Nokea
After percutaneous cervical cordotomy:
- A. Ptosis and miosis occur on same side as the thermal lesion.
- B. Temporary reduced power in the arm or leg occur on the same side as the thermal lesion.
- C. Patients are likely to stay in hospital until retitration of opioid medication is complete.
- D. Immediately after successful cervical cordotomy, the pretreatment dose of opioid is likely to be reduced by 10%.
Correct Answer: A
Rationale: Post-percutaneous cervical cordotomy (PCC), outcomes relate to its C1-C2 approach. Ptosis and miosis (Horner's syndrome) occur ipsilateral to the lesion from sympathetic chain disruption common but often transient. Weakness, if any, affects the contralateral side due to corticospinal tract proximity, not ipsilateral, and is rare with modern precision. Hospital stay varies; opioid retitration may occur outpatient unless complications arise. Successful PCC reduces opioid needs by >50% often, not just 10%, due to effective pain relief. Neuropathic pain can emerge from tract damage. Horner's syndrome's ipsilateral presentation is a hallmark, reflecting local anatomy and PCC's occasional sympathetic impact, typically self-limiting.
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Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors were shown to reduce albuminuria and proteinuria by X%. What is X?
- A. 10--30
- B. 20-40
- C. 30-50
- D. 40-60
Correct Answer: C
Rationale: SGLT-2 inhibitors, used in type 2 diabetes, reduce albuminuria and proteinuria by 30-50%, as evidenced in trials like CREDENCE and DAPA-CKD. They lower glomerular hyperfiltration by inhibiting glucose and sodium reabsorption in the proximal tubule, decreasing intraglomerular pressure and thus protecting kidney function. This 30-50% reduction is significant in slowing chronic kidney disease (CKD) progression, a key benefit beyond glycemic control. Lower ranges (10-30%, 20-40%) underestimate this effect, while higher ranges (40-60%) may apply to specific subgroups but aren't the average. This renal protection makes SGLT-2 inhibitors a cornerstone in managing diabetic nephropathy, vital knowledge for physicians optimizing chronic disease outcomes.
Which of the following medication is recommended for all patients with NAFLD in improving liver histology?
- A. Statins
- B. Aspirins
- C. Ursodeoxycholic acid
- D. None of the above
Correct Answer: D
Rationale: NAFLD no med fits all; statins, aspirin, ursodiol, E lack universal proof. Nurses skip this chronic blanket pill.
People with metabolic syndrome have an increased risk of which of the following disorders, besides type 2 diabetes mellitus?
- A. Hypertension, infections
- B. Myocardial infarction, hypertension
- C. Myocardial infarction, infections
- D. Myocardial infarction, liver cirrhosis
Correct Answer: B
Rationale: Metabolic syndrome hikes heart attacks, hypertension vascular hits, not infections or cirrhosis extras. Nurses track this, a chronic CV duo.
In assigning patients with alterations related to gastrointestinal (GI) cancer, which would be the most appropriate nursing care tasks to assign to the LPN/LVN, under supervision of the team leader RN?
- A. A patient with severe anemia secondary to GI bleeding
- B. A patient who needs enemas and antibiotics to control GI bacteria
- C. A patient who needs pre-op teaching for bowel resection surgery
- D. A patient who needs central line insertion for chemotherapy
Correct Answer: B
Rationale: LPN/LVNs operate under RN supervision, handling tasks within their scope like administering enemas and antibiotics to control GI bacteria in a cancer patient, a straightforward, protocol-driven intervention to reduce infection risk before procedures. Severe anemia from GI bleeding demands RN assessment for transfusion or instability, beyond LPN scope. Pre-op teaching for bowel resection requires detailed education and evaluation, an RN duty to ensure comprehension. Central line insertion for chemotherapy involves advanced skills and risk management, reserved for RNs or specialized staff. Enemas and antibiotics fit LPN/LVN training, optimizing team efficiency while keeping complex care with RNs, aligning with safe delegation principles in GI cancer management.
Which of the following interventions should be included in the nutrition care plan of the client with atherosclerosis?
- A. Limit sodium intake to 6 g per day
- B. Increase full-fat dairy products
- C. Increase saturated fats
- D. Increase daily intake of vegetables, fruits, and whole grains
Correct Answer: D
Rationale: Atherosclerosis plaque-laden arteries thrives on poor diet. Boosting vegetables, fruits, and whole grains slashes cholesterol and inflammation, slowing plaque via fiber and antioxidants, a cornerstone of cardiac nutrition. Sodium limits help hypertension, but 6 g exceeds heart-healthy goals (2.3 g). Full-fat dairy and saturated fats fuel plaque, worsening disease. Nurses push plant-based eating, aligning with evidence to reverse atherosclerosis's march, a proactive step over mere restriction in this vascular battle.