Nokea
An oncology patient has just returned from the postanesthesia care unit after an open hemicolectomy. This patient's plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome
- B. Assess the patient's fine motor skills once per shift
- C. Assess the patient's wound for dehiscence every 4 hours
- D. Maintain the patient's head of bed at 45 degrees or more at all times
Correct Answer: C
Rationale: Post-hemicolectomy, wound dehiscence splitting open is a killer risk, tied to infection or poor healing, needing checks every 4 hours. Compartment syndrome's a fracture thing, not gut surgery. Fine motor's irrelevant here neuro's not the issue. High head-of-bed helps breathing but isn't universal post-op. Nurses in oncology prioritize this, catching leaks or redness early, critical after cancer gut surgery.
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There are several different transmembranous glucose transporters (Gluts). Question: Which Gluts occur most frequently in the liver and which in the pancreas?
- A. Glut 1 in the liver and Glut 2 in the pancreas
- B. Glut 2 in the liver and Glut 2 in the pancreas
- C. Glut 2 in the liver and Glut 1 in the pancreas
- D. Glut 4 in the liver and Glut 2 in the pancreas
Correct Answer: B
Rationale: Liver slurps glucose with Glut 2, pancreas senses it the same both lean on this transporter's flow. Glut 1's elsewhere, Glut 4's muscle-fat turf nurses know this, a chronic glucose gate map.
The glycaemic profiles of people living with diabetes is affected by the following EXCEPT:
- A. Dietary intake
- B. Exercise
- C. Monitoring of blood glucose
- D. Stress
Correct Answer: C
Rationale: Glycemic profiles in diabetes are influenced by dietary intake (carbohydrate amount/type), exercise (glucose uptake), stress (cortisol-driven hyperglycemia), and medications (dose/effect). Monitoring blood glucose, however, doesn't affect the profile it measures it. While vital for management, the act of checking doesn't alter underlying glucose levels, unlike the others, which directly impact metabolism. This distinction is key for physicians educating patients on factors driving glycemic control, ensuring focus on actionable influencers rather than tools in chronic diabetes care.
A 30yr NZ man goes to PNG, takes 300 mg chloroquine weekly for 2 weeks prior and 4 weeks post his trip. 3/12 later gets febrile/sweats/maleana with malaria parasites on film. The following is true
- A. He took 1/2 the normal dose of chloroquine
- B. If he took primaquine for 2/52 this wouldn't have happened
- C. Assume chloroquine resistance and treat accordingly
- D. This is probably p. falciparum
Correct Answer: C
Rationale: PNG malaria chloroquine's 250 mg norm, resistance rife, not dose, primaquine, or falciparum lock. Nurses switch this chronic resistant fix.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary modifications are generally not sustainable and hence dietary approaches are not as important as pharmacological approaches
- B. There is no Randomised Controlled Trial (RCT) level of evidence regarding decreasing sugar sweetened beverages
- C. Dietary approaches can be broadly categorised into energy-focused, macronutrient-focused, dietary pattern-focused, and dietary timing-focused
- D. Long-term diet trials have shown intermittent fasting to be superior to continuous energy restriction with respect to average weight loss
Correct Answer: C
Rationale: Diet's obesity fight splits smart energy, macros, patterns, and timing frame approaches, a true lens on options like low-carb or fasting. Sustainability varies, RCTs back sugar cuts, fasting ties (not tops) restriction, and proteins sate more than carbs. Clinicians wield this quartet, tailoring chronic plans, a broad truth in food's fat battle.