Nokea
People with obesity generally respond more strongly to food cues than non-obese people. Question: Which behavioural training is most indicated to reduce this mechanism?
- A. Cognitive modulation training
- B. Compulsivity training
- C. Extinction training
- D. None of the options above
Correct Answer: C
Rationale: Food cues overdrive extinction dims them, not cognitive tweaks or compulsion drills. Nurses train this, a chronic cue fade.
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For a patient on the chemotherapeutic drug vincristine (Oncovin), which of the following side effects should be reported to the physician?
- A. Fatigue
- B. Nausea and vomiting
- C. Paresthesia
- D. Anorexia
Correct Answer: C
Rationale: Vincristine, a vinca alkaloid, disrupts nerve function, making paresthesia tingling or numbness a critical side effect signaling neurotoxicity, warranting physician review for dose adjustment or cessation. Fatigue, nausea, and anorexia, while common in chemotherapy, are manageable with nursing interventions rest, antiemetics, small meals unless severe. Paresthesia's specificity to vincristine's mechanism, targeting microtubules, elevates its urgency; unchecked, it risks permanent nerve damage, impacting mobility and quality of life. Reporting it ensures timely intervention, distinguishing it from routine effects, a key nursing responsibility in monitoring chemotherapy's narrow therapeutic window.
Postoperative care at the completion of bimaxillary surgery:
- A. Is likely to be complicated by the presence of intermaxillary fixation (IMF).
- B. Involves awake rather than asleep extubation.
- C. Requires gentle removal of the tracheal tube to avoid damage of mandibular plates and screws.
- D. Involves reinsertion of a nasal tracheal tube when complicated by airway bleeding or obstruction requiring emergency reintubation.
Correct Answer: A
Rationale: Bimaxillary surgery's postoperative phase is complex. Intermaxillary fixation (IMF) aligns jaws but restricts mouth opening, complicating airway management, vomiting, and oral care raising aspiration or obstruction risks. Awake extubation is preferred, ensuring airway reflexes return, critical with IMF and swelling. Gentle tube removal prevents surgical site trauma (e.g., plates), though mandibular hardware is internal, less tube-accessible. Emergency reintubation may use nasal routes due to IMF, addressing bleeding/obstruction. HDU care is case-specific, not mandatory. IMF's presence drives tailored strategies, prioritizing airway security and patient stability in this high-risk recovery period.
Which of the following is FALSE regarding patient education for insulin therapy?
- A. It improves the patients experience and adherence to insulin therapy
- B. It requires time and preparation
- C. Different topics and focus can be covered at different stages of insulin therapy
- D. It can only be done by diabetes nurse educators
Correct Answer: D
Rationale: Patient education for insulin therapy enhances experience and adherence, requires time, and varies by stage e.g., injection skills at initiation, hypoglycemia management later all true per diabetes guidelines. However, stating it can only be done by diabetes nurse educators is false. While specialized educators excel, other healthcare professionals (physicians, pharmacists) can deliver effective education, especially in resource-limited settings. Multidisciplinary involvement ensures broader access and periodic understanding checks, vital for chronic disease management. This flexibility empowers diverse teams to support patients, debunking the exclusivity myth.
A 4 week old baby is due for her second Hepatitis B vaccine dose. However, you note that the baby is mildly jaundiced. What would be the most appropriate step to take next?
- A. Screen for the Hepatitis B virus and only proceed with immunisation if the results are negative
- B. Immunisation is not required as the baby may already have hepatitis
- C. Give the hepatitis B vaccine and arrange for investigation for the jaundice
- D. Proceed with the vaccination but also give the Hepatitis B immunoglobulin at another site
Correct Answer: C
Rationale: Mild jaundice at 4 weeks likely physiologic or breast milk, not hep B vaccine's safe, so jab and probe cause. Screening delays, skipping's wrong, deferring's cautious overkill, immunoglobulin's for exposure. Nurses roll this, a chronic vax-plus-check play.
Cortical stimulation:
- A. Occurs before resection of a tumour.
- B. Localizes areas involved with hearing.
- C. Occurs by indirect application of electrodes.
- D. Allows identification of Wernicke's area, which is involved in the comprehension of language.
Correct Answer: D
Rationale: Cortical stimulation in awake craniotomy maps eloquent brain areas before tumor resection to avoid functional loss. It's performed pre-resection to define safe boundaries, localizing motor, sensory, and language areas, including hearing-related regions in the temporal lobe. Electrodes are applied directly to the cortex, not indirectly, for precision. Wernicke's area, in the dominant temporal lobe, is critical for language comprehension, and stimulation identifies it by eliciting speech errors (e.g., paraphasia). Seizures can occur, managed with cold saline irrigation, not warm. The ability to pinpoint Wernicke's area is pivotal, as its preservation ensures postoperative language function, balancing oncologic goals with quality of life in eloquent cortex surgeries.