Nokea
Mr Tan aged 50 years old has a blood pressure of 160/100 mmHg taken on waking up and 140/90 mmHg at night. He also has a UAE of 200 mg/24 hours. He has type 2 diabetes. Which of the following actions will be most likely reduce the UAE to normal?
- A. Get the patient to lose 10% of his body weight
- B. Prescribe a SGLT2 e.g. empagliflozin
- C. Control the blood pressure to 130/80 mmHg
- D. Get the patient to exercise 150 minutes a week
Correct Answer: C
Rationale: UAE 200, diabetes BP to 130/80 slashes albumin; weight, SGLT2, exercise, nifedipine help less direct. Nurses hit this chronic kidney key.
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A client diagnosed with stable angina is complaining of substernal chest pain, rating the pain 5 out of 10. What would be the priority action by the nurse?
- A. Administer the client's prescribed beta-blocker
- B. Administer nitroglycerin intravenously immediately
- C. Administer morphine
- D. Administer 325 mg of chewable aspirin immediately
Correct Answer: D
Rationale: Stable angina's oxygen pinch 5/10 pain bows to aspirin's antiplatelet punch, cutting clot risk fast, a priority over beta-blockers' slow rate drop. IV nitroglycerin's for MI, morphine's overkill, aspirin's chewed for quick absorption. Nurses hit this, easing ischemia, a front-line move in this chest squeeze.
Diabetes mellitus can cause damage to the microvasculature and macrovasculature. Question: The microvasculature is involved in which of the following disorders?
- A. Nephropathy
- B. Retinopathy
- C. Polyneuropathy
- D. All answers are correct
Correct Answer: D
Rationale: Diabetes' micro hits kidneys, eyes, nerves all bleed small, no dodge. Nurses track this, a chronic tiny vessel trio.
The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider?
- A. Generalized muscle aches
- B. Crackles heard at the lung bases
- C. Complaints of nausea and anorexia
- D. Oral temperature of 100.6°F (38.1°C)
Correct Answer: B
Rationale: IL-2 can spark capillary leak crackles at lung bases signal pulmonary edema, an emergency needing fast action over aches , nausea , or low fever , all common. Nurses in oncology flag this fluid in lungs kills quick, demanding stat calls.
A nurse is caring for a client who has recently diagnosed with left ventricular heart failure. What is an early sign the client is most likely to report?
- A. Dyspnea on exertion
- B. Abdominal distention
- C. Swollen legs
- D. Weight gain
Correct Answer: A
Rationale: Left ventricular failure backs blood into lungs dyspnea on exertion hits early as fluid seeps, taxing breathing during activity, a telltale sign before systemic effects. Abdominal distention or leg swelling marks right-sided or late failure. Weight gain tracks fluid, not initial. Nurses catch dyspnea, educating clients to report it, key to early management in this progressive pump failure.
An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRMs). The nurse should know that these achieve a therapeutic effect by what means?
- A. Promoting the synthesis and release of leukocytes
- B. Focusing the patient's immune system exclusively on the tumor
- C. Potentiating the effects of chemotherapeutic agents and radiation therapy
- D. Altering the immunologic relationship between the tumor and the patient
Correct Answer: D
Rationale: BRMs (e.g., interferon, IL-2) tweak the immune-tumor dance revving up the body's attack or slowing cancer's evasion, not just pumping out leukocytes or boosting chemo/radiation. They don't laser-focus immunity but shift the balance, like marking tumors for T-cells. Nurses in oncology grasp this, knowing BRMs offer a Hail Mary when standard stuff flops, targeting that host-tumor interplay.