Nokea
The glycaemic profiles of people living with diabetes is affected by the following EXCEPT:
- A. Monitoring of blood glucose
- B. Dietary intake
- C. Exercise
- D. Stress
Correct Answer: A
Rationale: Diabetes' sugar swings dance to diet, exercise, stress, and meds intake, burn, cortisol, and pills all tug levels. Monitoring tracks, not tweaks, the profile; it's a mirror, not a mover. Clinicians lean on this quintet's interplay, adjusting levers, not the gauge, a chronic puzzle where tools shape, not tally, the game.
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You measure the abdominal circumference and the hip circumference of a male patient with hypertension, overweight and recently-diagnosed type 2 diabetes mellitus. Question: Which values are most likely to be found in this patient?
- A. Abdomen: 78 cm, hip: 78 cm
- B. Abdomen: 78 cm, hip: 86 cm
- C. Abdomen: 102 cm, hip: 90 cm
- D. Abdomen: 90 cm, hip: 102 cm
Correct Answer: C
Rationale: Type 2, hypertension, overweight belly bulges past hips, 102 cm to 90 cm fits metabolic syndrome's apple shape, not slim or reverse. Nurses measure this, a chronic girth clue.
The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching?
- A. The patient has a history of dental caries.
- B. The patient swims several days each week.
- C. The patient snacks frequently during the day.
- D. The patient showers each day with mild soap.
Correct Answer: B
Rationale: Abdominal radiation fries skin swimming in chlorinated or salt water during treatment risks irritation or infection in that tender zone. Dental caries don't tie in. Snacking might help nutrition, not hurt. Mild soap showers are fine. Nurses in oncology flag this no swimming' protects radiated skin, a teaching must to dodge complications.
A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate?
- A. Don't you have any friends that will raise the children for you?'
- B. Would you like to talk about options for the care of your children?'
- C. For now you need to concentrate on getting well and not worrying about your children.'
- D. Many patients with cancer live for a long time, so there is time to plan for your children.'
Correct Answer: B
Rationale: Metastatic ovarian cancer's end-stage she's scared for her kids. Asking about options opens a lifeline, validating her fear without shutting it down. Friends assumes too much; get well' dodges reality; long time' sugarcoats. Nurses in oncology lean in here listening, planning ease her burden, a human touch amid grim odds.
The nurse is caring for a 6-year-old child with leukemia who is having an oncological emergency. Which of the following signs and symptoms would indicate hyperleukocytosis?
- A. Bradycardia and distinct S1 and S2 sounds
- B. Wheezing and diminished breath sounds
- C. Respiratory distress and poor tissue perfusion
- D. Intermittent fever and frequent vomiting
Correct Answer: C
Rationale: Hyperleukocytosis, a leukemia emergency with white blood cell counts over 100,000/mm³, causes blood hyperviscosity, leading to venous stasis and microvessel occlusion by blast cells. This results in respiratory distress (from lung infarction or hypoxemia) and poor tissue perfusion (from impaired circulation), critical signs requiring urgent intervention like leukapheresis or hydration. Bradycardia and clear heart sounds don't fit tachycardia might occur from hypoxia, not bradycardia. Wheezing and diminished breath sounds suggest asthma or infection, not hyperleukocytosis's systemic impact. Fever and vomiting are non-specific and less acute here. Nurses recognizing these symptoms prioritize airway and circulation support, aligning with oncology's focus on rapid response to life-threatening complications in pediatric leukemia care.
When conventional routes of analgesia have been unsuccessful or are contraindicated for chronic pain syndromes, intrathecal drug delivery systems may be considered. Appropriate indications are likely to include:
- A. Patients with cancer-related pain in whom life expectancy is estimated to be >3 months.
- B. Chronic pancreatitis.
- C. Haematuria loin pain syndrome.
- D. Chronic low back pain.
Correct Answer: A
Rationale: Intrathecal drug delivery systems (IDDS) treat severe, refractory pain. Cancer pain with >3 months life expectancy justifies IDDS, balancing implantation risks with prolonged benefit shorter expectancy favors simpler methods. Chronic pancreatitis may respond, but evidence is weaker; it's not a primary indication. Haematuria loin pain syndrome (loin pain haematuria syndrome) is niche, rarely managed with IDDS due to limited data. Chronic low back pain often fails conservative treatment, but IDDS is reserved for extreme cases (e.g., failed back surgery syndrome), not routine. Chronic refractory angina is cardiac, not typically IDDS-eligible. Cancer pain's prevalence, severity, and responsiveness to intrathecal opioids/ziconotide make it the clearest indication, optimizing quality of life in palliative care.