Nokea
In the treatment of COPD:
- A. Inhaled long-acting β₂ agonists are a first-line treatment for breathlessness.
- B. Most patients require maintenance use of oral corticosteroids.
- C. The dosage of oral theophylline needs to be reduced in patients commenced on erythromycin.
- D. Long-term oxygen therapy is indicated in a stable patient with a Paâ‚“â‚‚ of 8.5 kPa.
Correct Answer: C
Rationale: COPD management focuses on symptom relief and preventing exacerbations. Inhaled long-acting β₂ agonists are indeed used for breathlessness but are not always first-line; short-acting bronchodilators often precede them. Maintenance oral corticosteroids are not standard due to significant side effects; inhaled corticosteroids are preferred. Theophylline, a bronchodilator, has its metabolism inhibited by erythromycin (a CYP3A4 inhibitor), increasing plasma levels and toxicity risk, necessitating dose reduction. Long-term oxygen therapy is indicated for severe hypoxemia (Paₓ₂ < 7.3 kPa or 7.3-8 kPa with complications), not at 8.5 kPa, which is relatively normal. Non-invasive ventilation is reserved for acute exacerbations, not first-line treatment. The interaction between theophylline and erythromycin is a critical pharmacological consideration in COPD management, making it the standout correct statement.
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Proven treatment for patients with noncirrhosis from NAFLD include the following except:
- A. Liver transplant
- B. Bariatric surgery
- C. Vitamin E
- D. Weight loss
Correct Answer: A
Rationale: Noncirrhotic NAFLD bends to weight loss, bariatric cuts, and Vitamin E's antioxidant punch proven aids. Transplant's endgame for cirrhosis, not here. Metformin flops for fat, despite diabetes use. Clinicians skip this organ swap, leaning on lifestyle and pills, a chronic fix before scars hit.
Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary modifications are generally not sustainable and hence dietary approaches are not as important as pharmacological approaches
- B. There is no Randomised Controlled Trial (RCT) level of evidence regarding decreasing sugar sweetened beverages
- C. Dietary approaches can be broadly categorised into energy-focused, macronutrient-focused, dietary pattern-focused, and dietary timing-focused
- D. Long-term diet trials have shown intermittent fasting to be superior to continuous energy restriction with respect to average weight loss
Correct Answer: C
Rationale: Diet's obesity fight splits smart energy, macros, patterns, and timing frame approaches, a true lens on options like low-carb or fasting. Sustainability varies, RCTs back sugar cuts, fasting ties (not tops) restriction, and proteins sate more than carbs. Clinicians wield this quartet, tailoring chronic plans, a broad truth in food's fat battle.
The role of the nurse and other health professions in chronic disease is to:
- A. Support the person in managing their condition
- B. Provide direction to the person about their treatment
- C. Ensure the person takes their medications and avoids risk factors
- D. Decide on the best approach to manage the condition and direct the implementation of this care
Correct Answer: A
Rationale: Chronic disease management hinges on patient empowerment, not authoritarian control. Supporting individuals in managing their condition aligns with modern nursing philosophy, fostering self-efficacy through education, emotional support, and resource provision key in texts like Deravin and Anderson (2019). Providing direction implies guidance, but it's less collaborative than support, often overstepping patient autonomy. Ensuring medication adherence and risk avoidance is paternalistic, assuming enforcement over partnership, which conflicts with patient-centered care principles. Deciding and directing care outright disregards patient input, undermining shared decision-making critical for long-term adherence in chronic illness. Support encompasses holistic care physical, psychological, and social enabling patients to navigate their condition, adapt lifestyles, and cope with challenges, reflecting the multidisciplinary team's role in enhancing quality of life rather than dictating it.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Recognition and self-management of hypoglycaemia
- C. Sick day management
- D. Stopping all oral hypoglycaemic agents
Correct Answer: D
Rationale: Insulin education builds control technique, hypo spotting, sick days, and driving safety are musts, ensuring delivery, crisis handling, and road smarts. Stopping all oral agents isn't universal; many stay on metformin or SGLT-2s for synergy, not a blanket rule. Tailored plans keep or ditch orals, dodging this absolute. Clinicians teach what fits, not a one-size purge, a nuanced chronic care tweak over rigid cuts.
A nurse is caring for a client recently diagnosed with pericarditis. Which of the following is a common assessment finding with this disorder?
- A. Elevated troponin
- B. Pericardial friction rub
- C. Heart failure
- D. ST-segment depression
Correct Answer: B
Rationale: Pericarditis rubs the sac pericardial friction rub, a scratchy sound, marks inflammation, a common find as layers grate. Troponin rises with muscle damage, not here. Heart failure or ST depression hints tamponade or ischemia, not direct. Nurses auscultate this rub, tying it to pericarditis's irritated core, a diagnostic bellwether.