Nokea
The following are major causes of death among patients with NAFLD over the long term, except:
- A. Pancreatic cancer
- B. Acute myocardial infarct
- C. Road traffic accident
- D. Colon cancer
Correct Answer: C
Rationale: NAFLD's long haul kills via heart attacks, pancreatic, colon, or breast cancers metabolic and inflammation's toll. Road accidents? Random, not tied to fat liver's chronic grind. Clinicians watch these big hitters, not crash stats, in NAFLD's mortal map.
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All of the following are potential factors leading to weight gain EXCEPT:
- A. Disrupted circadian rhythm
- B. Use of anti-histamines and sulphonylureas
- C. Changes in gut microbiota
- D. Controlled food portions that are of low energy density
Correct Answer: D
Rationale: Weight gain factors include disrupted circadian rhythm (metabolic dysregulation), antihistamines/sulphonylureas (appetite increase, insulin secretion), and gut microbiota shifts (altered energy harvest). Controlled food portions of low energy density (e.g., vegetables) reduce calorie intake, aiding weight loss, not gain, per obesity research. This exception highlights dietary control's role in managing chronic conditions like diabetes or obesity, guiding physicians in patient counseling for sustainable weight regulation.
A hospitalized client has a platelet count of 58,000/mm³. What action by the nurse is best?
- A. Implement fall precautions
- B. Encourage high-protein foods
- C. Limit visitors to healthy adults
- D. Institute neutropenic precautions
Correct Answer: A
Rationale: A platelet count of 58,000/mm³ below 150,000 signals thrombocytopenia, raising bleeding risk, especially from falls. Implementing fall precautions curbs trauma, preventing bleeds like intracranial hemorrhage, a practical priority over dietary tweaks. High-protein foods aid healing but don't address immediate danger. Limiting visitors or neutropenic precautions fits low WBCs, not platelets 58,000 isn't neutropenic (below 1,000 neutrophils). Nurses prioritize safety, making fall precautions the best action, directly mitigating this lab's implications in a hospitalized client prone to injury.
The nurse is discharging home a client at risk for venous thromboembolism on enoxaparin sodium. What instruction is a priority for the nurse to provide to this client?
- A. Notify your health care provider if your stools appear dark or tarry
- B. You must have your prothrombin time (PT)/international normalized ratio (INR) checked every 2 weeks
- C. Massage the injection site after the heparin is injected
- D. You must have your activated partial thromboplastin time (aPTT) checked every 72 hours
Correct Answer: A
Rationale: Enoxaparin, a low-molecular-weight heparin, thins blood dark, tarry stools signal GI bleed, a dire side effect needing instant reporting to halt hemorrhage. PT/INR tracks warfarin, not enoxaparin; aPTT's for unfractionated heparin. Massaging injection sites risks bruising. Nurses prioritize bleed watch, ensuring safety on this clot-busting med, a discharge must-know.
What is the essence of motivational interviewing?
- A. That change strategies must exactly match the patient's motivation
- B. That behavioural change is impossible if the patient does not want it
- C. That the counsellor motivates the patient to change and increases patient involvement
- D. That the patient's motives to show unhealthy behaviour are systematically analysed
Correct Answer: C
Rationale: Motivational interviewing counsellor sparks, pulls patients in, not rigid matches, impossibles, or motive digs. Nurses roll this, a chronic engagement art.
A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate?
- A. Avoid getting salt water on the radiation site.
- B. Do not expose the radiation area to direct sunlight.
- C. Have a wonderful time and enjoy your vacation!
- D. Remember you should not drink alcohol for a year.
Correct Answer: B
Rationale: Post-radiation skin at the treatment site remains highly sensitive to ultraviolet (UV) rays due to damage to the epidermal layer, increasing the risk of burns, irritation, or delayed healing. The nurse's most appropriate response is to advise against exposing the radiation area to direct sunlight, a precaution that persists for at least a year after treatment to protect skin integrity. Avoiding saltwater isn't a standard concern unless the skin is broken, which isn't indicated here. Simply wishing the client well ignores the teaching opportunity and potential risk. The alcohol restriction isn't a universal post-radiation rule unless tied to specific treatments or conditions not mentioned. Educating about sun exposure empowers the client to enjoy the vacation safely, aligning with nursing's preventive care focus and ensuring the celebration isn't marred by avoidable complications.