Nokea
Proven treatment for patients with noncirrhosis from NAFLD include the following except:
- A. Liver transplant
- B. Bariatric surgery
- C. Vitamin E
- D. Weight loss
Correct Answer: A
Rationale: Noncirrhotic NAFLD bends to weight loss, bariatric cuts, and Vitamin E's antioxidant punch proven aids. Transplant's endgame for cirrhosis, not here. Metformin flops for fat, despite diabetes use. Clinicians skip this organ swap, leaning on lifestyle and pills, a chronic fix before scars hit.
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Which patient is at greatest risk for pancreatic cancer?
- A. An elderly black male with a history of smoking and alcohol use
- B. A young, white obese female with no known health issues
- C. A young black male with juvenile onset diabetes
- D. An elderly white female with a history of pancreatitis
Correct Answer: A
Rationale: Pancreatic cancer risk escalates with specific factors: age, race, smoking, and alcohol. An elderly Black male with smoking and alcohol history tops the list incidence peaks in older adults, Black populations face higher rates, and both habits are strong carcinogens, damaging pancreatic tissue over time. A young, obese white female has obesity as a risk, but youth and fewer exposures lower her odds. A young Black male with diabetes links to a risk factor, yet juvenile onset and age reduce immediate concern. An elderly white female with pancreatitis has a notable risk chronic inflammation predisposes but lacks the compounded impact of smoking and alcohol. The elderly Black male's profile aligns with epidemiological data, making him the nurse's focus for vigilant monitoring and early detection efforts.
Which is the most common organism/s causing osteomyelitis in all age groups?
- A. streptococci
- B. staph aureus
- C. gm negatives
- D. hemophilus
Correct Answer: B
Rationale: Staph aureus reigns in osteomyelitis bone's bane across kids to geezers, sticking to marrow like glue. Streptococci hit less, gram-negatives tag trauma, hemophilus fades post-vaccine, fungi creep rare. Nurses bank on this staph stat, a chronic skeleton scourge needing targeted juice.
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.
In the treatment of COPD:
- A. Inhaled long-acting β₂ agonists are a first-line treatment for breathlessness.
- B. Most patients require maintenance use of oral corticosteroids.
- C. The dosage of oral theophylline needs to be reduced in patients commenced on erythromycin.
- D. Long-term oxygen therapy is indicated in a stable patient with a Paâ‚“â‚‚ of 8.5 kPa.
Correct Answer: C
Rationale: COPD management focuses on symptom relief and preventing exacerbations. Inhaled long-acting β₂ agonists are indeed used for breathlessness but are not always first-line; short-acting bronchodilators often precede them. Maintenance oral corticosteroids are not standard due to significant side effects; inhaled corticosteroids are preferred. Theophylline, a bronchodilator, has its metabolism inhibited by erythromycin (a CYP3A4 inhibitor), increasing plasma levels and toxicity risk, necessitating dose reduction. Long-term oxygen therapy is indicated for severe hypoxemia (Paₓ₂ < 7.3 kPa or 7.3-8 kPa with complications), not at 8.5 kPa, which is relatively normal. Non-invasive ventilation is reserved for acute exacerbations, not first-line treatment. The interaction between theophylline and erythromycin is a critical pharmacological consideration in COPD management, making it the standout correct statement.
The nurse is caring for four clients on a post-surgical unit. The nurse understands that monitoring the client for which post-operative complication takes priority?
- A. Nausea
- B. Constipation
- C. Pneumonia
- D. Urinary retention
Correct Answer: C
Rationale: Post-op lungs falter pneumonia from atelectasis or aspiration tops risks, a breathing threat per ABCs over nausea's discomfort. Constipation or retention nag, not kill. Nurses watch breathing, pushing incentive spirometry, a priority catch in this surgical haze.