Nokea
The body has several mechanisms to increase the blood glucose level in case of hypoglycaemia. Question: Which of the following options best describes the role of glucagon and adrenaline in hypoglycaemia?
- A. Glucagon and adrenaline stimulate glycogenolysis in the liver
- B. Glucagon and adrenaline inhibit the insulin-stimulated glucose uptake in the muscles
- C. Glucagon stimulates glycogen synthase and adrenaline stimulates glycogenolysis in the liver
- D. Glucagon and adrenaline stimulate glycogen synthase en adrenaline stimulates glycogenolysis in the muscles
Correct Answer: A
Rationale: Hypo hits glucagon and adrenaline rip glycogen apart in liver, sugar surges. No muscle block, no synthase flip straight breakdown's the play nurses watch this, a chronic rescue duo.
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A 65-year-old male client is brought via EMS to the emergency department with chest pain. He rates the pain as a 10 on a scale from 0-10; the pain is located mid-sternum and radiates to his left arm. His heart rate is 126 beats/minute and blood pressure are 96/60 mm Hg. A 12-lead electrocardiogram is performed and reveals ST-segment elevation. Which of the following interventions does the nurse anticipate performing immediately?
- A. Administer oxygen
- B. Administer morphine
- C. Administer a statin
- D. Administer nitroglycerin
Correct Answer: A
Rationale: ST-elevation MI (STEMI) signals acute coronary occlusion severe chest pain, tachycardia, and hypotension demand oxygen first to counter hypoxia, per ABCs, buying time for reperfusion. Morphine eases pain, nitroglycerin dilates (if BP allows), but oxygen's immediate. Statins aid long-term, not now. Nurses prioritize oxygen, anticipating cath lab prep, a critical step in this time-sensitive infarct emergency.
The nurse is reviewing laboratory values for a client. Which of the following lab values should the nurse address immediately?
- A. Potassium 5.9 mmol/L
- B. Phosphorus 5.1 mg/dL
- C. Creatinine 6.2 mg/dL
- D. Sodium 147 mEq/L
Correct Answer: A
Rationale: Potassium 5.9 mmol/L above 5.5 sparks hyperkalemia, risking arrhythmias, a now-or-never fix over phosphorus's mild bump (3.0-4.5 normal). Creatinine's renal cry waits; sodium's high but tolerable. Nurses jump on potassium, anticipating ECG or kayexalate, a heart-stopping lab in this urgent sweep.
Your junior trainee has been in theatre for 5 h with a patient undergoing a femorodistal bypass procedure. He is yawning and seems withdrawn. The trainee's fatigue is likely to be improved by:
- A. Imbibing one 60 ml shot of espresso coffee.
- B. Taking a 1-h nap.
- C. Increasing the brightness of the theatre lighting.
- D. Walking around and chatting to other members of staff.
Correct Answer: B
Rationale: Fatigue during long procedures impairs performance. A 60 ml espresso shot (50-100 mg caffeine) boosts alertness temporarily (20-30 minutes onset), but its effect wanes after 5 hours of sustained effort. A 1-hour nap restores cognitive function and vigilance significantly, countering sleep pressure per sleep research (e.g., NASA nap studies), with benefits lasting hours. Bright lighting enhances alertness via circadian stimulation but is less effective mid-fatigue. Walking and chatting provide a break, mildly boosting arousal, but lack restorative depth. Microsleeps signal severe fatigue, worsening performance. A nap's superiority lies in addressing accumulated sleep debt, critical in high-stakes settings like surgery, offering sustained recovery over stimulants or environmental tweaks.
Which is not a differential diagnosis for tetanus?
- A. strychnine poisoning
- B. dystonic reactions
- C. quinsy
- D. rabies
Correct Answer: C
Rationale: Tetanus mimics strychnine, dystonia, rabies flex muscles; cyanide gasps, quinsy's throat, not spasms. Nurses sift this chronic stiffness list.
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.