Nokea
Glibenclamide belongs to the class
- A. Sulphonylureas
- B. Thiazolidinediones
- C. Benzoic acid derivatives
- D. Biguanides
Correct Answer: A
Rationale: Glibenclamide's a sulphonylurea pumps insulin from beta cells, a classic diabetes fix. Thiazolidinediones tweak sensitivity, benzoic acids like repaglinide hit fast, biguanides like metformin curb liver glucose. It's a chronic pancreas prod, not a sensitivity or liver play nurses and pharmacists peg it for type 2's insulin lag, a distinct class with a clear job.
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Which enzyme is activated by oxidative stress in endothelial cells and plays a key role in the development of complications?
- A. GAPDH
- B. Glyoxalase-1
- C. PARP
- D. Transketolase
Correct Answer: C
Rationale: PARP wakes to oxidative hits repairs DNA, drives damage in diabetes vessels, not GAPDH's stall, glyoxalase's detox, or transketolase's shunt. Nurses clock this, a chronic complication cog.
A 56 yo man presents with a penetrating wound to his leg from a wooden stake. The wound is contaminated with debris. His last tetanus booster was 12 years ago, but records reliably indicate he's had 3 doses of tetanus vaccine. The most appropriate anti-tetanus regimen for him is:
- A. ADT (Adult Diphtheria Tetanus) plus tetanus Ig (immunoglobulin)
- B. Tetanus Ig only
- C. ADT only
- D. Child diphtheria tetanus, as he is immunologically 'immature'
Correct Answer: C
Rationale: Dirty stake, 12 years off ADT boosts his three-dose base, no Ig for primed; kid shots, nothing's off. Nurses jab this chronic recall.
The nurse knows that hemolytic to blood transfusions occur most often when the first milliliters of the infusion.
- A. 125
- B. 50
- C. 100
- D. 75
Correct Answer: B
Rationale: Hemolytic reactions strike early 50 mL often triggers as mismatched blood clashes, a rapid antigen-antibody storm. Later volumes (75-125) build on it; 100's common but not peak. Nurses watch those first drops, stopping at 50 mL's hint of fever or pain, a tight window in this transfusion trap.
Autonomic neuropathies affecting people with chronic diabetes affect many body systems. Which of the following is not a clinical manifestation of this problem?
- A. Tachycardia
- B. Mental confusion
- C. Urinary retention
- D. Anhidrosis
Correct Answer: B
Rationale: Diabetes' nerve mess fast heart, pee stalls, no sweat autonomic signs. Confusion's brain sugar or stroke, not this. Nurses clock these, a chronic nerve quirk.
Chronic obstructive pulmonary disease (COPD) is associated with:
- A. Skeletal muscle dysfunction.
- B. Mean pulmonary arterial pressure of ≥ 25 mm Hg.
- C. Significant reversibility in airflow limitation with bronchodilator therapy.
- D. Depression.
Correct Answer: A
Rationale: COPD is a progressive lung disease characterized by airflow limitation that is not fully reversible. Skeletal muscle dysfunction is a well-documented extrapulmonary manifestation due to systemic inflammation, oxidative stress, and reduced physical activity, leading to muscle wasting and weakness. Elevated mean pulmonary arterial pressure (≥ 25 mm Hg) defines pulmonary hypertension, which can occur secondary to COPD but is not a universal feature. Significant reversibility in airflow limitation is more typical of asthma, not COPD, where bronchodilator response is limited. The FEVâ‚/FVC ratio in COPD is typically <0.7, not >0.7, making that option incorrect. Depression is common in COPD patients due to chronic illness and reduced quality of life, but it's not a defining feature. Among these, skeletal muscle dysfunction is most consistently associated with COPD pathophysiology, reflecting its systemic impact beyond the lungs.