Nokea
Question: Which statement applies to glucose measurement in a central laboratory? Statement 1: Glucose values are normally determined in venous blood. Statement 2: Glucose values are given in plasma values. Which answer is correct?
- A. Both statements are correct
- B. Both statements are incorrect
- C. Statement 1 is correct; statement 2 is incorrect
- D. Statement 1 is incorrect; statement 2 is correct
Correct Answer: A
Rationale: Lab glucose venous blood, plasma read, both true, a chronic standard nurses trust.
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In the UK, percutaneous cervical cordotomy is likely to be:
- A. Indicated in patients with unilateral pain due to cancer.
- B. Indicated in patients with non-malignant pain.
- C. Effective for neck pain.
- D. Deferred until less invasive techniques have been shown to be unsuccessful.
Correct Answer: A
Rationale: Percutaneous cervical cordotomy (PCC) targets intractable pain in the UK. It's primarily indicated for unilateral cancer pain (e.g., mesothelioma), ablating the contralateral spinothalamic tract for relief below the lesion level. Non-malignant pain rarely justifies PCC due to its invasiveness and risks; alternatives like opioids suffice. Neck pain, above the typical C1-C2 entry, isn't effectively treated by PCC, which addresses lower body pain. CT guidance is common, not just fluoroscopy, for precision. It's a last resort after failed conservative treatments (e.g., nerve blocks), but the cancer-specific indication is primary unilateral pain's anatomical fit with PCC's mechanism (thermoablation) makes it a specialized palliative tool, balancing efficacy with procedural risk.
Appropriate statements concerning radiology and trauma interventional radiology include:
- A. To rule out injury of the cervical spine in the unconscious patient, application of a protocol involving a computed tomography (CT) scan to the neck is recommended.
- B. A FAST (Focused Assessment with Sonography for Trauma) scan is a specific investigation for assessment of intraperitoneal bleeding.
- C. In a patient who is persistently hypotensive in the emergency department despite adequate fluid resuscitation, radiological interventions to treat bleeding caused by a pelvic fracture are not recommended.
- D. Interventional radiology has a role in the management of injuries to the liver, kidney and spleen.
Correct Answer: A
Rationale: Trauma radiology optimizes diagnosis and intervention. CT is the gold standard for cervical spine assessment in unconscious patients, per NICE guidelines, offering high sensitivity for fractures/ligamentous injury versus plain films. FAST scans detect free fluid (e.g., blood) intraperitoneally but lack specificity positive findings need confirmation (e.g., CT). Persistent hypotension with pelvic fracture warrants interventional radiology (e.g., embolization), not dismissal contrary to the statement. Interventional radiology manages solid organ injuries (liver, kidney, spleen) via embolization, reducing surgical need. Staffing in radiology matches theatre for critical cases. CT's diagnostic precision in cervical spine trauma ensures timely, accurate management, critical in unconscious patients where clinical exam is unreliable.
For a patient who is receiving chemotherapy, which laboratory result is of particular importance?
- A. WBC
- B. PT and PTT
- C. Electrolytes
- D. BUN
Correct Answer: A
Rationale: Chemotherapy suppresses bone marrow, slashing white blood cell counts especially neutrophils heightening infection risk, making WBC monitoring paramount. Low counts trigger protective measures or treatment holds, directly tied to therapy's myelosuppressive core. PT and PTT track clotting, relevant for bleeding but less immediate. Electrolytes matter for overall status, but imbalances aren't chemotherapy's primary threat. BUN reflects kidney function, indirectly affected by some drugs, not the frontline concern. WBC's critical drop demands swift action fevers in neutropenia are emergencies underscoring its priority in safeguarding patients through treatment's immune-compromising phases.
Obesity is associated with an increased incidence of which of the following disorders?
- A. Dyslipidaemia
- B. Hypertension
- C. Cancer
- D. All disorders mentioned above
Correct Answer: D
Rationale: Obesity hauls dyslipidaemia, hypertension, cancer fat's a triple threat, no dodge. Nurses see this, a chronic disease bundle.
Caution should be exercised in the initiation of an ARNI in all of the following clinical scenarios except:
- A. Significant hyperkalaemia
- B. Significant renal dysfunction (eGFR <30 ml/min)
- C. Patient on a maximal dose ACE-inhibitor
- D. Non-alcoholic fatty liver disease (NAFLD)
Correct Answer: D
Rationale: ARNI (sacubitril/valsartan) risks spike with hyperkalemia, renal flop (eGFR <30), ACE-I overlap, or low BP potassium, filtration, washout, and perfusion all teeter. NAFLD? No biggie liver fat doesn't sway ARNI's game. Clinicians greenlight this, dodging chronic cautions elsewhere.