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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In Europe and the USA, drugs licensed for use in intrathecal drug delivery systems include:
- A. Diamorphine.
- B. Methadone.
- C. Morphine.
- D. Ziconotide.
Correct Answer: C
Rationale: Intrathecal drug delivery systems (IDDS) use specific licensed drugs in Europe and the USA. Morphine is widely approved for its efficacy in cancer and chronic pain, binding spinal opioid receptors with a strong evidence base. Ziconotide, a non-opioid, is also licensed, targeting calcium channels for refractory cases. Diamorphine (heroin) isn't licensed intrathecally; it's used epidurally or systemically in some regions (e.g., UK palliative care) but lacks IDDS approval. Methadone's long half-life and oral efficacy preclude intrathecal use; it's not licensed. Ketamine has experimental use but no formal approval. Morphine's prominence stems from its pharmacokinetic suitability high potency and spinal receptor affinity making it a cornerstone of IDDS therapy alongside ziconotide.
According to Johnson and Chang (2014) the role of the nurse and other health professions in chronic disease is to:
- A. Support the person in managing their condition more effectively
- B. Provide care to manage the disease process
- C. Ensure the patient takes their medications and avoids all risk factors
- D. Decide as a team on the best approach to manage the condition and direct the implementation of this care
Correct Answer: A
Rationale: Nurses in chronic care empower supporting self-management beats just treating, enforcing meds, or dictating plans. It's about patients steering their diabetes or asthma, with pros as guides, not bosses. Care's given, compliance nudged, teams plan, but support's the heart, a chronic win where autonomy rules.
For a patient who is experiencing side effects of radiation therapy, which task would be the most appropriate to delegate to the nursing assistant?
- A. Assist the patient to identify patterns of fatigue
- B. Recommend participation in a walking program
- C. Report the amount and type of food consumed from the tray
- D. Check the skin for redness and irritation after the treatment
Correct Answer: C
Rationale: Radiation side effects like fatigue and anorexia benefit from team care. Reporting food consumed from the tray suits nursing assistants observing and relaying intake data supports nutrition monitoring without requiring clinical judgment. Identifying fatigue patterns demands analysis, a nurse's role to adjust care plans. Recommending exercise exceeds assistants' scope physicians or RNs initiate such advice. Checking skin for redness post-treatment needs assessment skills to detect burns or infection, RN territory. Food reporting leverages assistants' observational role, aiding nurses in tracking radiation's impact on appetite, ensuring basic needs are flagged efficiently in a collaborative approach.
The nurse is teaching the parents of a 15-year-old who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which of the following symptoms should the parents seek medical care immediately?
- A. Earache, stiff neck or sore throat
- B. Blisters, ulcers or a rash appear
- C. A temperature of 101.5 degrees Fahrenheit
- D. Difficulty or pain when swallowing
Correct Answer: C
Rationale: Chemotherapy for acute myelogenous leukemia suppresses the immune system by reducing white blood cell production, leaving the child highly susceptible to infections. A fever of 101.5°F is a critical sign in this context, as it may indicate an infection that, without a functioning immune response, could rapidly progress to sepsis a life-threatening condition. Parents must seek immediate medical care to evaluate and treat the underlying cause, often requiring emergency department intervention. While earache, stiff neck, or sore throat could suggest infection, they are less urgent without fever and may not necessitate immediate action unless severe. Blisters, ulcers, or rashes might reflect chemotherapy side effects like mucositis or drug reactions, manageable with outpatient care unless infected. Difficulty swallowing could stem from mucositis or infection, but fever trumps it in urgency due to its systemic implications. Educating parents to prioritize fever ensures timely intervention, aligning with oncology nursing's focus on preventing complications in immunocompromised pediatric patients.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Stopping all oral hypoglycaemic agents
- C. Recognition and self-management of hypoglycaemia
- D. Sick day management
Correct Answer: B
Rationale: Insulin therapy education for diabetes patients covers injection technique, hypoglycemia recognition and management, sick day rules, and safe driving, per diabetes care standards. However, stopping all oral hypoglycemic agents isn't universally essential many patients continue agents like metformin or SGLT-2 inhibitors alongside insulin for synergistic effects, depending on glycemic control needs. Assuming cessation oversimplifies treatment plans, potentially reducing efficacy. Education must tailor to individual regimens, not mandate stopping orals, making this the exception. Physicians ensure comprehensive teaching to enhance adherence and safety, critical in chronic disease management.