Nokea
NASH contributes to the risk of cardiovascular disease via which mechanism in the liver?
- A. Reduced production of VLDL
- B. Reduced production of glucose
- C. Increased production of CRP
- D. Increased production of HDL
Correct Answer: C
Rationale: NASH ups heart risk CRP, inflammation's flag, flares from liver, not VLDL drop, glucose dip, or HDL boost. Nurses spot this, a chronic CV spark.
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The nurse is caring for a 55-year-old male who presented to this primary physician's office for his yearly check-up. Upon the physical assessment, the provider noted enlarged lymph nodes in the groin and neck region. The provider Questioned Joe regarding the possible causes of the finding. Which of the following diagnosis are consistent with this finding?
- A. Leukemia
- B. Lymphoma
- C. Sickle cell anemia
- D. Polycythemia vera
Correct Answer: B
Rationale: Lymphoma swells nodes neck and groin lumps fit this cancer's lymphoid sprawl, a diagnosis matching this check-up find. Leukemia bones out, sickle cell pains, polycythemia thickens none node-centric. Nurses tie this to lymphoma, anticipating biopsy, a nodal tale in this cancer hunt.
While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as the priority in the client's care?
- A. Ineffective peripheral tissue perfusion
- B. Alteration in body image
- C. Impaired skin integrity
- D. Alteration in activity tolerance
Correct Answer: C
Rationale: Varicose veins with ulcerations, edema, and heaviness scream venous stasis impaired skin integrity tops the list as open sores risk infection, a pressing threat needing immediate wound care. Ineffective perfusion drives the issue, but skin breakdown's acuity trumps. Body image matters emotionally, less urgently. Activity tolerance lags behind active complications. Nurses prioritize skin integrity, addressing ulcers' vulnerability, a direct care focus to halt deterioration in this chronic venous picture, aligning with safety and healing goals.
A primary nursing responsibility is the prevention of lung cancer by assisting patients in smoking/tobacco cessation. Which tasks would be appropriate to delegate to the LPN/LVN?
- A. Develop a quit plan
- B. Explain the application of a nicotine patch
- C. Discuss strategies to avoid relapse
- D. Suggest ways to deal with urges for a tobacco
Correct Answer: B
Rationale: LPN/LVNs shine in standardized teaching like explaining nicotine patch application, a medication-focused task within their scope, detailing placement and timing to aid cessation. Developing a quit plan requires RN-level planning and assessment of individual needs. Discussing relapse strategies involves behavioral counseling, an RN forte. Suggesting urge-coping methods needs tailored insight, beyond LPN/LVN training. Patch explanation leverages their skills, supporting lung cancer prevention through practical cessation aid, a delegated task enhancing team efforts while keeping complex planning with RNs.
Ziconotide is:
- A. Licensed for administration by the intrathecal route in Europe and North America.
- B. Associated with intrathecal granuloma formation.
- C. Contraindicated in schizophrenic patients.
- D. Likely to lead to hypogonadotropic hypogonadism during long-term infusion.
Correct Answer: A
Rationale: Ziconotide, a non-opioid analgesic, blocks N-type calcium channels intrathecally. It's licensed in Europe and North America for chronic pain (e.g., cancer, neuropathic), delivered via pumps. Unlike opioids, it doesn't form granulomas at catheter tips those are opioid-specific complications. It's contraindicated in psychosis (e.g., schizophrenia) due to neuropsychiatric side effects (confusion, hallucinations), per prescribing guidelines. Hypogonadism isn't linked; that's an opioid effect via hypothalamic suppression. Tolerance occurs, requiring dose escalation, but it's manageable. Its licensure reflects extensive trials showing efficacy and safety for refractory pain, distinguishing it as a targeted, non-addictive option in intrathecal therapy, critical for patients intolerant to opioids.
Strategies to overcome barriers and challenges faced in insulin therapy include the following EXCEPT:
- A. Close supervision for the patient's first jab
- B. Threaten patient into adherence with insulin therapy
- C. Engage patient from the start
- D. Offer the least painful options currently available in the market
Correct Answer: B
Rationale: Insulin wins guide first shots, engage early, ease pain, set sharp goals; threats flop, breed resentment. Nurses coach this chronic game, not bully.