Hyperglycaemia is involved in cardiovascular complications in diabetes. There are several mechanisms through which high glucose levels in endothelial cells can lead to complications. Question: Which mechanism is NOT directly associated with cardiovascular complications in diabetes?
- A. Activation of PKC
- B. AGE pathway
- C. Sorbitol pathway
- D. Fatty acid oxidation
Correct Answer: D
Rationale: High glucose trashes vessels PKC, AGEs, sorbitol clog the works, but fatty acid burn's metabolic, not direct CV. Nurses spot this, a chronic heart sidestep.
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Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.
Which of these clients assigned to the nurse is most likely to need planning for long-term nursing management?
- A. 22-year-old with appendicitis who has had an emergency appendectomy
- B. 56-year-old with bilateral knee osteoarthritis who weighs 159 kg
- C. 34-year-old with cholecystitis who has had a laparoscopic cholecystectomy
- D. 62-year-old with acute sinusitis who will require antibiotic therapy for 5 days
Correct Answer: B
Rationale: Osteoarthritis at 159 kg screams chronic long-term PT, diet plans beat appendectomy, gallbladder, or sinus quickies. Nurses plot this, a marathon, not sprints.
A general practitioner (GP) advises an overweight patient to go to the gym to work out. Question: This advice is an example of which type of prevention?
- A. Primary prevention
- B. Secondary prevention
- C. Tertiary prevention
- D. Quaternary prevention
Correct Answer: A
Rationale: Gym nudge for overweight primary, stops diabetes before it starts, not screening or late fixes. Nurses push this, a chronic preemptive strike.
The nurse is teaching the parents of a 15-year-old who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which of the following symptoms should the parents seek medical care immediately?
- A. Earache, stiff neck or sore throat
- B. Blisters, ulcers or a rash appear
- C. A temperature of 101.5 degrees Fahrenheit
- D. Difficulty or pain when swallowing
Correct Answer: C
Rationale: Chemotherapy for acute myelogenous leukemia suppresses the immune system by reducing white blood cell production, leaving the child highly susceptible to infections. A fever of 101.5°F is a critical sign in this context, as it may indicate an infection that, without a functioning immune response, could rapidly progress to sepsis a life-threatening condition. Parents must seek immediate medical care to evaluate and treat the underlying cause, often requiring emergency department intervention. While earache, stiff neck, or sore throat could suggest infection, they are less urgent without fever and may not necessitate immediate action unless severe. Blisters, ulcers, or rashes might reflect chemotherapy side effects like mucositis or drug reactions, manageable with outpatient care unless infected. Difficulty swallowing could stem from mucositis or infection, but fever trumps it in urgency due to its systemic implications. Educating parents to prioritize fever ensures timely intervention, aligning with oncology nursing's focus on preventing complications in immunocompromised pediatric patients.
In patients who are awake during craniotomy, appropriate statements include:
- A. For a temporal lesion, neurosurgeons are likely to require the sitting position.
- B. A tracheal tube is likely to be used.
- C. A urinary catheter is likely to be inserted.
- D. Intraoperative seizures are likely to occur during cortical mapping.
Correct Answer: C
Rationale: Awake craniotomy allows functional mapping and patient cooperation. The sitting position is rare due to air embolism risks and is not specific to temporal lesions; supine or lateral positions are standard. A tracheal tube is avoided to maintain airway control via less invasive means (e.g., nasal cannula), as patients must remain responsive. A urinary catheter is routine for longer procedures to manage fluid balance and patient comfort, given immobility and duration. Patient anxiety is common but manageable, not an absolute contraindication. Seizures can occur during cortical mapping due to electrical stimulation, but likely' overstates frequency; they're a risk, not a certainty. The urinary catheter's inclusion reflects practical perioperative care, ensuring monitoring and comfort without interrupting the procedure's focus on brain function preservation.
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