Nokea
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Stopping all oral hypoglycaemic agents
- C. Recognition and self-management of hypoglycaemia
- D. Sick day management
Correct Answer: B
Rationale: Insulin therapy education for diabetes patients covers injection technique, hypoglycemia recognition and management, sick day rules, and safe driving, per diabetes care standards. However, stopping all oral hypoglycemic agents isn't universally essential many patients continue agents like metformin or SGLT-2 inhibitors alongside insulin for synergistic effects, depending on glycemic control needs. Assuming cessation oversimplifies treatment plans, potentially reducing efficacy. Education must tailor to individual regimens, not mandate stopping orals, making this the exception. Physicians ensure comprehensive teaching to enhance adherence and safety, critical in chronic disease management.
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In patients who are awake during craniotomy, appropriate statements include:
- A. For a temporal lesion, neurosurgeons are likely to require the sitting position.
- B. A tracheal tube is likely to be used.
- C. A urinary catheter is likely to be inserted.
- D. Intraoperative seizures are likely to occur during cortical mapping.
Correct Answer: C
Rationale: Awake craniotomy allows functional mapping and patient cooperation. The sitting position is rare due to air embolism risks and is not specific to temporal lesions; supine or lateral positions are standard. A tracheal tube is avoided to maintain airway control via less invasive means (e.g., nasal cannula), as patients must remain responsive. A urinary catheter is routine for longer procedures to manage fluid balance and patient comfort, given immobility and duration. Patient anxiety is common but manageable, not an absolute contraindication. Seizures can occur during cortical mapping due to electrical stimulation, but likely' overstates frequency; they're a risk, not a certainty. The urinary catheter's inclusion reflects practical perioperative care, ensuring monitoring and comfort without interrupting the procedure's focus on brain function preservation.
The nurse is caring for a 65-year-old female who presented to the emergency department with shortness of breath and chest discomfort. The client has not been feeling well for the past few days and complains of a productive cough of blood-tinged sputum. Laboratory tests reveal an elevated brain natriuretic peptide (BNP), and chest x-ray reveals pulmonary congestion. Based on the assessment findings, which of the following diagnosis are consistent with these findings?
- A. Heart failure (left-sided)
- B. Lung cancer
- C. Heart failure (right-sided)
- D. Pulmonary embolism
Correct Answer: A
Rationale: Elevated BNP and pulmonary congestion plus dyspnea, chest pain, hemoptysis point to left-sided heart failure, where ventricle falters, flooding lungs with fluid. Lung cancer might bleed but lacks BNP spike. Right-sided failure swells periphery, not lungs initially. Pulmonary embolism clots, not congests, with normal BNP. Nurses link this to left heart strain, anticipating diuretics, a diagnosis fitting this wet-lung picture.
Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.
Prescription of long term oxygen therapy has some very strict guidelines. In order to qualify for this treatment, the patient has to:
- A. Be admitted to hospital 3 times within a 12 month time frame with acute exacerbation of COPD
- B. Demonstrate a significant impairment of QOL because of dyspnoea and decreased exercise capacity
- C. Have very high levels of anxiety which impact on their ability to self-manage and increase stress on carer
- D. Have a diagnosis of severe COPD with PaO2 of >55 mmHg, or evidence of tissue hypoxia and end organ damage
Correct Answer: D
Rationale: O2's lifeline demands proof severe COPD with PaO2 ≤55 mmHg or hypoxia's organ bite, a strict cut. Admissions, QOL dips, anxiety don't seal it hypoxemia does. Nurses gatekeep this, a chronic oxygen rule.
What is an important independent risk factor for the development of type 2 diabetes mellitus?
- A. Alcohol use
- B. Ethnicity
- C. Socioeconomic status
- D. All three options above
Correct Answer: B
Rationale: Ethnicity stands tall South Asians, Hispanics outpace Caucasians in type 2 risk, genes and fat patterns at play. Alcohol's murky, socioeconomic status shapes access, not biology nurses see heritage trump these, a chronic marker needing tailored screens.