Nokea
The genetic profile determines the prevalence of diabetic nephropathy in a population group. Question: Which population group has the LOWEST risk to develop endstage renal disease as a consequence of diabetes?
- A. Afro-Americans
- B. Iberians (Spanish origin)
- C. Caucasians
- D. Native Americans
Correct Answer: C
Rationale: Caucasians dodge worst kidney doom Afro-Americans, Native Americans soar high, Iberians mid-tier. Genes and diabetes hit lighter here, a chronic renal risk low nurses screen this gradient.
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According to Johnson and Chang (2014), compared to the non-indigenous population, the Australian indigenous population is more likely to:
- A. Live in the bush, eat native food and have increased exposure to the elements
- B. Have a higher incidence of chronic disease, be less healthy, die at a much younger age, and have lower quality of life
- C. Access health care and implement appropriate lifestyle changes equitably
- D. Experience death at a rate of twice that of the non-indigenous population
Correct Answer: B
Rationale: Indigenous Australians face a heavier chronic disease load diabetes, heart issues dying younger, with life expectancy gaps of 10+ years, and poorer quality of life from systemic inequities. Bush living's a stereotype, not a health driver; equitable care's a myth access lags; death rate's high but not precisely double. Nurses see this burden, tackling social determinants, a stark chronic care reality rooted in data, not just location or access claims.
A 36 year old woman visits her family doctor requesting blood test to check her cholesterol. She has family history of premature coronary heart disease. Physical examinations are unremarkable. Lipid profile is done and shows it the following results: Total cholesterol 5.8 mmol/L, HDL-cholesterol 1.1 mmol/L, LDL-cholesterol 3.6 mmol/L, Triglyceride 2.4 mmol/L. What is the MOST likely diagnosis?
- A. Familial hyperlipidemia
- B. Mixed hyperlipidemia
- C. Hypercholesterolaemia
- D. Familial combined hyperlipidemia
Correct Answer: B
Rationale: Cholesterol 5.8, LDL 3.6, triglycerides 2.4 both up, HDL lowish screams mixed hyperlipidemia, not lone cholesterol or triglyceride spikes. Family heart history hints genetics, but numbers don't pin familial types yet. Nurses flag this chronic dual lipid mess, tied to early coronary risk.
A client is receiving interleukins along with chemotherapy. What assessment by the nurse takes priority?
- A. Blood pressure
- B. Lung assessment
- C. Oral mucous membranes
- D. Skin integrity
Correct Answer: A
Rationale: Interleukins, a type of biologic response modifier used with chemotherapy, can cause capillary leak syndrome, where fluid shifts from blood vessels into tissues, leading to hypotension and edema. This makes blood pressure the priority assessment, as a drop could indicate intravascular depletion, risking shock or organ failure if undetected. Lung assessment is relevant for potential pulmonary edema, but hypotension precedes respiratory distress in this context. Oral mucous membranes and skin integrity matter for chemotherapy's broader effects (e.g., mucositis, rashes), but these are less urgent than hemodynamic stability. Monitoring blood pressure first ensures early detection of a life-threatening complication, aligning with nursing's focus on airway, breathing, and circulation principles, critical in managing interleukin therapy's systemic impact.
A nurse reviews the arterial blood gas (ABG) values of a client admitted with end-stage kidney disease; pH 7.26; PaCO2 37 mm Hg; PaO2 94 mm Hg and HCO3 15 mEq/L. What do these values indicate?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: End-stage kidney disease hampers acid excretion pH 7.26 (below 7.35) and HCO3 15 mEq/L (below 22) confirm metabolic acidosis, as kidneys fail to buffer, dropping bicarbonate. PaCO2 37 mm Hg (normal) rules out respiratory issues lungs aren't compensating yet. PaO2 94 mm Hg shows oxygenation's fine. Alkalosis options contradict low pH; respiratory acidosis needs high CO2. Nurses recognize this acid-base shift, anticipating bicarbonate or dialysis, a key intervention in renal failure's metabolic chaos.
A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?
- A. Are you getting adequate rest and sleep each day?
- B. It is normal to be fatigued even for years afterward.
- C. This is not normal and I'll let the provider know.
- D. Try adding more vitamins B and C to your diet.
Correct Answer: B
Rationale: Radiation therapy, commonly used for breast cancer, can cause persistent fatigue as a side effect due to cellular damage and the body's prolonged healing process. This fatigue can last for months or even years post-treatment, varying by individual factors like radiation dose and overall health. Telling the client it's normal validates her experience, reduces anxiety, and helps her family understand this as a common outcome rather than a personal failing. Asking about rest is useful but doesn't address the family's frustration or provide context. Declaring it abnormal and escalating to the provider is inaccurate unless other symptoms suggest a new issue, potentially causing unnecessary worry. Suggesting vitamins lacks evidence for resolving radiation-induced fatigue and shifts focus from education. The nurse's role here is to reassure and educate, making the normalization of long-term fatigue the most appropriate response, fostering coping and support within the family.