Nokea
Regarding oxygen consumption by the adult human body:
- A. It is approximately 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at rest in the awake adult patient.
- B. It rises to approximately 11 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at peak exercise in healthy young adults.
- C. Increases by approximately 5-fold after major surgery.
- D. Peak oxygen consumption is likely to be quantified accurately by cardiopulmonary exercise testing.
Correct Answer: A
Rationale: Oxygen consumption (VOâ‚‚) reflects metabolic demand. At rest, VOâ‚‚ is approximately 3-4 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ in awake adults, aligning with basal energy needs (250-300 ml/min total). During peak exercise, healthy young adults can reach 30-40 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹, far exceeding 11 ml, depending on fitness. Post-major surgery, VOâ‚‚ increases 50-100% (1.5-2-fold), not 5-fold, due to stress and healing, though critical illness may spike higher briefly. Cardiopulmonary exercise testing (CPET) accurately measures peak VOâ‚‚, unlike the Duke Activity Status Index, which estimates it via questionnaire. The resting value of 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ is a physiological constant, foundational to understanding perioperative oxygen delivery and demand.
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The best way to prevent chronic complications of diabetes is to:
- A. Take medications as prescribed and remove sugar from the diet completely.
- B. Check feet daily for cuts, long toe nails and infections between the toes.
- C. Maintain a BGL that is as close to normal as possible.
- D. Undertake daily exercise to burn up the excess glucose in the system.
Correct Answer: C
Rationale: Preventing diabetes complications (e.g., neuropathy, retinopathy) hinges on glycemic control. Medications and sugar elimination help, but total sugar removal is impractical carbohydrates are broader, and control, not absence, matters. Daily foot checks prevent ulcers but address consequences, not root causes. Maintaining blood glucose levels (BGL) near normal (e.g., HbA1c <7%) via diet, exercise, and drugs prevents microvascular (kidney, eye) and macrovascular (heart) damage, per ADA guidelines. Exercise burns glucose, aiding control, but isn't singularly best' it's part of a triad. Tight BGL management reduces oxidative stress, glycation, and vascular injury, evidenced by trials (e.g., DCCT), making it the cornerstone strategy over isolated tactics, ensuring long-term organ protection.
Which enzyme is activated by oxidative stress in endothelial cells and plays a key role in the development of complications?
- A. GAPDH
- B. Glyoxalase-1
- C. PARP
- D. Transketolase
Correct Answer: C
Rationale: PARP wakes to oxidative hits repairs DNA, drives damage in diabetes vessels, not GAPDH's stall, glyoxalase's detox, or transketolase's shunt. Nurses clock this, a chronic complication cog.
A 3-year-old girl with a Wilms tumor is returning to the unit after a simple nephrectomy. Which of the following actions have the highest priority in caring for this child?
- A. Maintaining NPO.
- B. Monitoring the BP every 2 hours.
- C. Turning her every 2 hours.
- D. Administering pain medication every 4 hours.
Correct Answer: B
Rationale: After a nephrectomy for Wilms tumor, monitoring blood pressure (BP) every 2 hours is the highest priority because kidney removal disrupts renin-angiotensin regulation, risking hypo- or hypertension, especially in a young child with one remaining kidney. Using the ABCs (airway, breathing, circulation), BP falls under circulation, a critical postoperative focus to detect shock or fluid imbalance early. Maintaining NPO is temporary post-anesthesia but shifts to hydration once awake, less urgent than BP. Turning every 2 hours prevents pressure ulcers, but a mobile 3-year-old post-simple nephrectomy likely moves independently unless sedated, lowering its priority. Pain medication is key but ranks lower (e.g., G' in extended ABCs) than circulation. Frequent BP checks ensure stability, aligning with nursing's role in pediatric surgical care to prevent complications in a child adapting to single-kidney function.
In which illness can hydrophobia be seen?
- A. tetanus
- B. malaria
- C. rabies
- D. EBV
Correct Answer: C
Rationale: Hydrophobia rabies' brain hates water, not tetanus' clench, malaria's sweat, EBV's glands, or HSV's sores. Nurses clock this chronic rabies red flag.
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.