Nokea
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.
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Which of the following statements regarding weight regulation is TRUE?
- A. Weight regain after weight loss is physiological and not necessarily due to a failure of conscious efforts (to lose weight)
- B. The reward system of weight regulation is homeostatic in nature
- C. Liking' and wanting' of food are mainly conscious processes
- D. In human studies, functional MRI (fMRI) studies have shown deficiency in reward-encoding brain regions and/or over activation in cortical inhibitory networks in obese people
Correct Answer: A
Rationale: Weight bounces back biology, not just willpower; rewards aren't homeostatic, liking's subconscious, fMRI flips, hypothalamus rules. Nurses get this chronic rebound truth.
The nurse is assessing a client with severe anemia. Which clinical manifestation does the nurse expect to see in this client?
- A. Bradycardia
- B. Pale, cool skin
- C. Hypertension
- D. Warm, flushed skin
Correct Answer: B
Rationale: Severe anemia starves oxygen pale, cool skin reflects shunted flow and low hemoglobin, a classic find as body compensates. Bradycardia's rare; tachycardia revs to pump more. Hypertension doesn't fit BP may drop. Warm, flushed skin suits overload, not anemia. Nurses expect pallor, tying it to blood's oxygen flop, a sign guiding transfusion or iron.
In the UK, appropriate statements concerning the trauma network include:
- A. Major trauma centres, but not minor trauma units, need facilities to deal with polytrauma patients.
- B. Hospitals dealing with trauma are expected to contribute data to the Trauma Audit Research Network (TARN) database.
- C. Within their network, trauma units have transfer arrangements for moving seriously injured patients to major trauma centres.
- D. Trauma networks have an ambulance protocol for bypassing the nearest unit for injuries that may be best treated at a distant specialist centre.
Correct Answer: B
Rationale: The UK trauma network, established pre-2014, enhances care coordination. Major trauma centres (MTCs) handle polytrauma; trauma units manage less severe cases, though both need capabilities severity dictates MTC referral. TARN collects data from all trauma-receiving hospitals, tracking outcomes (e.g., mortality) to improve standards, a core network feature. Transfer protocols ensure escalation from trauma units to MTCs for complex injuries. Ambulance bypass protocols prioritize specialist MTCs (e.g., neurosurgery) over proximity, per triage tools. Rehabilitation is included in network responsibilities. TARN's mandatory data submission drives quality, transparency, and research, distinguishing the system's evidence-based evolution.
An HIV-positive patient presents to the ED complaining of shortness of breath and non-productive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85% on room air. All of the following statements regarding this patient's probable diagnosis are TRUE, EXCEPT
- A. Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients
- B. Pentamidine isothionate is an effective alternate therapy to TMP-SMX
- C. A normal chest x-ray rules out acute PCP infection
- D. 65% of patients relapse within 18 months
Correct Answer: H
Rationale: PCP top AIDS bug, pentamidine swaps TMP-SMX, relapse hits, steroids for hypoxia; normal CXR misses 20%. Nurses nix this chronic x-ray lie.
A 30yr NZ man goes to PNG, takes 300 mg chloroquine weekly for 2 weeks prior and 4 weeks post his trip. 3/12 later gets febrile/sweats/maleana with malaria parasites on film. The following is true
- A. He took 1/2 the normal dose of chloroquine
- B. If he took primaquine for 2/52 this wouldn't have happened
- C. Assume chloroquine resistance and treat accordingly
- D. This is probably p. falciparum
Correct Answer: C
Rationale: PNG malaria chloroquine's 250 mg norm, resistance rife, not dose, primaquine, or falciparum lock. Nurses switch this chronic resistant fix.