Nokea
According to Johnson and Chang (2014) the role of the nurse and other health professions in chronic disease is to:
- A. Support the person in managing their condition more effectively
- B. Provide care to manage the disease process
- C. Ensure the patient takes their medications and avoids all risk factors
- D. Decide as a team on the best approach to manage the condition and direct the implementation of this care
Correct Answer: A
Rationale: Nurses in chronic care empower supporting self-management beats just treating, enforcing meds, or dictating plans. It's about patients steering their diabetes or asthma, with pros as guides, not bosses. Care's given, compliance nudged, teams plan, but support's the heart, a chronic win where autonomy rules.
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A client is receiving treatment for the diagnosis of hemophilia A. Which of the following is the most appropriate to include in the assessment of this client?
- A. Cranial nerves
- B. Appetite
- C. Joint pain and bruising
- D. Urine output
Correct Answer: C
Rationale: Hemophilia A, a factor VIII deficiency, impairs clotting joint pain and bruising from hemarthrosis and bleeds are hallmark signs, demanding assessment to gauge bleeding severity and guide factor replacement. Cranial nerves check neurologic status, irrelevant unless bleeds hit the brain. Appetite or urine output offers general insight, not hemophilia-specific. Nurses zero in on joints and skin, tracking this genetic disorder's impact, critical for managing acute episodes and preventing long-term damage in this bleeding-prone client.
In the ACC/AHA 2017 Guideline for Hypertension, what is the cut off for hypertension diagnosis?
- A. 120/70 mmHg
- B. 130/80 mmHg
- C. 135/85 mmHg
- D. 140/90 mmHg
Correct Answer: B
Rationale: ACC/AHA 2017 130/80 tags hypertension, not old 140/90 or looser. Nurses gauge this chronic pressure shift.
You are seeing 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 INCORRECT 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 normal
- B. Colchicine can 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 NEW medications, he should inform his doctor or pharmacist that he is on colchicine regularly as colchicine can have drug interactions. If unsure and he needs to take NEW medications, such as a short course of antibiotics, he is to omit colchicine until the new medication is completed
- D. Regular colchicine prophylaxis in someone with normal renal function and regular monitoring can lead to renal failure
Correct Answer: D
Rationale: Colchicine curbs flares 500 mcg fits normal kidneys, cuts attacks in urate-lowering's rocky start, and needs drug interaction flags or skips with gut upset. But renal failure from regular use with monitoring? False colchicine's safe there, not a kidney killer. Clinicians nix this myth, grounding chronic gout aid in truth.
A 50 year old Chinese man is suspected to have metabolic syndrome. According to the International Diabetes Federation (IDF) 2006 definition, which ONE of the following diagnostic criteria is mandatory to make a diagnosis in this gentleman?
- A. Triglycerides of 1.7 mmol/L
- B. Waist circumference of 90 cm
- C. HDL-cholesterol of <1.03 mmol/L
- D. Blood pressure of 130/85 mmHg
Correct Answer: B
Rationale: IDF 2006 metabolic syndrome hinges on waist 90 cm for Asian men, mandatory, then two more like lipids, BP, or glucose. Others count, but girth's the chronic core nurses measure first.
A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate?
- A. Have the patient eat large meals when nausea is not present.
- B. Offer dry crackers and carbonated fluids during chemotherapy.
- C. Administer prescribed antiemetics 1 hour before the treatments.
- D. Give the patient a glass of a citrus fruit beverage during treatments.
Correct Answer: C
Rationale: Chemo vomiting's a beast pre-dosing antiemetics (e.g., ondansetron) an hour before blocks the gut-brain puke loop, the gold standard. Big meals overload; crackers and soda or citrus during treatment spark nausea acidity and fizz don't help. Nurses in oncology time this right prevention trumps mopping up, keeping patients steady.