Nokea
A nurse is caring for a client recently diagnosed with pericarditis. Which of the following is a common assessment finding with this disorder?
- A. Elevated troponin
- B. Pericardial friction rub
- C. Heart failure
- D. ST-segment depression
Correct Answer: B
Rationale: Pericarditis rubs the sac pericardial friction rub, a scratchy sound, marks inflammation, a common find as layers grate. Troponin rises with muscle damage, not here. Heart failure or ST depression hints tamponade or ischemia, not direct. Nurses auscultate this rub, tying it to pericarditis's irritated core, a diagnostic bellwether.
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Repaglinide belongs to the class
- A. Sulphonylureas
- B. Thiazolidinediones
- C. Benzoic acid derivatives
- D. Biguanides
Correct Answer: C
Rationale: Repaglinide's benzoic acid kin short, sharp insulin jolts, not sulphonylureas' long haul, thiazolidinediones' sensitivity boost, or biguanides' glucose clamp. It's a mealtime spike buster, a chronic tool pharmacists slot apart from sulphonylurea's sustained push, a nuanced diabetes dance.
Which does not cause genital ulceration?
- A. syphilis
- B. herpes simplex infection
- C. HIV
- D. lymphogranuloma venereum
Correct Answer: C
Rationale: HIV no direct ulcers; syphilis, herpes, LGV, chancroid carve sores. Nurses rule this chronic outlier.
A patient with a large stomach tumor attached to the liver is scheduled for a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure?
- A. Pain will be relieved by cutting sensory nerves in the stomach.
- B. Relief of pressure in the stomach will promote better nutrition.
- C. Decreasing the tumor size will improve the effects of other therapy.
- D. Tumor growth will be controlled by the removal of malignant tissue.
Correct Answer: C
Rationale: Debulking shrinks a stomach tumor stuck to the liver, boosting chemo and radiation's punch smaller targets respond better. Pain relief isn't the goal nerves aren't cut. Pressure relief might help eating, but it's secondary. Growth control fails it's not curative; tumor regrows. Nurses in oncology pitch this: it's a team play, enhancing other treatments' odds, vital for patients facing inoperable masses.
Which of the following management activities is not part of the nursing care of a patient with COPD?
- A. Achieving airway clearance and improving breathing patterns
- B. Ensuring the patient stays in bed and does not exert themselves causing increased dyspnoea
- C. Improving activity tolerance and assisting with lifestyle modification
- D. Monitoring and managing potential complications
Correct Answer: B
Rationale: COPD nursing pushes clearance, tolerance, and complication watch active goals. Bedrest flops deconditions, worsens breathlessness, a chronic care no-no nurses dodge.
A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.