Nokea
Glycaemic profiles of people with diabetes varies with all EXCEPT:
- A. Diet
- B. Exercise
- C. Stress
- D. Monitoring of blood glucose
Correct Answer: C
Rationale: Sugar swings food, sweat, drugs, checks shift it; dress' is a typo for stress, but stress fits, not fabric. Nurses track this chronic dance, not wardrobe.
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The nurse caring for oncology clients knows that which form of metastasis is the most common?
- A. Bloodborne
- B. Direct invasion
- C. Lymphatic spread
- D. Via bone marrow
Correct Answer: A
Rationale: Metastasis is the process by which cancer spreads from its original site to distant parts of the body, a critical concern in oncology nursing. Among the various mechanisms, bloodborne metastasis is the most common, as cancer cells often enter the bloodstream and travel to organs like the lungs, liver, or brain. This occurs because the circulatory system provides an efficient pathway for tumor cells to disseminate widely, especially in cancers like breast or lung cancer. Lymphatic spread is also frequent, particularly in carcinomas, where cells travel via lymph nodes, but it is less dominant than bloodborne spread across all cancer types. Direct invasion involves cancer growing into adjacent tissues, which is a local process rather than true metastasis. Bone marrow is not a medium for metastasis but a potential site where cancer can settle, such as in leukemia or multiple myeloma. Understanding that bloodborne metastasis predominates helps nurses prioritize monitoring for systemic symptoms and complications, such as organ dysfunction, in clients with advanced cancer.
The nurse is caring for a 65-year-old female who presented to the emergency department with shortness of breath and chest discomfort. The client has not been feeling well for the past few days and complains of a productive cough of blood-tinged sputum. Laboratory tests reveal an elevated brain natriuretic peptide (BNP), and chest x-ray reveals pulmonary congestion. Based on the assessment findings, which of the following diagnosis are consistent with these findings?
- A. Heart failure (left-sided)
- B. Lung cancer
- C. Heart failure (right-sided)
- D. Pulmonary embolism
Correct Answer: A
Rationale: Elevated BNP and pulmonary congestion plus dyspnea, chest pain, hemoptysis point to left-sided heart failure, where ventricle falters, flooding lungs with fluid. Lung cancer might bleed but lacks BNP spike. Right-sided failure swells periphery, not lungs initially. Pulmonary embolism clots, not congests, with normal BNP. Nurses link this to left heart strain, anticipating diuretics, a diagnosis fitting this wet-lung picture.
In the ACC/AHA 2017 Guideline for Hypertension, what is the cut off for hypertension diagnosis?
- A. 120/70 mmHg
- B. 130/80 mmHg
- C. 135/85 mmHg
- D. 140/90 mmHg
Correct Answer: B
Rationale: ACC/AHA 2017 130/80 tags hypertension, not old 140/90 or looser. Nurses gauge this chronic pressure shift.
The definition of Chronic Heart Failure is:
- A. Failure of the heart to adequately pump blood to the body.
- B. Long-term inability of the heart to meet metabolic demands required to maintain homeostasis.
- C. Prolonged enlargement of the left ventricle impacting on the contractility of the muscle.
- D. Long term fluid build-up, causing increase in blood volume and reducing the ability of the heart to maintain blood flow.
Correct Answer: B
Rationale: Chronic heart failure (CHF) is a syndrome, not a singular defect. Failure to pump adequately describes acute failure but lacks chronicity's scope. CHF is the heart's prolonged inability to meet metabolic demands for oxygen and nutrients, disrupting homeostasis per Farrell (2017) encompassing systolic (reduced ejection) and diastolic (impaired filling) dysfunction. Left ventricular enlargement may occur (e.g., dilated cardiomyopathy), but it's a cause or result, not the definition; contractility varies. Fluid buildup (congestion) is a feature, not the essence blood volume rises secondary to neurohormonal activation (e.g., renin-angiotensin system), not as the primary failure. The metabolic demand focus captures CHF's systemic impact fatigue, edema, dyspnea reflecting chronic adaptation failure over structural or fluid-centric descriptions.
An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRMs). The nurse should know that these achieve a therapeutic effect by what means?
- A. Promoting the synthesis and release of leukocytes
- B. Focusing the patient's immune system exclusively on the tumor
- C. Potentiating the effects of chemotherapeutic agents and radiation therapy
- D. Altering the immunologic relationship between the tumor and the patient
Correct Answer: D
Rationale: BRMs (e.g., interferon, IL-2) tweak the immune-tumor dance revving up the body's attack or slowing cancer's evasion, not just pumping out leukocytes or boosting chemo/radiation. They don't laser-focus immunity but shift the balance, like marking tumors for T-cells. Nurses in oncology grasp this, knowing BRMs offer a Hail Mary when standard stuff flops, targeting that host-tumor interplay.