Nokea
The glycaemic profiles of people living with diabetes is affected by the following EXCEPT:
- A. Dietary intake
- B. Exercise
- C. Monitoring of blood glucose
- D. Stress
Correct Answer: C
Rationale: Glycemic profiles in diabetes are influenced by dietary intake (carbohydrate amount/type), exercise (glucose uptake), stress (cortisol-driven hyperglycemia), and medications (dose/effect). Monitoring blood glucose, however, doesn't affect the profile it measures it. While vital for management, the act of checking doesn't alter underlying glucose levels, unlike the others, which directly impact metabolism. This distinction is key for physicians educating patients on factors driving glycemic control, ensuring focus on actionable influencers rather than tools in chronic diabetes care.
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A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- A. Helping clients adjust to their appearance
- B. Reassuring clients that this change is temporary
- C. Referring clients to a reputable wig shop
- D. Teaching measures to prevent scalp injury
Correct Answer: D
Rationale: Alopecia, or hair loss, is a common chemotherapy side effect due to drugs targeting rapidly dividing cells, including hair follicles. While emotional support is vital, the priority is client safety. Teaching measures to prevent scalp injury such as avoiding harsh brushing or sun exposure takes precedence because the scalp becomes vulnerable without hair's protective barrier, risking cuts, infections, or burns. Helping clients adjust to appearance and reassuring them about regrowth address psychosocial needs but don't mitigate physical risk. Referring to a wig shop is practical but secondary to safety. In oncology nursing, prioritizing physical protection aligns with the hierarchy of needs, ensuring the client avoids complications like infection, especially if immunocompromised, before addressing emotional impacts.
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?
- A. These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies
- B. These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer
- C. Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy
- D. Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying
Correct Answer: A
Rationale: Radiation zaps energy fatigue and weakness are par for the course, tied to inflammation and repair in treated tissues. Saying this, plus promising lab and imaging checks, reassures him it's expected, not a red flag, and keeps him in the loop. Blaming cancer alone dodges the treatment link, unsettling him. Dismissing it as universal or a good sign' feels flippant normal cells die too. Nurses in oncology lean on honesty and vigilance, easing fears while tracking for worse issues like anemia or infection.
Which drug should not be given with midazolam?
- A. zidovudine
- B. lamivudine
- C. nevirapine
- D. indinavir
Correct Answer: D
Rationale: Indinavir boosts midazolam P450 clash sedates too deep, unlike zidovudine, lamivudine, nevirapine, or ritonavir's fit. Nurses dodge this chronic sleep trap.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
The nurse understands that the physician would need to be notified regarding a chemotherapy dose if the client experiences:
- A. Fatigue
- B. Nausea and vomiting
- C. Stomatitis
- D. Bone marrow suppression
Correct Answer: D
Rationale: Chemotherapy's marrow hit bone marrow suppression drops counts like neutrophils or platelets, risking infection or bleeding, a dose-limiting toxicity needing physician review to adjust or pause treatment. Fatigue, nausea, and stomatitis are common, manageable with nursing care rest, antiemetics, mouth rinses unless extreme. Suppression's severity, tied to labs (e.g., ANC <500), halts therapy to protect the client, a critical threshold nurses monitor, distinguishing it from routine side effects, ensuring safety in this marrow-bashing regimen.