Nokea
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Recognition and self-management of hypoglycaemia
- C. Sick day management
- D. Stopping all oral hypoglycaemic agents
Correct Answer: D
Rationale: Insulin education builds control technique, hypo spotting, sick days, and driving safety are musts, ensuring delivery, crisis handling, and road smarts. Stopping all oral agents isn't universal; many stay on metformin or SGLT-2s for synergy, not a blanket rule. Tailored plans keep or ditch orals, dodging this absolute. Clinicians teach what fits, not a one-size purge, a nuanced chronic care tweak over rigid cuts.
You may also like to solve these questions
In the clinical assessment of heart failure, which of the following is FALSE?
- A. Jugular venous distention, an S1 heart sound, and non-displaced apical impulse significantly increase the likelihood of the diagnosis
- B. Hypertension, CAD, and valvular disease are the most common causes
- C. Fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and edema are common symptoms
- D. Cardiomegaly on CXR is helpful in supporting the diagnosis
Correct Answer: A
Rationale: Jugular venous distention and edema suggest heart failure, but S1 (normal first sound) and non-displaced apical impulse don't increase diagnostic likelihood S3 or displaced impulse do, per clinical criteria. Common causes (HTN, CAD, valvular disease), symptoms, and cardiomegaly on CXR are true. ECG is vital. This corrects diagnostic focus in chronic HF assessment.
Heart failure with preserved ejection fraction is caused by:
- A. Ventricular hypertrophy reducing contractility of muscles
- B. Decreased perfusion of the myocardium
- C. Dilated cardiomyopathy
- D. Impaired ventricular relaxation resulting in the lack of ability of ventricles to fill with blood
Correct Answer: D
Rationale: HFpEF stiff ventricles won't relax, slashing fill-up, not pump-out. Hypertrophy aids, doesn't cause; perfusion dips hurt supply; dilated's HFrEF. Nurses target this, a chronic fill flaw.
Percutaneous cervical cordotomy:
- A. Is performed under general anaesthesia.
- B. Occurs by entry of a needle into the intervertebral foramen between cervical vertebrae C4 and C5.
- C. Involves thermoablation of the anterior spinothalamic tract.
- D. Is performed on the same side as the pain.
Correct Answer: C
Rationale: Percutaneous cervical cordotomy (PCC) relieves cancer pain via targeted nerve destruction. It's done under local anesthesia with sedation, not general, to monitor patient response (e.g., pain relief, side effects) during stimulation. The needle enters at C1-C2, not C4-C5, targeting the lateral spinothalamic tract contralateral to the pain not the anterior tract explicitly, though terminology varies. Thermoablation destroys pain fibers, confirmed by test stimulation. It's performed opposite the pain side due to crossed spinothalamic pathways. Complete numbness isn't typical; sensory loss is partial. Thermoablation's specificity using radiofrequency to interrupt pain transmission defines PCC's efficacy, minimizing damage to adjacent motor tracts while achieving analgesia.
A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
- A. Pruritis (itching)
- B. Nausea and vomiting
- C. Altered glucose metabolism
- D. Confusion
Correct Answer: B
Rationale: Nausea and vomiting top the chemo side-effect list, hitting most patients due to drugs (e.g., cisplatin, doxorubicin) irritating the gut and triggering the brain's vomiting center. It can last 24-48 hours post-dose, often needing antiemetics like ondansetron. Pruritis might occur with specific agents or reactions, but it's less universal. Glucose metabolism shifts are rare, tied to steroids or endocrine effects, not a chemo hallmark. Confusion could stem from brain mets or fatigue, not a primary effect. Nurses prep patients for this duo nausea and vomiting ensuring they know it's manageable with meds and timing, easing anxiety and boosting adherence in early oncology treatment.
When caring for a patient who is pancytopenic, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene?
- A. The UAP assists the patient to use dental floss after eating.
- B. The UAP adds baking soda to the patient's saline oral rinses.
- C. The UAP puts fluoride toothpaste on the patient's toothbrush.
- D. The UAP has the patient rinse after meals with a saline solution.
Correct Answer: A
Rationale: Pancytopenia low everything means flossing risks bleeding and infection in a mouth with no platelets or immunity; baking soda , fluoride , and saline are safe. Nurses in oncology stop this UAP need soft-brush guidance, not floss, to protect fragile mucosa.