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The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Threaten patient into adherence with insulin therapy
- B. Engage the patient in shared decision-making, select an insulin regimen that they can adhere to
- C. Provide close supervision and follow up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLP-1RA
Correct Answer: A
Rationale: Effective insulin therapy strategies include shared decision-making, close supervision at initiation, and weight gain mitigation via lifestyle and adjunctive drugs like metformin all fostering adherence and success. Threatening patients, however, is counterproductive, increasing resistance, anxiety, and non-compliance, contrary to patient-centered care principles. It undermines trust, critical in chronic disease management, where collaboration and support drive outcomes. Physicians must avoid coercive tactics, focusing instead on empowerment and tailored solutions to overcome insulin therapy barriers.
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The best way to prevent chronic complications of diabetes is to:
- A. Take medications as prescribed and remove sugar from the diet completely.
- B. Check feet daily for cuts, long toe nails and infections between the toes.
- C. Maintain a BGL that is as close to normal as possible.
- D. Undertake daily exercise to burn up the excess glucose in the system.
Correct Answer: C
Rationale: Preventing diabetes complications (e.g., neuropathy, retinopathy) hinges on glycemic control. Medications and sugar elimination help, but total sugar removal is impractical carbohydrates are broader, and control, not absence, matters. Daily foot checks prevent ulcers but address consequences, not root causes. Maintaining blood glucose levels (BGL) near normal (e.g., HbA1c <7%) via diet, exercise, and drugs prevents microvascular (kidney, eye) and macrovascular (heart) damage, per ADA guidelines. Exercise burns glucose, aiding control, but isn't singularly best' it's part of a triad. Tight BGL management reduces oxidative stress, glycation, and vascular injury, evidenced by trials (e.g., DCCT), making it the cornerstone strategy over isolated tactics, ensuring long-term organ protection.
What is the result of bariatric surgery as a therapy for morbid obesity?
- A. Reduced insulin sensitivity
- B. Increased insulin sensitivity
- C. Reduced lipolysis
- D. Increased lipolysis
Correct Answer: B
Rationale: Bariatric fix insulin sensitivity jumps, fat shrinks, glucose flows, not lipolysis shifts. Nurses cheer this, a chronic reset win.
The Barker hypothesis describes the relationship between birth weight and the development of diseases. Question: Which relationship is correct?
- A. High birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
- B. High birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
- C. Low birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
- D. Low birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
Correct Answer: D
Rationale: Barker's call low birth weight scars metabolism, upping later obesity, diabetes, heart woes. High weight leans risky too, but low's the proven chronic link nurses track this fetal echo.
A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to support the patient's self-esteem?
- A. Encourage the patient to purchase a wig or hat to wear when hair loss begins.
- B. Suggest that the patient limit social contacts until regrowth of the hair occurs.
- C. Teach the patient to wash hair gently with mild shampoo to minimize hair loss.
- D. Inform the patient that hair usually grows back once chemotherapy is complete.
Correct Answer: A
Rationale: Alopecia from chemo (e.g., cyclophosphamide) guts self-esteem prepping with wigs or hats hands control back, softening the blow. Limiting contact isolates; gentle washing won't stop it follicles are toast. Regrowth is true but delayed. Nurses in oncology push this proactive step it's practical, empowering, and tackles the psychosocial hit head-on.
Cardiac catheterisation (angiography) is performed to assess blood flow through the coronary arteries through use of a contrast agent and radiographic imaging. The nursing responsibilities in caring for the patient post angiography do not include:
- A. Applying pressure and observing the insertion site for bleeding or haematoma formation
- B. Informing the patient of the findings of the angiogram to allay fear and provide reassurance
- C. Monitor for arrhythmias by both cardiac monitoring and assessing apical or peripheral pulses
- D. Encourage fluids to increase urinary output and flush out the dye
Correct Answer: B
Rationale: Post-angio, nurses press sites, watch rhythms, flush dye hands-on musts. Telling results? Docs' turf nurses soothe, don't spill, a chronic care line.