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Many people with obesity have a lower insulin-stimulated glucose uptake compared with people without increased body weight. It is assumed that several factors play a role in the development of insulin resistance. Question: Which of the following factors is LEAST likely to play a role in the development of insulin resistance?
- A. Reduced insulin levels
- B. Increased adipokine levels
- C. Increased triglyceride levels
- D. Low-grade continuous inflammation
Correct Answer: A
Rationale: Insulin resistance brews from fat's adipokines, triglycerides, inflammation not low insulin, that's type 1's game. Obesity's chronic jam needs excess, not lack nurses flag this misfit.
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The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider?
- A. Hematocrit of 32%
- B. Pain with deep inspiration
- C. Serum sodium of 126 mEq/L
- D. Decreased breath sounds on left side
Correct Answer: C
Rationale: Lung cancer can spark SIADH sodium at 126 risks seizures, outpacing anemia , pleuritic pain , or expected breath loss . Nurses in oncology report this low sodium's a metabolic emergency, needing swift fix.
During his internship at a general practice, a medical student is asked to check the blood glucose level in a 50-year-old patient with type 2 diabetes. The measurement is performed at a random moment and the carbohydrate intake has not been standardised before the measurement is taken. The result of the measurement is shown below. The general practitioner (GP) asks the student to report the result using standard medical terminology. Question: Which diagnosis is most consistent with the findings provided above?
- A. Hyperglycaemia
- B. Hypoglycaemia
- C. Hyperglycaemia with hyperosmolar state
- D. Normoglycaemia (euglycaemia)
Correct Answer: A
Rationale: Random high glucose in type 2 hyperglycaemia, no hypo, osmolar crash, or norm. Nurses call this, a chronic sugar spike.
Postoperative care at the completion of bimaxillary surgery:
- A. Is likely to be complicated by the presence of intermaxillary fixation (IMF).
- B. Involves awake rather than asleep extubation.
- C. Requires gentle removal of the tracheal tube to avoid damage of mandibular plates and screws.
- D. Involves reinsertion of a nasal tracheal tube when complicated by airway bleeding or obstruction requiring emergency reintubation.
Correct Answer: A
Rationale: Bimaxillary surgery's postoperative phase is complex. Intermaxillary fixation (IMF) aligns jaws but restricts mouth opening, complicating airway management, vomiting, and oral care raising aspiration or obstruction risks. Awake extubation is preferred, ensuring airway reflexes return, critical with IMF and swelling. Gentle tube removal prevents surgical site trauma (e.g., plates), though mandibular hardware is internal, less tube-accessible. Emergency reintubation may use nasal routes due to IMF, addressing bleeding/obstruction. HDU care is case-specific, not mandatory. IMF's presence drives tailored strategies, prioritizing airway security and patient stability in this high-risk recovery period.
Choose the CORRECT statement Babies born from mothers with gestational diabetes:
- A. Are at a high risk of being born with diabetes
- B. Are usually hypoglycaemic due to maternal insulin drug therapy
- C. Are usually of higher birth weight
- D. Are always given a glucose challenge test
Correct Answer: C
Rationale: Gestational diabetes fattens babies high maternal sugar pumps fetal growth, a hefty birth norm. They don't inherit diabetes at birth, hypo's rare unless mom's on insulin, tests aren't routine. Nurses track this, a chronic womb echo.
The nurse is assessing a 14-year-old girl with a tumor. Which of the following findings would indicate Ewing sarcoma?
- A. Child complains of dull bone pain just above the knee.
- B. Palpation reveals non-tender swelling on the right ribs.
- C. Parents report a mass on the abdomen that crosses the midline.
- D. Palpation reveals asymptomatic mass on the upper back.
Correct Answer: B
Rationale: Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents, typically arising in flat bones like the pelvis, chest wall (e.g., ribs), or vertebrae, and the diaphysis of long bones. A hallmark is a palpable, non-tender mass, making non-tender swelling on the ribs a strong indicator, as it aligns with the tumor's common chest wall location and lack of initial pain sensitivity. Dull bone pain above the knee suggests a long bone issue, possibly osteosarcoma, which favors the metaphysis, not Ewing's typical diaphysis site. An abdominal mass crossing the midline is more characteristic of Wilms tumor or neuroblastoma, not Ewing sarcoma. An asymptomatic upper back mass could suggest various tumors, but lacks specificity for Ewing's flat bone preference. Nurses must recognize this presentation to facilitate prompt imaging and biopsy, critical for early diagnosis and treatment planning in pediatric oncology.