Nokea
Strategies to overcome barriers and challenges faced in insulin therapy include the following EXCEPT:
- A. Close supervision for the patient's first jab
- B. Threaten patient into adherence with insulin therapy
- C. Engage patient from the start
- D. Offer the least painful options currently available in the market
Correct Answer: B
Rationale: Insulin wins guide first shots, engage early, ease pain, set sharp goals; threats flop, breed resentment. Nurses coach this chronic game, not bully.
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The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.
The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse?
- A. Shortness of breath
- B. Shivering and chills
- C. Muscle aches and pains
- D. Temperature of 100.2°F (37.9°C)
Correct Answer: A
Rationale: Rituximab, a monoclonal antibody, can trigger anaphylaxis shortness of breath yells airway trouble, needing stat infusion halt over chills , aches , or mild fever . Nurses in oncology jump breathing trumps flu-like norms, a life-or-death call.
With regards to metabolic and bariatric surgery performed in East Asia, which ONE of the following is most commonly performed?
- A. Roux-en-Y gastric bypass (RYGB)
- B. Adjustable gastric banding (AGB)
- C. Mini-gastric bypass
- D. Sleeve gastrectomy (SG)
Correct Answer: D
Rationale: In East Asia, sleeve gastrectomy (SG) has emerged as the most common bariatric surgery, surpassing Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB), per regional data and trends. SG's popularity stems from its technical simplicity, lower complication rates, and effectiveness in weight loss and metabolic improvement, appealing in populations with lower average BMI but high visceral fat, like Asians. RYGB, while effective, is less favored due to complexity and malabsorption risks. AGB has declined globally due to less sustained outcomes. Mini-gastric bypass is rising but not dominant. SG's prominence reflects practical and cultural fit, informing physicians on regional preferences for obesity management.
Which statement about carcinogenesis is accurate?
- A. An initiated cell will always become clinical cancer.
- B. Cancer becomes a health problem once it is 1 cm in size.
- C. Normal hormones and proteins do not promote cancer growth.
- D. Tumor cells need to develop their own blood supply.
Correct Answer: D
Rationale: Carcinogenesis is the multi-step process by which normal cells transform into cancer cells, involving initiation, promotion, and progression. A key aspect of this process is angiogenesis, where tumor cells induce the formation of new blood vessels to supply nutrients and oxygen, enabling their growth beyond a minimal size. This is a critical step, as without a blood supply, tumors cannot sustain themselves or expand significantly. The statement that an initiated cell always becomes cancer is inaccurate because initiation alone is not sufficient; it requires promoters to progress. Similarly, the idea that cancer only becomes a problem at 1 cm oversimplifies the issue tumors can pose health risks earlier depending on location and type, though 1 cm is a detectable size. Normal hormones and proteins, like estrogen or growth factors, can indeed act as promoters in carcinogenesis, contradicting that option. Thus, the need for a tumor to develop its own blood supply is the most accurate statement, reflecting a fundamental biological requirement for cancer progression, which nurses must recognize when caring for oncology patients.
Which of the following statements is INCORRECT? The treatment of diabetes in traditional Chinese medicine involves
- A. Formula for Diabetes (Xiaoke Fang) for the Upper Type: Heat in the Lung which consumes Body Fluid
- B. Jade Maid Decoction (Yunu Jiang) for the Middle Type: excessive Heat in the Stomach
- C. Six Ingredients Rehmannia Pill (Liuwei Dihuang Wan) for the Lower Type: excessive of Kidney Yin and excessive of Yin and Yang
- D. Yam (Dioscorea opposita)
Correct Answer: C
Rationale: Traditional Chinese diabetes care Upper, Middle, Lower types nails Lung heat, Stomach fire, but Kidney's Yin deficiency, not excess Yin-Yang, flops. Xiaoke Fang, Yunu Jiang fit; Liuwei Dihuang Wan balances, doesn't overdo; yam's a lone root, not typed. Clinicians spot this, a chronic TCM misstep.