B. More adipose tissue and less muscle mass
- C. More adipose tissue and more muscle mass
- D. More adipose tissue and less muscle mass, including a change in the ratio of different types of muscle fibres
Correct Answer: B
Rationale: Glucose tolerance tanks overweight pile fat, lose muscle, not same or more, no fibre shift specifics. Nurses see this, a chronic lean loss.
A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patient's nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: Gastric cancer blocking oral and enteral routes needs TPN via a PICC delivering calories and protein centrally, bypassing the gut. Peripheral IV can't handle TPN's osmolarity veins fry. NG's out with tumor placement. NPO with just fluids starves her long-term. Nurses in oncology peg TPN as the lifeline, keeping strength up when cancer chokes other options.
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