Nokea
All of the following are broad categories of dietary approaches EXCEPT:
- A. Energy-focused
- B. Macronutrient-focused
- C. Reward-focused
- D. Dietary timing-focused
Correct Answer: C
Rationale: Diets calories, macros, patterns, timing rule; reward's brain, not plate. Nurses map this chronic food frame, skipping psyche.
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With regards to adverse effects of first-line antihypertensive medications, angioedema has been associated with which ONE of the following classes of antihypertensives?
- A. Angiotensin receptor blockers
- B. Angiotensin-converting enzyme inhibitors
- C. Calcium channel blockers (dihydropyridine)
- D. Thiazide diuretics
Correct Answer: B
Rationale: Angioedema, a potentially life-threatening swelling of deep skin layers or mucous membranes, is a well-documented adverse effect of angiotensin-converting enzyme (ACE) inhibitors, occurring in about 0.1-0.7% of patients due to bradykinin accumulation from enzyme inhibition. This distinguishes ACE inhibitors from other first-line antihypertensives. Angiotensin receptor blockers (ARBs) rarely cause angioedema, as they don't affect bradykinin levels. Calcium channel blockers (e.g., dihydropyridines like amlodipine) may cause peripheral edema but not angioedema. Thiazide diuretics are linked to electrolyte imbalances or rashes, not angioedema. Family physicians must recognize this ACE inhibitor risk, ensuring prompt discontinuation and airway management if it occurs, critical for safe chronic disease management.
Assessment of a wound does not include which of the following?
- A. Location
- B. Size
- C. Blood Pressure
- D. Colour of wound
Correct Answer: C
Rationale: Wound checks where, how big, what hue guide care. BP's body-wide, not wound-specific. Nurses skip it, a chronic sore's focus.
A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?
- A. Are you getting adequate rest and sleep each day?
- B. It is normal to be fatigued even for years afterward.
- C. This is not normal and I'll let the provider know.
- D. Try adding more vitamins B and C to your diet.
Correct Answer: B
Rationale: Radiation therapy, commonly used for breast cancer, can cause persistent fatigue as a side effect due to cellular damage and the body's prolonged healing process. This fatigue can last for months or even years post-treatment, varying by individual factors like radiation dose and overall health. Telling the client it's normal validates her experience, reduces anxiety, and helps her family understand this as a common outcome rather than a personal failing. Asking about rest is useful but doesn't address the family's frustration or provide context. Declaring it abnormal and escalating to the provider is inaccurate unless other symptoms suggest a new issue, potentially causing unnecessary worry. Suggesting vitamins lacks evidence for resolving radiation-induced fatigue and shifts focus from education. The nurse's role here is to reassure and educate, making the normalization of long-term fatigue the most appropriate response, fostering coping and support within the family.
In the year 2012, appropriate statements regarding complications of percutaneous cervical cordotomy in the UK include:
- A. Estimates of complication rates are based on pooled data in a national registry.
- B. Complications are similar to those after open surgical cordotomy.
- C. Rates of major complications such as death and paralysis are between 1 in 10000 and 1 in 1000.
- D. Persistent postural hypotension is uncommon.
Correct Answer: D
Rationale: In 2012, UK percutaneous cervical cordotomy (PCC) complication data were limited, not pooled nationally case series or institutional reports dominated. PCC's minimally invasive nature yields fewer complications (e.g., no wound infections) than open cordotomy's extensive approach. Major complications like death or paralysis are rare (<1%), below 1-in-1000 estimates, due to precise imaging and technique. Persistent postural hypotension is uncommon, linked to rare sympathetic disruption (e.g., Horner's syndrome), resolving typically. Headaches occur but aren't persistent. The low incidence of sustained hypotension reflects PCC's targeted spinothalamic focus, sparing autonomic pathways, making it a safer palliative option versus historical benchmarks.
The signs and symptoms of heart failure do not include:
- A. Dyspnoea
- B. Orthopnoea
- C. Urinary frequency
- D. Fatigue
Correct Answer: C
Rationale: Heart failure floods breathless, flat-lie gasps, swelling, wiped out. Peeing often? Kidneys, not heart others scream pump fail. Nurses clock these, a chronic wet mess minus bladder.