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A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient?
- A. Remove food debris from the teeth and oral mucosa with a stiff toothbrush.
- B. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
- C. Gargle and rinse the mouth several times a day with an antiseptic mouthwash.
- D. Rinse the mouth before and after each meal and at bedtime with a saline solution.
Correct Answer: D
Rationale: Head and neck radiation trashes the mouth ulcers and ropey saliva need saline rinses to clean gently, easing pain without wrecking tissue. Stiff brushes shred mucosa; peroxide burns it; antiseptic washes sting and dry. Nurses in oncology teach this saline's soothing, safe, and fights infection risk in a radiated, vulnerable mouth.
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Patients with poorly controlled type 2 diabetes often have increased fasting triglyceride levels. Question: Which explanation for these increased fasting triglyceride levels is most likely?
- A. The triglyceride production of adipose tissue is not sufficiently inhibited by insulin
- B. Increased VLDL production leads to increased levels of free fatty acids
- C. The VLDL production by the liver is not sufficiently inhibited by insulin
- D. The LDL uptake by adipose tissue is not sufficiently stimulated by insulin
Correct Answer: C
Rationale: Type 2's triglyceride rise liver VLDL pumps unchecked, insulin flops, not fat tissue or LDL games. Nurses target this, a chronic liver lipid leak.
Which of the following factors has a major impact on the development of chronic illness?
- A. Poverty
- B. Social stability
- C. Urban dwelling
- D. High school diploma
Correct Answer: A
Rationale: Poverty slams chronic illness cash shortages spike stress, skimp care, and fuel risks like poor diet, a root driver nurses see in diabetes or heart woes. Stability's a buffer, urban life's neutral, education helps but lacks poverty's punch. Socioeconomic holes breed disease, a chronic trap clinicians fight.
A client is receiving interleukins along with chemotherapy. What assessment by the nurse takes priority?
- A. Blood pressure
- B. Lung assessment
- C. Oral mucous membranes
- D. Skin integrity
Correct Answer: A
Rationale: Interleukins, a type of biologic response modifier used with chemotherapy, can cause capillary leak syndrome, where fluid shifts from blood vessels into tissues, leading to hypotension and edema. This makes blood pressure the priority assessment, as a drop could indicate intravascular depletion, risking shock or organ failure if undetected. Lung assessment is relevant for potential pulmonary edema, but hypotension precedes respiratory distress in this context. Oral mucous membranes and skin integrity matter for chemotherapy's broader effects (e.g., mucositis, rashes), but these are less urgent than hemodynamic stability. Monitoring blood pressure first ensures early detection of a life-threatening complication, aligning with nursing's focus on airway, breathing, and circulation principles, critical in managing interleukin therapy's systemic impact.
In the year 2012, appropriate statements regarding complications of percutaneous cervical cordotomy in the UK include:
- A. Estimates of complication rates are based on pooled data in a national registry.
- B. Complications are similar to those after open surgical cordotomy.
- C. Rates of major complications such as death and paralysis are between 1 in 10000 and 1 in 1000.
- D. Persistent postural hypotension is uncommon.
Correct Answer: D
Rationale: In 2012, UK percutaneous cervical cordotomy (PCC) complication data were limited, not pooled nationally case series or institutional reports dominated. PCC's minimally invasive nature yields fewer complications (e.g., no wound infections) than open cordotomy's extensive approach. Major complications like death or paralysis are rare (<1%), below 1-in-1000 estimates, due to precise imaging and technique. Persistent postural hypotension is uncommon, linked to rare sympathetic disruption (e.g., Horner's syndrome), resolving typically. Headaches occur but aren't persistent. The low incidence of sustained hypotension reflects PCC's targeted spinothalamic focus, sparing autonomic pathways, making it a safer palliative option versus historical benchmarks.
A study by the Dutch Institute for Public Health and Environment (RIVM) called 'Nederland de maat genomen' [Measuring the Dutch], conducted in 2009-2010, shows that more than half of all Dutch people are overweight (BMI >25). Question: What are the results of this study when looking separately at men and women?
- A. 55% of the men and 55% of the women are overweight
- B. 60% of the men and 45% of the women are overweight
- C. 65% of the men and 50% of the women are overweight
- D. 70% of the men and 55% of the women are overweight
Correct Answer: B
Rationale: Over half the Dutch being overweight suggests a split men typically tip higher than women in Western stats. Sixty percent men, 45% women fits: men's bigger frames and habits stack BMI over 25 more, while women hover lower, averaging out above 50%. Even splits or higher jumps overshoot trends nurses see this gender gap in obesity clinics, a chronic load reflecting lifestyle and biology.