Nokea
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.
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Damage control resuscitation:
- A. Is not indicated unless it is clear the patient's physiology has been deranged by severe injury.
- B. Is not indicated unless the patient is in the hospital.
- C. Is likely to involve restriction of fluid administration in a hypotensive, bleeding patient.
- D. Is likely is be assessed for adequacy by palpation of the radial pulse in patients with a head injury.
Correct Answer: C
Rationale: Damage control resuscitation (DCR) mitigates trauma's lethal triad (hypothermia, acidosis, coagulopathy). It's indicated preemptively in severe bleeding, not just post-derangement, to prevent physiologic collapse. It begins pre-hospital (e.g., paramedics), not only in-hospital, using blood products early. Fluid restriction in hypotensive bleeding limits dilutional coagulopathy, favoring permissive hypotension until haemostasis crucial in uncontrolled haemorrhage. Radial pulse palpation gauges perfusion broadly, but head injury patients need cerebral perfusion pressure prioritization, not DCR adequacy. ABC remains foundational. Fluid restriction's role balancing shock correction with bleeding exacerbation defines DCR's shift from crystalloid overload, improving survival in exsanguinating trauma.
Assessment of NAFLD at primary care clinic includes for followings except:
- A. Fibroscan
- B. Fasting glucose
- C. Liver biopsy
- D. Liver function test
Correct Answer: C
Rationale: NAFLD's primary peek Fibroscan, glucose, lipids, and LFTs flags fat and fallout, all doable outpatient. Liver biopsy, gold but invasive, stays secondary, not routine. Clinicians lean on non-pokey tools, screening chronic liver load smart, a practical dodge of the knife.
The Lee Revised Cardiac Risk Index:
- A. Has been validated to predict the risk of mortality after major non-cardiac surgery.
- B. Is a complex algorithm.
- C. Provides a simple additive score incorporating six risk factors.
- D. Discriminates well between patients at moderate and severe risk of adverse cardiac outcome.
Correct Answer: C
Rationale: The Lee Revised Cardiac Risk Index (RCRI) predicts cardiac complications (e.g., myocardial infarction) after non-cardiac surgery. It's validated for morbidity, not mortality specifically, though it correlates with outcomes. It's not a complex algorithm but a straightforward tool: six factors (high-risk surgery, ischemic heart disease, heart failure, stroke/TIA, diabetes on insulin, renal insufficiency) are scored additively (0-6). This simplicity aids clinical use, providing risk percentages (e.g., 0.4% for 0 points, 11% for ≥3). It discriminates moderate-to-high risk well but less so at extremes. Age >70 isn't an automatic point; risk factors are specific. Its strength lies in its evidence-based, user-friendly design for perioperative cardiac risk stratification.
The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
- A. Monthly self-breast exams
- B. Smoking cessation
- C. Annual colonoscopies
- D. Monthly testicular exams
Correct Answer: B
Rationale: Lung cancer tops the list of cancer deaths in North America for both men and women, as noted in the feedback, with over 570,000 deaths projected in 2011 alone. Smoking is the primary risk factor for lung cancer, making cessation the most direct intervention to tackle this killer. Self-breast and testicular exams target breast and testicular cancers, respectively, which rank lower in mortality (breast is second for women, prostate second for men). Colonoscopies address colorectal cancer, third in frequency, but lung cancer's dominance ties directly to smoking's prevalence. By pushing cessation, nurses hit the root cause head-on, reducing exposure to carcinogens like tar and nicotine that drive malignant transformation in lung tissue. This aligns with primary prevention, cutting incidence before it starts, unlike screening which catches disease later.
According to Johnson and Chang (2014), compared to the non-indigenous population, the Australian indigenous population is more likely to:
- A. Live in the bush, eat native food and have increased exposure to the elements
- B. Have a higher incidence of chronic disease, be less healthy, die at a much younger age, and have lower quality of life
- C. Access health care and implement appropriate lifestyle changes equitably
- D. Experience death at a rate of twice that of the non-indigenous population
Correct Answer: B
Rationale: Indigenous Australians face a heavier chronic disease load diabetes, heart issues dying younger, with life expectancy gaps of 10+ years, and poorer quality of life from systemic inequities. Bush living's a stereotype, not a health driver; equitable care's a myth access lags; death rate's high but not precisely double. Nurses see this burden, tackling social determinants, a stark chronic care reality rooted in data, not just location or access claims.