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Fatty liver disease is more common in people with metabolic syndrome or type 2 diabetes. The pathogenesis of fatty liver disease is not yet completely known. Question: What does current research suggest with respect to the pathogenesis?
- A. Steatosis correlates with inflammation
- B. Inflammation correlates with fibrosis
- C. Steatosis correlates with liver damage
- D. Steatosis correlates with insulin resistance
Correct Answer: D
Rationale: Fatty liver's tale steatosis ties to insulin resistance, a metabolic syndrome root, not just inflammation, fibrosis, or vague damage. Nurses see this, a chronic fat-glucose knot.
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A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
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.
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?
- A. These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies
- B. These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer
- C. Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy
- D. Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying
Correct Answer: A
Rationale: Radiation zaps energy fatigue and weakness are par for the course, tied to inflammation and repair in treated tissues. Saying this, plus promising lab and imaging checks, reassures him it's expected, not a red flag, and keeps him in the loop. Blaming cancer alone dodges the treatment link, unsettling him. Dismissing it as universal or a good sign' feels flippant normal cells die too. Nurses in oncology lean on honesty and vigilance, easing fears while tracking for worse issues like anemia or infection.
In the clinical assessment of heart failure, which of the following is FALSE?
- A. Jugular venous distention, an S1 heart sound, and non-displaced apical impulse significantly increase the likelihood of the diagnosis
- B. Hypertension, CAD, and valvular disease are the most common causes
- C. Fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and edema are common symptoms
- D. Cardiomegaly on CXR is helpful in supporting the diagnosis
Correct Answer: A
Rationale: Jugular venous distention and edema suggest heart failure, but S1 (normal first sound) and non-displaced apical impulse don't increase diagnostic likelihood S3 or displaced impulse do, per clinical criteria. Common causes (HTN, CAD, valvular disease), symptoms, and cardiomegaly on CXR are true. ECG is vital. This corrects diagnostic focus in chronic HF assessment.
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.