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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The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective?
- A. After cancer has not recurred for 5 years, it is considered cured.
- B. The cancer will be cured if the entire tumor is surgically removed.
- C. I will need follow-up examinations for many years after treatment before I can be considered cured.
- D. Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation.
Correct Answer: C
Rationale: Stage III breast cancer's advanced local spread means long-term vigilance, not a quick cured' label. Five years recurrence-free is a milestone, but not universal some hit sooner, others never. Surgery alone won't cut it; chemo and radiation tag-team it. Never cured' overstates control's the goal, but cure's possible. Nurses in oncology drill this: years of follow-ups track sneaky recurrence, key for stage III's tricky prognosis.
Which of the following cancer patients could potentially be placed together as roommates?
- A. A patient with a neutrophil count of 1000/mm³
- B. A patient who underwent debulking of a tumor to relieve pressure
- C. A patient receiving high-dose chemotherapy after a bone marrow harvest
- D. A patient who is post-op laminectomy for spinal cord compression
Correct Answer: B
Rationale: Roommate pairing hinges on infection risk and care needs. The debulking patient tumor reduced for symptom relief and post-laminectomy patient spinal decompression both underwent palliative surgeries, not inherently immunocompromised, making them compatible. A neutrophil count of 1000/mm³ signals moderate neutropenia, needing isolation to dodge infections. High-dose chemotherapy post-bone marrow harvest obliterates immunity, demanding strict protection. The surgical pair's stability, lacking acute immune suppression, allows safe cohabitation, a nurse's practical call to optimize space and reduce cross-infection risks in cancer care settings.
Non modifiable risk factors for developing chronic illness include:
- A. Smoking and hypertension
- B. Sedentary lifestyle and diabetes
- C. Family history and socio-political factors
- D. Working/living conditions and stress
Correct Answer: C
Rationale: Non-modifiable risk factors are inherent traits or circumstances that cannot be changed, unlike modifiable factors tied to behavior or environment. Smoking and hypertension are modifiable through lifestyle changes or medical intervention, not fixed. Sedentary lifestyle is a choice, and diabetes, while influenced by genetics, is often manageable, making them modifiable. Family history, such as genetic predisposition to diseases like cancer or heart disease, is unalterable, and socio-political factors like access to healthcare shaped by policy or socioeconomic status are beyond individual control, fitting the non-modifiable category. Working and living conditions, plus stress, can be adjusted with resources or coping strategies, classifying them as modifiable. The distinction lies in control: family history and socio-political factors remain static, influencing chronic illness risk without personal alteration, as noted in foundational chronic disease literature like Farrell (2017), emphasizing genetics and societal context over mutable habits.
A 79 year old woman is told by his GP that she has postural hypertension. Which of the following BP is she likely to be having?
- A. A drop of 15 mmHg/10 mmHg within 3 minutes of standing
- B. A drop of 17 mmHg/10 mmHg within 3 minutes of standing
- C. A drop of 21 mmHg/10 mmHg within 3 minutes of standing
- D. A rise of 5 mmHg/10 mmHg within 3 minutes of standing
Correct Answer: C
Rationale: Postural hypotension 21/10 drop flags, not rises or mild dips. Nurses catch this chronic stand slip (assuming typo meant hypotension).
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.