Nokea
People with poorly controlled type 2 diabetes often show increased fasting blood glucose levels. Question: What causes these increased fasting blood glucose levels?
- A. Disturbed glucose uptake in adipose tissue due to insulin resistance
- B. Disturbed hepatic glucose uptake due to insulin resistance
- C. Disturbed suppression of hepatic glucose production by insulin
- D. Disturbed hepatic glucose uptake due to reduced insulin levels in portal blood
Correct Answer: C
Rationale: Type 2's fasting high liver pumps glucose, insulin can't hush it, resistance rules. Fat uptake's small, liver uptake's not key production's the leak nurses target this, a chronic dawn gush.
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After receiving the hand-off report, which client should the oncology nurse see first?
- A. Client who is afebrile with a heart rate of 108 beats/min
- B. Older client on chemotherapy with mental status changes
- C. Client who is neutropenic and in protective isolation
- D. Client scheduled for radiation therapy today
Correct Answer: B
Rationale: In oncology nursing, prioritizing care is critical due to the complexity of cancer patients' conditions. An older client on chemotherapy with mental status changes is the priority because this could signal sepsis or infection, especially since chemotherapy-induced neutropenia often masks typical signs like fever in the elderly. Mental confusion might be the only early clue, and delayed assessment could lead to rapid deterioration or death. A heart rate of 108 beats/min without fever suggests tachycardia, possibly from dehydration or anxiety, but it's less urgent without other red flags. A neutropenic client in isolation needs monitoring, but no acute change is noted. The client scheduled for radiation has a planned treatment, not an immediate crisis. Assessing the older client first allows the nurse to rule out or address a life-threatening issue, aligning with the principle of prioritizing unstable patients in acute care settings.
Which set of classification values indicates the most extensive and progressed cancer?
- A. T1 N0 M0
- B. T10 N0 M0
- C. T1 N1 M0
- D. T4 N3 M1
Correct Answer: D
Rationale: TNM staging gauges cancer extent: T (tumor size), N (node involvement), M (metastasis). T4 N3 M1 marks the worst T4 signals a large, invasive tumor, N3 extensive nodal spread, M1 distant metastases, painting a picture of widespread, advanced disease. T1 N0 M0 is small, localized, no spread early stage. T10 isn't standard (likely T1), still less severe. T1 N1 M0 has minor nodal involvement, not extensive. T4 N3 M1's combination screams progression, guiding nurses to expect aggressive care or palliation, a stark contrast to earlier stages' hopeful prognosis, critical for planning in advanced cancer.
The client is admitted for heart failure and has edema, neck vein distension, and ascites. What is the most accurate way to monitor fluid gain or loss in this client?
- A. Auscultate the lungs for crackles or wheezing
- B. Weigh the client daily at the same time with the same scale
- C. Check for pitting edema in the dependent body parts
- D. Assess skin turgor and the condition of mucus membranes
Correct Answer: B
Rationale: Heart failure's fluid dance edema, JVD, ascites needs precise tracking. Daily weights, same time, same scale, catch 1 kg shifts (1 L fluid), the gold standard for gain or loss, outpacing lung sounds' subjectivity. Edema checks or turgor gauge trends, less exact. Nurses weigh in, ensuring diuretic tweaks hit the mark, a reliable ruler in this swollen saga.
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.
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.