Nokea
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching?
- A. The patient ambulates around the room.
- B. The patient's visitors bring in fresh peaches.
- C. The patient cleans with a warm washcloth after having a stool.
- D. The patient uses soap and shampoo to shower every other day.
Correct Answer: B
Rationale: Neutropenia post-chemo drops immunity fresh peaches with thin skins harbor bacteria, a no-no on neutropenic diets. Walking , cleaning post-stool , and mild showers are fine safe self-care. Nurses in oncology reteach this raw fruits are infection traps, a critical miss for this fragile patient.
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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 rehabilitation (PR) is a cornerstone COPD intervention, emphasizing functional improvement over mere compliance. Ensuring diet, medication, and daily exercise is supportive but not PR's primary aim it's too prescriptive. Involving patients in teams and self-management is valuable, but PR's core is outcome-driven: reducing dyspnea, enhancing quality of life (QOL), and boosting physical/emotional engagement in daily activities via exercise, education, and psychosocial support. Preventing deterioration and hospitalization are benefits, not goals PR doesn't directly support carers. Evidence (e.g., GOLD guidelines) highlights PR's efficacy in symptom relief (e.g., breathlessness), QOL gains (e.g., St. George's Respiratory Questionnaire), and participation (e.g., 6-minute walk test), per multidisciplinary programs outlined in chronic care texts, making it a holistic, patient-centered strategy beyond disease containment.
The BMI that does NOT INCREASE the risk of renal disease and CKD is X. What is X?
- A. 25 or more
- B. 30 or more
- C. 35 or more
- D. 40 or more
Correct Answer: A
Rationale: Body Mass Index (BMI) correlates with chronic kidney disease (CKD) risk, with higher values linked to increased incidence due to obesity-related glomerular hypertension and inflammation. A BMI of 25 or more defines overweight and obesity, elevating CKD risk, though 18.5-24.9 is the range typically not increasing risk. The question's phrasing implies the threshold where risk begins, making 25 or more the level where renal disease risk rises, per studies like the Framingham Heart Study. Higher BMIs (30+, 35+, 40+) progressively worsen risk, with 30 marking obesity. Thus, 25 or more is the correct cutoff, guiding family physicians in counseling patients on weight management to prevent CKD onset.
A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate?
- A. Don't you have any friends that will raise the children for you?'
- B. Would you like to talk about options for the care of your children?'
- C. For now you need to concentrate on getting well and not worrying about your children.'
- D. Many patients with cancer live for a long time, so there is time to plan for your children.'
Correct Answer: B
Rationale: Metastatic ovarian cancer's end-stage she's scared for her kids. Asking about options opens a lifeline, validating her fear without shutting it down. Friends assumes too much; get well' dodges reality; long time' sugarcoats. Nurses in oncology lean in here listening, planning ease her burden, a human touch amid grim odds.
In order to reduce cardiovascular, renal and all-cause mortality, the American Heart Association (AHA) and the American College of Cardiology (ACC) has set the definition of hypertension as a BP of X in 2017. What is X?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/80 mmHg
- D. 135/85 mmHg
Correct Answer: C
Rationale: Hypertension's threshold shifted in 2017 when the AHA and ACC pegged it at 130/80 mmHg, aiming to catch cardiovascular and renal risks earlier, slashing mortality via tighter control. Lower cutoffs like 120/70 or 125/75 flag normal or elevated, not yet disease. Higher ones 135/85 or 140/90 stick to older, laxer standards, missing early intervention's benefit. This pivot reflects evidence tying 130/80 to doubled event risk versus <120, pushing clinicians to act sooner with lifestyle or meds, a proactive stance in chronic disease's long game.
Rehabilitation utilises two types of rehabilitation interventions. The goal of the intervention support is to
- A. Maintaining existing abilities
- B. Restoring function
- C. Preventing deterioration and further disability
- D. Maintaining existing abilities while preventing new or further disabilities
Correct Answer: D
Rationale: Rehab's dual play hold steady, fend off worse blends maintenance and prevention, a chronic balance. Nurses aim here, a full guard.