Nokea
In the UK, appropriate statements concerning the trauma network include:
- A. Major trauma centres, but not minor trauma units, need facilities to deal with polytrauma patients.
- B. Hospitals dealing with trauma are expected to contribute data to the Trauma Audit Research Network (TARN) database.
- C. Within their network, trauma units have transfer arrangements for moving seriously injured patients to major trauma centres.
- D. Trauma networks have an ambulance protocol for bypassing the nearest unit for injuries that may be best treated at a distant specialist centre.
Correct Answer: B
Rationale: The UK trauma network, established pre-2014, enhances care coordination. Major trauma centres (MTCs) handle polytrauma; trauma units manage less severe cases, though both need capabilities severity dictates MTC referral. TARN collects data from all trauma-receiving hospitals, tracking outcomes (e.g., mortality) to improve standards, a core network feature. Transfer protocols ensure escalation from trauma units to MTCs for complex injuries. Ambulance bypass protocols prioritize specialist MTCs (e.g., neurosurgery) over proximity, per triage tools. Rehabilitation is included in network responsibilities. TARN's mandatory data submission drives quality, transparency, and research, distinguishing the system's evidence-based evolution.
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Epigenetic changes play a role in the development of type 2 diabetes mellitus. Question: Which of the following statements about epigenetics is correct?
- A. Epigenetic modifications lead to mutations in DNA
- B. Mutations in DNA lead to epigenetic modifications
- C. Epigenetic modifications only take place at a young age
- D. None of the statements provided above is correct
Correct Answer: D
Rationale: Epigenetics tweaks gene dials no mutations, not from mutations, not age-locked. Diet, stress flip switches anytime, a chronic type 2 player nurses note this, no false leads fit.
Which of the following procedures are performed for a client with a pericardial effusion?
- A. Thoracotomy
- B. Pericardiocentesis
- C. Coronary artery bypass graft
- D. Thoracentesis
Correct Answer: B
Rationale: Pericardial effusion fluid around the heart threatens tamponade, compressing cardiac output. Pericardiocentesis drains this via needle or catheter, relieving pressure, a targeted fix for this diagnosis. Thoracotomy, an open chest surgery, is overkill unless complications escalate. Coronary bypass addresses arterial blockages, unrelated to effusion. Thoracentesis taps pleural fluid, not pericardial. Nurses prep for pericardiocentesis, anticipating its urgency in restoring function, a procedure matching the condition's anatomy and risk, critical for stabilizing clients in this cardiac emergency.
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.
Which is the most common organism/s causing osteomyelitis in all age groups?
- A. streptococci
- B. staph aureus
- C. gm negatives
- D. hemophilus
Correct Answer: B
Rationale: Staph aureus reigns in osteomyelitis bone's bane across kids to geezers, sticking to marrow like glue. Streptococci hit less, gram-negatives tag trauma, hemophilus fades post-vaccine, fungi creep rare. Nurses bank on this staph stat, a chronic skeleton scourge needing targeted juice.
Post exposure prophylaxis against Human Immunodeficiency Virus (HIV):
- A. is probably not effective when commenced 36 hours post exposure
- B. is administered intramuscularly
- C. is generally well-tolerated by patients
- D. when given, precludes the need for follow up serology
Correct Answer: C
Rationale: HIV PEP tolerable pills, not IM, works past 36 hours, needs serology, safe in pregnancy. Nurses dose this chronic shield easy.