Nokea
Caution should be exercised in the initiation of an ARNI in all of the following clinical scenarios except:
- A. Significant hyperkalaemia
- B. Significant renal dysfunction (eGFR <30 ml/min)
- C. Patient on a maximal dose ACE-inhibitor
- D. Non-alcoholic fatty liver disease (NAFLD)
Correct Answer: D
Rationale: ARNI (sacubitril/valsartan) risks spike with hyperkalemia, renal flop (eGFR <30), ACE-I overlap, or low BP potassium, filtration, washout, and perfusion all teeter. NAFLD? No biggie liver fat doesn't sway ARNI's game. Clinicians greenlight this, dodging chronic cautions elsewhere.
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For a patient who is receiving chemotherapy, which laboratory result is of particular importance?
- A. WBC
- B. PT and PTT
- C. Electrolytes
- D. BUN
Correct Answer: A
Rationale: Chemotherapy suppresses bone marrow, slashing white blood cell counts especially neutrophils heightening infection risk, making WBC monitoring paramount. Low counts trigger protective measures or treatment holds, directly tied to therapy's myelosuppressive core. PT and PTT track clotting, relevant for bleeding but less immediate. Electrolytes matter for overall status, but imbalances aren't chemotherapy's primary threat. BUN reflects kidney function, indirectly affected by some drugs, not the frontline concern. WBC's critical drop demands swift action fevers in neutropenia are emergencies underscoring its priority in safeguarding patients through treatment's immune-compromising phases.
Question: Which statement applies to glucose measurement in a central laboratory? Statement 1: Glucose values are normally determined in venous blood. Statement 2: Glucose values are given in plasma values. Which answer is correct?
- A. Both statements are correct
- B. Both statements are incorrect
- C. Statement 1 is correct; statement 2 is incorrect
- D. Statement 1 is incorrect; statement 2 is correct
Correct Answer: A
Rationale: Lab glucose venous blood, plasma read, both true, a chronic standard nurses trust.
What is the result of bariatric surgery as a therapy for morbid obesity?
- A. Reduced insulin sensitivity
- B. Increased insulin sensitivity
- C. Reduced lipolysis
- D. Increased lipolysis
Correct Answer: B
Rationale: Bariatric fix insulin sensitivity jumps, fat shrinks, glucose flows, not lipolysis shifts. Nurses cheer this, a chronic reset win.
A parent of a child with Wilms tumor asks the nurse about surgery. Which statement concerning the type of surgery for Wilms tumor is most accurate?
- A. Surgery is only done if chemotherapy and radiation fail.
- B. Surgery is usually performed within 24 to 48 hours of admission.
- C. Surgery is the least favorable therapy for the treatment of Wilms tumor.
- D. Surgery will be delayed until the child's overall health status improves.
Correct Answer: B
Rationale: Wilms tumor, a kidney cancer in children, is primarily treated with surgical resection (nephrectomy) as the cornerstone of therapy, typically performed within 24 to 48 hours of diagnosis to remove the tumor before it spreads. This urgency stems from its responsiveness to surgery and the need to stage the cancer accurately, guiding subsequent chemotherapy or radiation. Delaying surgery until chemotherapy or radiation fails is incorrect surgery is the initial step, not a last resort. It's not the least favorable option; rather, it's the preferred first-line treatment due to high cure rates when combined with adjuvant therapies. Waiting for health improvement isn't standard unless the child is critically unstable, which isn't typical at diagnosis. The nurse's accurate explanation reassures parents and underscores surgery's role, aligning with pediatric oncology protocols to optimize outcomes in Wilms tumor management.
Which of the following diseases has the highest proportion of chronic illness deaths in Canada?
- A. Cancer
- B. Diabetes
- C. Cardiovascular disease
- D. Chronic respiratory disease
Correct Answer: C
Rationale: Cardiovascular disease tops Canada's chronic death chart 37% globally in 2012 outpacing cancer's 27%, respiratory's 8%, and diabetes' 4%. Heart attacks and strokes dominate, fueled by aging and lifestyle, a stat nurses lean on for prevention focus. Cancer's big, breathing woes and sugar issues trail, but heart's the killer king, a chronic burden demanding vigilance.