Nokea
At what pressure goal can we optimally slow CKD progression in diabetic nephropathy?
- A. Less than 125/70 mmHg
- B. Less than 125/80 mmHg
- C. Less than 130/80 mmHg
- D. Less than 135/80 mmHg
Correct Answer: C
Rationale: Diabetic CKD <130/80 slows scarring best; tighter risks flow, looser misses. Nurses lock this chronic renal pace.
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You are caring for a patient with esophageal cancer. Which task could be delegated to the nursing assistant?
- A. Assist the patient with oral hygiene
- B. Observe the patient's response to feedings
- C. Facilitate expression of grief or anxiety
- D. Initiate daily weights
Correct Answer: A
Rationale: Delegating tasks in nursing hinges on scope of practice. Assisting with oral hygiene is a basic care activity nursing assistants are trained to perform, supporting hygiene needs in esophageal cancer patients who may struggle with swallowing. Observing responses to feedings requires clinical judgment to assess tolerance or complications, a nurse's responsibility. Facilitating emotional expression involves therapeutic communication skills beyond an assistant's training, critical for addressing cancer-related distress. Initiating daily weights implies deciding when to start, requiring understanding of fluid status assistants can weigh patients but not initiate the process independently. Oral hygiene delegation optimizes care efficiency, aligns with assistants' capabilities, and frees nurses for higher-level assessments, ensuring safe, effective management of this patient's complex needs.
A person is 178 cm high and weighs 89 kg. What is his BMI?
- A. 26
- B. 28
- C. 31
- D. 34
Correct Answer: B
Rationale: BMI's weight over height squared 89 kg ÷ (1.78 m × 1.78 m) ≈ 28. Height in meters, simple math, lands between 25 and 30, overweight, not obese. Nurses crunch this daily, a chronic weight watch pegging 28 spot-on.
The signs and symptoms of heart failure include:
- A. Polyphagia and polydipsia.
- B. Orthopnoea and gastrointestinal disruption.
- C. Urinary frequency and acute pulmonary oedema.
- D. Dyspnoea and peripheral oedema.
Correct Answer: D
Rationale: Heart failure (HF) manifests through circulatory and fluid overload effects. Polyphagia and polydipsia align with diabetes, not HF. Orthopnoea (breathlessness lying flat) is HF-specific, but gastrointestinal disruption (e.g., nausea) is secondary, less hallmark. Urinary frequency occurs nocturnally in HF (nocturia), but acute pulmonary edema is an acute crisis, not a chronic sign. Dyspnoea (shortness of breath) from pulmonary congestion and peripheral edema (swelling) from venous backup are classic, per Farrell (2017) reflecting left and right HF respectively. These stem from reduced cardiac output and fluid retention (e.g., elevated jugular venous pressure), driving clinical presentation. Dyspnoea limits activity, edema signals systemic impact, making them definitive over less specific or acute-only symptoms.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?
- A. Periodically apply ice to the area
- B. Keep the area cleanly shaven
- C. Apply petroleum jelly to the affected area
- D. Avoid using soap on the treatment area
Correct Answer: D
Rationale: Radiation erythema red, raw skin needs gentle care to dodge worsening. Soap dries and irritates, stripping fragile skin and upping infection risk, so skipping it's key. Ice or heat can burn or blister radiated tissue, already thin and sensitive. Shaving scrapes it raw; petroleum jelly traps moisture, breeding bacteria. Nurses teach this to protect the site, pushing mild cleansers (if needed) and air exposure, standard in oncology to heal radiation burns without sparking new problems.
A 66 year old man has recently been diagnosed with hypertension. He has no history of heart disease and diabetes mellitus. His average blood pressure is recorded as 154/82 mmHg. What is the MOST appropriate first line pharmacological therapy?
- A. Angiotensin converting enzyme-inhibitors
- B. Angiotensin receptor blockers
- C. Thiazide diuretics
- D. Calcium channel blockers
Correct Answer: C
Rationale: New hypertension at 66, 154/82 no heart or sugar issues thiazide diuretics kick off gentle, effective control, especially in older adults. ACE inhibitors or ARBs fit if kidneys or diabetes pop up; calcium blockers work but aren't first; beta blockers lag unless heart history. Nurses lean on thiazides cheap, proven for this chronic pressure nudge, keeping it simple and safe.