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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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Mr Yee two months later. At your last visit he did not want colchicine prophylaxis as he did not want to take 'too many tablets'. He has started and is adherent to his urate lowering agent. Last month, his uric acid had decreased to 390 mmol/L. He had a gout flare last week, hence he came to your clinic today to ask about colchicine prophylaxis. Which is correct advice regarding colchicine prophylaxis?
- A. Offer to start colchicine at 500 mcg once daily or alternate days as gout prophylaxis as his renal function is abnormal
- B. Colchicine cannot help to reduce the frequency of flares especially during the first six months of Urate lowering therapy
- C. Tell him that if he is started on clarithromycin, he does not need to inform his doctor or pharmacist that he is on colchicine regularly as colchicine can have drug interactions
- D. Regular colchicine prophylaxis in someone with normal renal function and regular monitoring can lead to renal failure
Correct Answer: A
Rationale: With eGFR 55 mL/min and a recent flare despite uric acid dropping to 390 mmol/L, colchicine prophylaxis at 500 mcg daily or alternate days is appropriate, adjusting for reduced renal clearance to prevent toxicity. Flares are common early in ULT as urate mobilizes, and colchicine reduces this, contrary to the false claim it can't help. Clarithromycin interacts dangerously with colchicine (CYP3A4 inhibition), requiring disclosure. Colchicine doesn't cause renal failure with monitoring; toxicity does. This dose suits chronic gout management safely.
A patient who has ovarian cancer is crying and tells the nurse, 'My husband rarely visits. He just doesn't care.' The husband indicates to the nurse that he does not know what to say to his wife. Which nursing diagnosis is appropriate for the nurse to add to the plan of care?
- A. Compromised family coping related to disruption in lifestyle
- B. Impaired home maintenance related to perceived role changes
- C. Risk for caregiver role strain related to burdens of caregiving responsibilities
- D. Dysfunctional family processes related to effect of illness on family members
Correct Answer: D
Rationale: Ovarian cancer's toll her tears, his silence points to dysfunctional family processes; illness jams communication, not lifestyle , home upkeep , or caregiving load . He's lost, not burdened. Nurses in oncology peg this cancer's ripple screws up dynamics, needing talks to bridge the gap, not just task fixes.
Officially approved blood glucose meters used for self-testing and point-of-care diagnostics are not always suitable to measure the blood glucose values in neonates. Question: What is the main cause for this?
- A. Some meters are calibrated to plasma glucose and other meters to blood glucose
- B. Some measurement methods are sensitive to high levels of ascorbic acid (vitamin C)
- C. The measurement variation of some meters is too large
- D. Some meters are sensitive to abnormal haematocrit values
Correct Answer: D
Rationale: Neonate glucose flubs haematocrit swings throw meters off, not calibration, vitamin C, or variance. Nurses adjust for this, a chronic baby glitch.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Recognition and self-management of hypoglycaemia
- C. Sick day management
- D. Stopping all oral hypoglycaemic agents
Correct Answer: D
Rationale: Insulin education builds control technique, hypo spotting, sick days, and driving safety are musts, ensuring delivery, crisis handling, and road smarts. Stopping all oral agents isn't universal; many stay on metformin or SGLT-2s for synergy, not a blanket rule. Tailored plans keep or ditch orals, dodging this absolute. Clinicians teach what fits, not a one-size purge, a nuanced chronic care tweak over rigid cuts.
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.