Nokea
In order to provide optimal management and prevent deterioration, the patient needs to be educated in selfmanagement of their condition. Which of the following are not elements of self-management?
- A. Engaging in activities that promote health
- B. Managing COPD by monitoring signs and symptoms
- C. Weekly visits with the medical practitioner
- D. Following a treatment plan
Correct Answer: C
Rationale: COPD self-care health habits, symptom checks, plan adherence empowers patients. Weekly doc visits? Overkill, not core self-management cuts reliance. Nurses teach this, a chronic autonomy boost.
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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.
Tetanus:
- A. typically has an incubation period of 23 days
- B. immunization status is particularly poor in elderly women
- C. toxoid is more effective by S.C. injection
- D. IgG will provide passive protection for about a week
Correct Answer: B
Rationale: Tetanus 7-10 days incubate, elderly women lag shots, IM toxoid, Ig lasts longer, pregnancy's fine. Nurses tag this chronic gap.
The signs and symptoms of heart failure do not include:
- A. Dyspnoea
- B. Orthopnoea
- C. Urinary frequency
- D. Fatigue
Correct Answer: C
Rationale: Heart failure floods breathless, flat-lie gasps, swelling, wiped out. Peeing often? Kidneys, not heart others scream pump fail. Nurses clock these, a chronic wet mess minus bladder.
Which organism can not be detected by antigen testing of CSF, serum or urine?
- A. cryptococcus neoformans
- B. TB
- C. Ecoli
- D. Hemophilus
Correct Answer: B
Rationale: TB hides from antigen tests slow grower, no quick CSF, serum, or urine markers like cryptococcus' capsular catch, E. coli's bits, Haemophilus' caps, or Group B strep's flags. Nurses lean on culture or PCR here, a chronic stealth bug dodging rapid nets.
The client is diagnosed with laryngeal cancer and is scheduled for a laryngectomy next week. Which intervention would be priority for the clinic nurse?
- A. Assess the client's ability to swallow
- B. Refer the client to a speech therapist
- C. Order the client's preoperative lab work
- D. Discuss the client's operative unit
Correct Answer: B
Rationale: Laryngectomy severs voice referring to a speech therapist pre-op sets up post-surgical communication, a priority as clients lose speech, facing isolation without aids like electrolarynx training. Swallowing matters, but airway and cancer trump function now. Labs are routine, delegated often; unit talk's secondary. Nurses push this referral, easing the mute transition, a proactive step in laryngeal cancer's life-altering prep, ensuring clients adapt to this voiceless future from day one.