Nokea
A client with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate?
- A. Have the patient eat large meals when nausea is not present
- B. Offer dry crackers and carbonated fluids during chemotherapy
- C. Administer prescribed antiemetics 1 hour before the treatments
- D. Give the patient two ounces of a citrus fruit beverage during treatments
Correct Answer: C
Rationale: Chemo's gut punch severe vomiting bows to preemptive antiemetics, given 1 hour before, blunting nausea's peak, the most effective move per oncology standards. Big meals overload; crackers help post-, not during; citrus risks acid reflux. Nurses time antiemetics, syncing with chemo's onslaught, a proactive strike to ease this metastatic misery, trumping reactive nibbles or sips.
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What is essential in an ecological approach to health behaviour?
- A. People should be approached in their natural environment
- B. People learn behaviour in a layered environment
- C. People aim to find a balance between risk and health
- D. If it is beneficial to one's health, it is also sustainable
Correct Answer: B
Rationale: Ecological health layered worlds shape acts, not just spots, balance, or green wins. Nurses weave this, a chronic context web.
Madam Tan is newly diagnosed to have Type 2 DM. Her fasting plasma glucose is 12 mmol/L. Her blood pressure and fasting lipid profile are normal. She has been provided with patient education and advice on therapeutic life-style modification. Which is the most appropriate course of management for this lady?
- A. Commence her on combination therapy of three oral hypoglycaemic agents
- B. Motivate her to adhere with life-style modification
- C. Commence her on monotherapy of oral hypoglycaemic agent
- D. Commence her on combination therapy of two oral hypoglycaemic agents
Correct Answer: C
Rationale: New type 2, fasting 12 lifestyle's fresh, so metformin monotherapy starts, easing glucose without overload. Triple or dual oral's too much; insulin's for later; pushing lifestyle alone won't cut it yet. Nurses build this chronic base, balancing effort and meds.
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.
What is the cut-off of blood pressure for the diagnosis of hypertension that is recommended by MOH Clinical Practice Guideline?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/70 mmHg
- D. 140/90 mmHg
Correct Answer: D
Rationale: MOH guidelines hold hypertension at 140/90 mmHg, a conventional cutoff balancing sensitivity and specificity for diagnosis in primary care, aligning with global norms like WHO. Lower thresholds 120/70, 125/75, 130/70, 135/80 catch prehypertension or align with newer AHA standards, but MOH sticks to 140/90 for actionable clarity, triggering treatment to curb stroke or heart risks. This higher bar avoids overdiagnosis in resource-stretched settings, ensuring focus on clear disease, a practical call for managing chronic vascular load.
The side effects of radiotherapy used in the treatment of cancer do not include which of the following:
- A. Stomatitis
- B. Fatigue
- C. Alopecia
- D. Anorexia
Correct Answer: C
Rationale: Radiotherapy zaps mouth sores, tired, appetite drop, but hair's chemo's game, not rays' unless scalp-targeted. Nurses split this, a chronic beam truth.