Nokea
The definition of Chronic Heart Failure is:
- A. Failure of the heart to adequately pump blood to the body
- B. Long-term inability of the heart to meet metabolic demands required to maintain homeostasis
- C. Prolonged enlargement of the left ventricle impacting on the contractility of the muscle
- D. Long term fluid build-up, causing increase in blood volume and reducing the ability of the heart to maintain blood flow
Correct Answer: B
Rationale: Chronic heart failure's essence long-term pump lag can't match body's metabolic needs, a homeostasis bust. Simple pump fail's vague; LV growth or fluid traps are bits, not the whole. Nurses grasp this, a chronic ticker's root.
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People with poorly controlled type 2 diabetes often show increased fasting blood glucose levels. Question: What causes these increased fasting blood glucose levels?
- A. Disturbed glucose uptake in adipose tissue due to insulin resistance
- B. Disturbed hepatic glucose uptake due to insulin resistance
- C. Disturbed suppression of hepatic glucose production by insulin
- D. Disturbed hepatic glucose uptake due to reduced insulin levels in portal blood
Correct Answer: C
Rationale: Type 2's fasting high liver pumps glucose, insulin can't hush it, resistance rules. Fat uptake's small, liver uptake's not key production's the leak nurses target this, a chronic dawn gush.
A 58-year-old woman with chronic gout is visiting the dietitian and the correct dietary advice given is:
- A. To stop fried food and eat fish for better gout control
- B. To increase fructose drinks as it removes uric acid from urine
- C. Avoid soybeans and plant proteins
- D. Stop alcohol and reduce animal protein
Correct Answer: D
Rationale: Gout diet cut booze, meat; fructose spikes uric, soy's fine, mushrooms hurt, cherries help. Nurses steer this chronic food fix.
It is the start of your second successive night shift on the labour ward. You have only managed to sleep for 4 h in the previous day. Your usual sleep requirement is 8 h per night. Appropriate statements regarding this situation include:
- A. Your total cumulative sleep deficit is 8 h.
- B. Your alertness will increase between 3 a.m. and 7 a.m. due to natural fluctuation in your circadian rhythm.
- C. Unintentional dural puncture during epidural insertion is more likely to occur during a night shift than during normal working hours.
- D. Sleeping for an extra 4 h will eliminate the sleep deficit.
Correct Answer: C
Rationale: Night shifts disrupt sleep and performance. After one night with 4 hours sleep (8-hour need), the deficit is 4 hours; a second night compounds it variably, but total' implies current state 8 hours overstates it without further context. Alertness dips 3-7 a.m. (circadian nadir), not increases, heightening fatigue. Night-shift studies (e.g., anaesthesia journals) show increased errors like dural puncture due to fatigue, reduced dexterity, and decision-making capacity, especially with sleep deprivation. Four extra hours reduce, not eliminate, a deficit if it's 4-12 hours cumulatively. Modafinil promotes wakefulness, not daytime sleep. The night-shift risk of dural puncture reflects fatigue's real-world impact on technical skills.
Prescription of long term oxygen therapy has some very strict guidelines. In order to qualify for this treatment, the patient has to:
- A. Be admitted to hospital 3 times within a 12 month time frame with acute exacerbation of COPD
- B. Demonstrate a significant impairment of QOL because of dyspnoea and decreased exercise capacity
- C. Have very high levels of anxiety which impact on their ability to self-manage and increase stress on carer
- D. Have a diagnosis of severe COPD with PaO2 of >55 mmHg, or evidence of tissue hypoxia and end organ damage
Correct Answer: D
Rationale: O2's lifeline demands proof severe COPD with PaO2 ≤55 mmHg or hypoxia's organ bite, a strict cut. Admissions, QOL dips, anxiety don't seal it hypoxemia does. Nurses gatekeep this, a chronic oxygen rule.
The hospice nurse is caring for a patient with cancer in her home. The nurse has explained to the patient and the family that the patient is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this patient and family to do to reduce the patient's risk of hypercalcemia?
- A. Stool softeners are contraindicated
- B. Laxatives should be taken daily
- C. Consume 2 to 4 L of fluid daily
- D. Restrict calcium intake
Correct Answer: C
Rationale: Hypercalcemia cancer's bone breakdown gift needs hydration (2-4 L/day) to flush calcium through kidneys, unless heart or renal issues say no. Stool softeners and laxatives fight constipation (a symptom), not the cause, and aren't contraindicated. Cutting calcium's pointless tumors, not diet, spike it. Nurses in hospice drill this, balancing fluid push with symptom watch (confusion, thirst), keeping comfort king in late-stage oncology care.