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In caring for a patient with neutropenia, what tasks can be delegated to the nursing assistant?
- A. Take vital signs every 4 hours
- B. Report temperature elevation >100.4°F
- C. Assess for sore throat, cough, or burning with urination
- D. Gather the supplies to prepare the room for protective isolation
Correct Answer: A
Rationale: Neutropenia heightens infection risk, requiring team vigilance. Taking vital signs every 4 hours fits nursing assistants' scope routine monitoring flags fevers, key in neutropenia, without needing assessment skills. Reporting fever >100.4°F is their duty once detected, but assessing symptoms like sore throat or cough demands RN judgment to interpret infection signs. Gathering supplies for isolation is assistive, not evaluative, suiting their role. Handwashing's universal, not a task to delegate. Vital signs delegation ensures timely data collection, freeing nurses to analyze and act, a practical split in caring for this vulnerable patient.
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One of the features of type 2 diabetes mellitus is the abnormally increased blood glucose values after meals. Question: What causes this abnormal rise of postprandial blood glucose?
- A. Insufficient glucose uptake in the liver due a shortage of Glut-2 transporters
- B. Insufficient glucose uptake in muscle tissue due to a defect in the Glut-4 transporters
- C. Insufficient glucose uptake in adipose tissue due to a defect in the intracellular insulin signal cascade
- D. Insufficient glucose uptake in muscle tissue due to a defect in the intracellular insulin signal cascade
Correct Answer: D
Rationale: Type 2's post-meal spike muscle's insulin signal jams, Glut-4 stalls, glucose piles up. Liver's Glut-2's fine, fat's minor, muscle's the big miss nurses peg this resistance core, a chronic uptake bust.
The nurse knows which of the following is the most common problem for a client with valvular heart disease?
- A. Altered body image
- B. Difficulty coping
- C. Bradycardia
- D. Decreased cardiac output
Correct Answer: D
Rationale: Valvular disease stenosis or regurgitation slashes flow; decreased cardiac output reigns as pump falters, driving fatigue and dyspnea, the top issue. Body image or coping lag; bradycardia's rare. Nurses peg output drop, targeting meds or surgery, a core fight in this valve-wrecked heart.
The glycaemic profiles of people living with diabetes is affected by the following EXCEPT:
- A. Monitoring of blood glucose
- B. Dietary intake
- C. Exercise
- D. Stress
Correct Answer: A
Rationale: Diabetes' sugar swings dance to diet, exercise, stress, and meds intake, burn, cortisol, and pills all tug levels. Monitoring tracks, not tweaks, the profile; it's a mirror, not a mover. Clinicians lean on this quintet's interplay, adjusting levers, not the gauge, a chronic puzzle where tools shape, not tally, the game.
According to Johnson and Chang (2014), people living with chronic illness are more likely than the general population to:
- A. Have significantly reduced activity and subsequent loss of independence
- B. Be required to see their doctor more regularly
- C. Experience periods of hospitalisation as a consequence of acute flare-ups of their underlying chronic disease
- D. Stay home and reduce their activity and social interactions
Correct Answer: A
Rationale: Chronic illness curbs activity arthritis, COPD slash mobility, stealing independence, a standout hit over frequent doctor visits, hospital stays from flares, or self-imposed isolation. Those ripple too, but reduced function's the core burden, reshaping daily life. Nurses prioritize this, boosting support, a chronic truth where physical loss leads.
A scalp block aims to stop conduction in the following nerves:
- A. Zygomaticotemporal.
- B. Infraorbital.
- C. Greater occipital.
- D. Auriculotemporal.
Correct Answer: C
Rationale: A scalp block is used in awake craniotomy to provide regional anesthesia by blocking sensory nerves innervating the scalp. The greater occipital nerve supplies the posterior scalp, making it a key target. The zygomaticotemporal nerve innervates the temple area, and the auriculotemporal nerve covers the lateral scalp and ear region both are also commonly blocked. The infraorbital nerve supplies the midface, not the scalp, and the trochlear nerve (likely a misnomer for supraorbital or supratrochlear) innervates the forehead, another typical target. However, the greater occipital stands out as essential for posterior coverage, consistently cited in scalp block techniques. The rationale hinges on anatomical innervation: effective scalp anesthesia requires blocking nerves from both trigeminal (V1, V2, V3 branches) and cervical (C2, C3) origins, with the greater occipital being a primary cervical contributor, ensuring comprehensive pain control during surgery.