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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The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer?
- A. Teach the patient about the seven warning signs of cancer.
- B. Plan to monitor the patient's carcinoembryonic antigen (CEA) level.
- C. Teach the patient about annual chest x-rays for lung cancer screening.
- D. Discuss risks associated with cigarette smoking during each patient encounter.
Correct Answer: D
Rationale: Smoking's the lung cancer kingpin two packs a day screams risk. Hitting the patient with smoking's dangers every visit pushes primary prevention, aiming to cut exposure to tar and carcinogens fueling 85% of cases. Warning signs (CAUTION) and chest x-rays are secondary catching cancer, not stopping it. CEA's a tumor marker for tracking, not prevention. Nurses in oncology know preaching cessation at every chance leverages behavior change, the gold standard to slash lung cancer odds, trumping screening or monitoring in a heavy smoker like this.
Mr Xavier, a 60-year-old accountant, was recently started on allopurinol 100 mg two months ago. This was increased to 200 mg three weeks ago in your clinic. He informed you that he was diagnosed with UTI and started on ciprofloxacin. Today, he returns to your clinic with maculopapular rashes on his trunk and abdomen. He has a low-grade fever of 37.5°C. Which is the most appropriate next step?
- A. Stop Ciprofloxacin and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to Moxifloxacin 500 mg bd instead
- C. Continue medications and check for Dengue serology
- D. Stop Allopurinol
Correct Answer: D
Rationale: Rashes and fever post-allopurinol hike scream drug reaction stopping it nips hypersensitivity, like SJS risk, tied to uric acid meds over cipro's rarer skin hit. Quitting cipro alone misses the likely culprit; swapping antibiotics or dengue checks dodge the drug link; full stop's overkill. Clinicians halt allopurinol, watching this chronic fix's nasty turn, a swift call.
Diabetes is associated with pathophysiological mechanisms that contribute to the development of cardiovascular events. Question: What is the approximate percentage of diabetes patients who also have hypertension?
- A. 25%
- B. 50%
- C. 75%
- D. 100%
Correct Answer: C
Rationale: Diabetes and hypertension 75% overlap, sugar and pressure tag-team hearts. Nurses watch this, a chronic duo hit.
A nurse is caring for a client who recently underwent a heart transplant. Which of the following postoperative nursing interventions is the priority?
- A. Maintain strict bedrest
- B. Advance diet as tolerated
- C. Educate the client on medication
- D. Ensure strict adherence to aseptic techniques
Correct Answer: D
Rationale: Heart transplant's success hinges on dodging infection immunosuppression skyrockets risk, making aseptic technique the priority to shield the graft. Bedrest aids early recovery but isn't top. Diet advances slowly, education's vital long-term, but infection's immediate threat trumps. Nurses enforce sterility dressings, lines safeguarding this fragile post-op phase, a life-or-death focus in transplant care.