Non modifiable risk factors for developing chronic illness includes
- A. Tobacco smoking
- B. Political factors
- C. Family history
- D. High blood pressure
Correct Answer: C
Rationale: Chronic illness risk splits family history's locked in, genes dictating diabetes or heart disease odds, unchangeable. Smoking's a choice, modifiable; politics shape systems, not biology; high BP's treatable, not fixed. Nurses flag this genetic thread, focusing prevention elsewhere, a chronic cornerstone where heritage trumps habits or policy.
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During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
You have just received the morning report from the night shift nurses. List the order of priority for assessing and caring for these patients.
- A. A patient who developed tumor lysis syndrome around 5:00 AM
- B. A patient with frequent reports of break-through pain over the past 24 hours
- C. A patient scheduled for exploratory laparotomy this morning
- D. A patient with anticipatory nausea and vomiting for the past 24 hours
Correct Answer: A
Rationale: Tumor lysis syndrome, an oncologic emergency from rapid cell breakdown, spikes electrolytes and risks renal failure its 5:00 AM onset demands immediate assessment for stability, trumping others. Surgery prep follows laparotomy needs readiness checks like NPO status, time-sensitive but stable. Breakthrough pain, chronic over 24 hours, requires analgesia adjustment, urgent but not life-threatening. Anticipatory nausea, psychogenic, needs comfort and antiemetics, least acute. Prioritizing tumor lysis aligns with ABCs circulation and organ function ensuring rapid intervention like fluids or dialysis, a nurse's critical triage call in this lineup.
Which of the following laboratory abnormalities is NOT associated with fatty liver?
- A. Elevated uric acid
- B. Elevated LDL-cholesterol
- C. Elevated fasting glucose
- D. Elevated creatinine kinase
Correct Answer: D
Rationale: Fatty liver (NAFLD) links to metabolic syndrome elevated uric acid, LDL-cholesterol, fasting glucose, and triglycerides reflect insulin resistance and dyslipidemia. Elevated creatinine kinase (CK) indicates muscle damage (e.g., myopathy), not a typical NAFLD feature, though liver enzymes (ALT/AST) rise. CK's absence from NAFLD profiles guides physicians in differential diagnosis during chronic liver disease assessment.
The New York Heart Association functional class has four grades and is used to assess severity of CHF and impact on QOL. Class III is described as:
- A. Slight impairment of physical activity: comfortable at rest but ordinary activity results in fatigue and palpitations
- B. Unable to carry out any physical activity without discomfort: symptoms of CHF are present even at rest with increased discomfort with any physical activity
- C. No limitation: ordinary physical activity does not cause undue fatigue, dyspnoea or palpitations
- D. Marked limitation of physical activity: comfortable at rest but less than ordinary activity results in symptoms
Correct Answer: D
Rationale: NYHA Class III big limits; rest's fine, but small moves spark symptoms, a QOL hit. Slight's I; none's 0; all-out's IV. Nurses gauge this, a chronic heart's midway bind.
People with metabolic syndrome have an increased risk of which of the following disorders, besides type 2 diabetes mellitus?
- A. Hypertension, infections
- B. Myocardial infarction, hypertension
- C. Myocardial infarction, infections
- D. Myocardial infarction, liver cirrhosis
Correct Answer: B
Rationale: Metabolic syndrome hikes heart attacks, hypertension vascular hits, not infections or cirrhosis extras. Nurses track this, a chronic CV duo.