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.
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The nurse is providing preoperative care for a 7-year-old patient with a brain tumor. Which of the following is the priority intervention?
- A. Assessing the child's level of consciousness
- B. Providing a tour of the intensive care unit for the child and parents
- C. Educating the child and parents about shunts
- D. Having the child talk to another child who has had this surgery
Correct Answer: A
Rationale: For a child with a brain tumor preoperatively, assessing level of consciousness (LOC) is the priority, as it monitors for increased intracranial pressure (ICP) from tumor mass effect vital signs like alertness or confusion shift rapidly and signal deterioration needing immediate action. No baseline data exists here, making LOC the first step in the nursing process to guide care. An ICU tour reduces anxiety but delays critical assessment. Shunt education applies post-diagnosis of hydrocephalus, not universally pre-op, and lacks urgency without LOC context. Peer support is psychosocial, not physiological, and secondary. LOC assessment aligns with ABCs (circulation includes cerebral perfusion), ensuring the nurse detects neurological decline early, a cornerstone of pediatric neuro-oncology care before surgery.
Patients with poorly controlled type 2 diabetes often have increased fasting triglyceride levels. Question: Which explanation for these increased fasting triglyceride levels is most likely?
- A. The triglyceride production of adipose tissue is not sufficiently inhibited by insulin
- B. Increased VLDL production leads to increased levels of free fatty acids
- C. The VLDL production by the liver is not sufficiently inhibited by insulin
- D. The LDL uptake by adipose tissue is not sufficiently stimulated by insulin
Correct Answer: C
Rationale: Type 2's triglyceride rise liver VLDL pumps unchecked, insulin flops, not fat tissue or LDL games. Nurses target this, a chronic liver lipid leak.
In infective endocarditis
- A. oslers nodes are tender
- B. Janeway lesions are tender
- C. Right ventricular MI is more likely to be acute than subacute
- D. A+C
Correct Answer: A
Rationale: Endocarditis Osler's nodes hurt, Janeway's don't, right heart's acute in IVDU. Nurses feel this chronic pain clue.
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.
Which of the following is not associated with non-alcoholic fatty liver disease?
- A. Diabetes mellitus
- B. Lung cancer
- C. Pre-diabetes mellitus
- D. Hyperuricemia
Correct Answer: B
Rationale: NAFLD diabetes, pre-sugar, uric, colon tie; lung cancer's out. Nurses link this chronic fat net.
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