Nokea
In infective endocarditis
- A. oslers nodes are tender
- B. Janeway lesions are tender
- C. Right ventricular MI is more likely to be acute than subacute
- D. A+C
Correct Answer: A
Rationale: Endocarditis Osler's nodes hurt, Janeway's don't, right heart's acute in IVDU. Nurses feel this chronic pain clue.
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All of the following are broad categories of dietary approaches EXCEPT:
- A. Energy-focused
- B. Macronutrient-focused
- C. Reward-focused
- D. Dietary timing-focused
Correct Answer: C
Rationale: Diets calories, macros, patterns, timing rule; reward's brain, not plate. Nurses map this chronic food frame, skipping psyche.
The Lee Revised Cardiac Risk Index:
- A. Has been validated to predict the risk of mortality after major non-cardiac surgery.
- B. Is a complex algorithm.
- C. Provides a simple additive score incorporating six risk factors.
- D. Discriminates well between patients at moderate and severe risk of adverse cardiac outcome.
Correct Answer: C
Rationale: The Lee Revised Cardiac Risk Index (RCRI) predicts cardiac complications (e.g., myocardial infarction) after non-cardiac surgery. It's validated for morbidity, not mortality specifically, though it correlates with outcomes. It's not a complex algorithm but a straightforward tool: six factors (high-risk surgery, ischemic heart disease, heart failure, stroke/TIA, diabetes on insulin, renal insufficiency) are scored additively (0-6). This simplicity aids clinical use, providing risk percentages (e.g., 0.4% for 0 points, 11% for ≥3). It discriminates moderate-to-high risk well but less so at extremes. Age >70 isn't an automatic point; risk factors are specific. Its strength lies in its evidence-based, user-friendly design for perioperative cardiac risk stratification.
During his internship at a general practice, a medical student is asked to check the blood glucose level in a 30-year-old patient with type 1 diabetes. Acute glycaemic dysregulation is suspected in this patient. The patient asks if the student is going to take a capillary blood sample as shown in the picture below. Which of the following statements applies best in case of suspected acute dysregulation?
- A. The result will equal that of a finger prick sample
- B. The result will be higher than that of a finger prick sample
- C. The result will be lower than that of a finger prick sample
- D. One must not draw blood from this site in this case
Correct Answer: D
Rationale: Acute type 1 chaos no arm vein draw, finger prick's king for fast reads, not this site. Nurses skip this, a chronic crisis dodge.
In the year 2012, appropriate statements regarding complications of percutaneous cervical cordotomy in the UK include:
- A. Estimates of complication rates are based on pooled data in a national registry.
- B. Complications are similar to those after open surgical cordotomy.
- C. Rates of major complications such as death and paralysis are between 1 in 10000 and 1 in 1000.
- D. Persistent postural hypotension is uncommon.
Correct Answer: D
Rationale: In 2012, UK percutaneous cervical cordotomy (PCC) complication data were limited, not pooled nationally case series or institutional reports dominated. PCC's minimally invasive nature yields fewer complications (e.g., no wound infections) than open cordotomy's extensive approach. Major complications like death or paralysis are rare (<1%), below 1-in-1000 estimates, due to precise imaging and technique. Persistent postural hypotension is uncommon, linked to rare sympathetic disruption (e.g., Horner's syndrome), resolving typically. Headaches occur but aren't persistent. The low incidence of sustained hypotension reflects PCC's targeted spinothalamic focus, sparing autonomic pathways, making it a safer palliative option versus historical benchmarks.
A nurse is planning a diet for a client who is iron deficient. Which of the following foods high in iron should the nurse include in the plan?
- A. Yogurt
- B. Leafy green vegetables
- C. Oranges
- D. Cashews
Correct Answer: B
Rationale: Iron deficiency craves heme leafy greens like spinach pack non-heme iron, boosting hemoglobin, a diet fix over dairy's low yield. Oranges aid absorption, not iron itself; cashews offer some, less potently. Nurses plan greens, pairing with vitamin C, a practical lift for this anemic client's blood.