Nokea
In the UK, orthognathic surgery is likely to:
- A. Be undertaken in specialist craniofacial surgery units rather than in maxillofacial surgery units.
- B. Be associated with a high incidence of postoperative nausea and vomiting.
- C. Require a nasal rather than an oral tracheal tube when a Le Fort I osteotomy is performed.
- D. Require admission of the patient to a high-dependency unit.
Correct Answer: B
Rationale: Orthognathic surgery corrects jaw deformities in the UK, typically by maxillofacial surgeons, not solely craniofacial units (reserved for complex congenital cases). Postoperative nausea and vomiting (PONV) are common due to blood swallowing, prolonged surgery, and opioids risk factors per Apfel criteria. Le Fort I osteotomy (maxillary) often uses oral intubation; nasal tubes suit mandibular focus or surgeon preference, not a requirement. High-dependency unit (HDU) admission isn't routine most recover in general wards unless complications (e.g., airway) arise. Cleft palate repair precedes, not follows, orthognathic work. PONV's prevalence reflects surgical and anaesthetic challenges, necessitating robust antiemetic prophylaxis.
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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.
Which of the following has been shown to be useful in managing fatty liver?
- A. Insulin injection
- B. Metformin
- C. Vitamin E
- D. Exercises
Correct Answer: C
Rationale: Vitamin E, an antioxidant, reduces hepatic inflammation in non-alcoholic steatohepatitis (NASH), per AASLD guidelines, aiding NAFLD management. Insulin treats diabetes, not NAFLD directly. Metformin improves insulin sensitivity but lacks strong evidence for NAFLD reversal. Exercise and diet are key but split here; exercise aids weight loss, indirectly helping. Vitamin E's specific benefit makes it notable in chronic liver disease care.
A nurse is assessing a female client who is taking progestins. What assessment finding requires the nurse to notify the provider immediately?
- A. Irregular menses
- B. Edema in the lower extremities
- C. Ongoing breast tenderness
- D. Red, warm, swollen calf
Correct Answer: D
Rationale: Progestins, used in some cancer treatments (e.g., endometrial cancer), increase thromboembolism risk due to their hormonal effects on clotting factors. A red, warm, swollen calf suggests deep vein thrombosis (DVT), a medical emergency requiring immediate provider notification to prevent pulmonary embolism. Irregular menses, edema, and breast tenderness are common side effects of progestins, manageable with monitoring or symptomatic relief, and don't pose the same urgency. DVT's potential to escalate rapidly into a life-threatening condition prioritizes it over other findings. The nurse's prompt reporting ensures timely imaging (e.g., ultrasound) and anticoagulation therapy, aligning with oncology nursing's focus on vigilant complication detection in hormonally treated clients.
Effective management of CHF has elements that are common to most programs. These do not include:
- A. Involvement of a multidisciplinary team across the health care sectors
- B. The use of evidence based management guidelines, including both pharmacological and nonpharmacological therapy
- C. Regular hospitalisation for monitoring of cardiac function and change in haemodynamic status
- D. Inclusion of patients and their family in care planning and development of individualised selfmanagement plans
Correct Answer: C
Rationale: CHF management leans on teams, guidelines, patient-family plans smart, evidence-based wins. Routine hospital stays? Nope home care's goal, not ward loops. Nurses push this, a chronic stay-out strategy.
The emergency management of the patient with acute asthma does not include:
- A. Performing a rapid physical examination
- B. Performing spirometry or peak flow on arrival
- C. Giving oxygen and short acting bronchodilator
- D. Close monitoring to determine efficacy of treatment and improvement or deterioration
Correct Answer: B
Rationale: Acute asthma's rush exam, O2, bronchodilators, tight watch saves breath fast. Spirometry's a no too tough mid-wheeze, delays care. Nurses skip it, a chronic flare's urgent dodge.