Nokea
Renal failure is the second cause of death in patients with diabetes mellitus. Question: What is the end (histological) stage in the development of diabetic nephropathy?
- A. Arteriolar hyalinosis
- B. GBM thickening
- C. Kimmerstiel Wilson lesions
- D. Mesangial matrix expansion
Correct Answer: C
Rationale: Diabetic nephropathy's end Kimmerstiel Wilson nodules scar kidneys, past thickening or expansion. Nurses dread this, a chronic renal doom mark.
You may also like to solve these questions
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
The pathophysiology of Asthma differs from COPD as:
- A. It is characterised by airflow limitation
- B. There is abnormal inflammatory response to exposure to noxious particles or gases
- C. The airflow limitation is reversible
- D. It is considered an obstructive lung disease
Correct Answer: C
Rationale: Asthma's twist reversible airflow block sets it apart from COPD's fixed choke. Both obstruct, inflame to triggers, but asthma's airways bounce back with puffs. Nurses spot this, a chronic split for treatment.
Which agent should not be part of the management of generalized tetanus?
- A. metronidazole
- B. penicillin
- C. midazolam
- D. tetanus immunoglobulin
Correct Answer: B
Rationale: Tetanus penicillin's old school, metronidazole's better for Clostridium now; midazolam calms, Ig neutralizes, labetalol steadies. Nurses skip this chronic bug zapper.
Which statement is not true?
- A. chloroquine does not extinguish the dormant liver phase in vivax and ovale
- B. malaria is possible even if full prophylaxis is taken
- C. splenomegaly with rupture is possible
- D. a maculopapular rash is characteristic and common
Correct Answer: D
Rationale: Malaria's rash rare, not hallmark unlike liver hideouts, prophylaxis slips, spleen bombs, or outpatient fits. Nurses nix this chronic myth.
The nurse is caring for a 4-year-old child following surgical removal of a stage I neuroblastoma. Which of the following interventions will be most appropriate for this child?
- A. Applying aloe vera lotion to irradiated areas of skin
- B. Administering antiemetics as prescribed for nausea
- C. Giving medications as ordered via least invasive route
- D. Maintaining isolation as prescribed to avoid infection
Correct Answer: C
Rationale: Post-surgical care for a stage I neuroblastoma (localized, surgically resected) focuses on recovery with minimal invasiveness, making giving medications via the least invasive route preferably oral most appropriate for a 4-year-old. This reduces trauma, anticipates needs like pain relief, antiemetics, or steroids (e.g., dexamethasone for swelling), and suits a stable post-op child without chemotherapy or radiation yet, as stage I often requires surgery alone. Aloe vera implies radiation, not indicated here post-surgery. Antiemetics are useful but too narrow broader medication needs apply. Isolation isn't standard for stage I post-op unless immunosuppression emerges later. This intervention balances efficacy and comfort, aligning with pediatric nursing's goal to minimize distress while ensuring effective postoperative management.