Nokea
Madam Tan is newly diagnosed to have Type 2 DM. Her fasting plasma glucose is 12 mmol/L. Her blood pressure and fasting lipid profile are normal. She has been provided with patient education and advice on therapeutic life-style modification. Which is the most appropriate course of management for this lady?
- A. Commence her on combination therapy of three oral hypoglycaemic agents
- B. Motivate her to adhere with life-style modification
- C. Commence her on monotherapy of oral hypoglycaemic agent
- D. Commence her on combination therapy of two oral hypoglycaemic agents
Correct Answer: C
Rationale: New type 2, fasting 12 lifestyle's fresh, so metformin monotherapy starts, easing glucose without overload. Triple or dual oral's too much; insulin's for later; pushing lifestyle alone won't cut it yet. Nurses build this chronic base, balancing effort and meds.
You may also like to solve these questions
Dexmedetomidine:
- A. Is recognized as an α₠receptor agonist.
- B. Increases the minimum alveolar concentration of volatile agents.
- C. Causes bradycardia.
- D. Has a loading dose of 0.5-1.0 μg kgâ»Â¹.
Correct Answer: C
Rationale: Dexmedetomidine is a highly selective α₂-adrenergic receptor agonist, not αâ‚, used for sedation with minimal respiratory depression. It reduces the minimum alveolar concentration of volatile anesthetics by enhancing sedation and analgesia, not increasing it. Bradycardia is a well-known side effect due to its sympatholytic action, decreasing heart rate via vagal stimulation and reduced catecholamine release. The standard loading dose is indeed 0.5-1.0 μg kgâ»Â¹ over 10 minutes, followed by infusion, aligning with clinical protocols. At high infusion rates, respiratory depression is unlikely, distinguishing it from opioids. Bradycardia's prominence as a side effect stems from its mechanism activation of α₂ receptors in the brainstem and periphery inhibits sympathetic outflow, making it a critical consideration in perioperative management, especially in patients with cardiovascular comorbidities.
A 75-year-old female presented to the emergency department with shortness of breath. The client's daughter is at the bedside and shares that the client has a history of heart failure. The nurse places the client on the cardiac monitor and finds that the client is in atrial fibrillation at a rate of 180 beats per minute. Which is a likely finding?
- A. Bounding pulses
- B. Lethargy
- C. Hypotension
- D. Edema
Correct Answer: C
Rationale: Atrial fibrillation at 180 beats/minute in heart failure loses atrial kick, slashing output hypotension follows as rapid, erratic beats fail to fill ventricles, a likely finding with this tachycardic chaos. Bounding pulses need strong ejection, not here. Lethargy or edema might emerge, but BP drop's immediate, tied to poor perfusion. Nurses expect this, anticipating rate control or fluids, a critical catch in this acute decompensation.
Why are endothelial cells in particular sensitive to the damage caused by high plasma glucose levels?
- A. Endothelial cells have a high metabolic activity
- B. Endothelial cells cannot regulate the glucose uptake
- C. Endothelial cells have a low level of antioxidants
- D. All statements provided above are correct
Correct Answer: B
Rationale: Endothelial cells drown in glucose no uptake brakes, high sugar slams them, not just metabolism or low shields. A chronic vessel weak spot nurses watch this sugar soak.
A nurse is caring for a 65-year-old male who recently underwent an aortic valve replacement. Which of the following is a post-operative nursing care priority?
- A. Temperature monitoring
- B. Assess for bleeding
- C. Advance diet as tolerated
- D. Dressing change
Correct Answer: B
Rationale: Valve replacement bleeds assessing for hemorrhage at surgical sites or anticoagulation tops post-op care, a life-or-death watch per ABCs. Fever, diet, dressings matter, but bleeding's immediate. Nurses hunt oozing or shock, ensuring stability, a priority in this fresh-cut cardiac zone.
The nurse is caring for a patient diagnosed with stage I colon cancer. When assessing the need for psychologic support, which question by the nurse will provide the most information?
- A. How long ago were you diagnosed with this cancer?'
- B. Do you have any concerns about body image changes?'
- C. Can you tell me what has been helpful to you in the past when coping with stressful events?'
- D. Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?'
Correct Answer: C
Rationale: Stage I colon cancer's early psych support hinges on coping history . Past wins reveal strengths, more than timing , body image (B less hit here), or textbook stages . Nurses in oncology dig this how they've handled stress before predicts now, guiding tailored help.