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 client suffering from a narcotic overdose is seen in the Emergency Department. The client is confused, with warm, flushed skin, headache, and weakness. Vital signs of noted are temperature 102.6 F, heart rate 128 beats/minute, respirations 24 breaths/minute, and blood pressure 130/86 mm Hg. A blood gas analysis sample was drawn on room air, and the results are as follows: pH 7.33 PaCO2 53 mm Hg, PaO2 72 mm Hg, HCO3 24 mEq/L. This client is at risk for which of the following?
- A. Metabolic alkalosis
- B. Respiratory alkalosis
- C. Respiratory acidosis
- D. Metabolic acidosis
Correct Answer: C
Rationale: Narcotics depress breathing pH 7.33 (low), PaCO2 53 mm Hg (high) signal respiratory acidosis, as CO2 piles up from hypoventilation, a classic overdose trap. PaO2 72 mm Hg shows mild hypoxia; HCO3 24 mEq/L hasn't compensated yet. Alkalosis needs low CO2 or high HCO3; metabolic acidosis drops HCO3. Nurses spot this, anticipating oxygen or reversal, a breath-stifled risk in this opioid haze.
Which of the following is an example of multimorbidity?
- A. Chronic obstructive pulmonary disease and a urinary tract infection
- B. Lung cancer and pneumonia
- C. Chronic kidney disease and appendicitis
- D. Diabetes and exacerbation of rheumatoid arthritis
Correct Answer: D
Rationale: Multimorbidity means chronic twins diabetes and rheumatoid arthritis flare together, a dual load, not acute add-ons like UTIs, pneumonia, or appendicitis. Those flare fast and fade; chronic pairs grind on, tangled or not, a nurse's radar for complex care, a hallmark of long-haul illness overlap.
Which of the following findings would be most indicative of retinoblastoma for an 18-month old child?
- A. Orbital inflammation of the right eye and head tilt when standing.
- B. Cat's eye reflex and yellow discharge from the left eye.
- C. Leukokoria and hyphema noted for the right eye.
- D. Strabismus in the left eye and light sensitivity in the opposite eye.
Correct Answer: C
Rationale: Retinoblastoma, a retinal cancer in young children, commonly presents with leukokoria (white pupil reflection) and hyphema (blood in the anterior eye chamber), making these findings most indicative due to tumor effects on retinal light reflection and vascular fragility. Orbital inflammation and head tilt suggest brain tumors or orbital cellulitis, not retinoblastoma's typical intraocular focus. Cat's eye reflex (leukokoria) fits, but yellow discharge points to infection (e.g., conjunctivitis), not cancer. Strabismus and light sensitivity may occur in retinoblastoma but are less specific strabismus from muscle imbalance and sensitivity from inflammation lacking hyphema's diagnostic weight. Nurses spotting leukokoria and hyphema trigger urgent ophthalmology referral, critical in pediatric oncology for early detection and vision-saving or life-saving intervention in this age group.
Which complications are the three main consequences of leukemia?
- A. Bone deformities, spherocytosis and infection.
- B. Anemia, infection, and bleeding tendencies.
- C. Lymphocytopoiesis, growth delays, and hirsutism.
- D. Polycythemia, decreased clotting time, and infection.
Correct Answer: B
Rationale: Leukemia, a bone marrow cancer, replaces normal marrow elements with immature, dysfunctional white blood cells (lymphoblasts), leading to three primary complications: anemia, infection, and bleeding tendencies. Anemia results from reduced red blood cell production, causing fatigue and pallor. Infection risk rises due to neutropenia immature lymphoblasts lack infection-fighting ability making children prone to severe illnesses. Bleeding tendencies occur from thrombocytopenia, low platelet counts causing bruising or petechiae. Bone deformities and spherocytosis aren't leukemia hallmarks; the former might occur in bone cancers like osteosarcoma, and the latter is a red cell disorder. Lymphocytopoiesis is a process, not a complication, while growth delays and hirsutism aren't primary leukemia effects. Polycythemia (high red cells) and decreased clotting time oppose leukemia's anemia and bleeding risks. Nurses must monitor these complications, as they guide interventions like transfusions or antibiotics, critical for supporting children through leukemia treatment.
Fatty liver disease is more common in people with metabolic syndrome or type 2 diabetes. The pathogenesis of fatty liver disease is not yet completely known. Question: What does current research suggest with respect to the pathogenesis?
- A. Steatosis correlates with inflammation
- B. Inflammation correlates with fibrosis
- C. Steatosis correlates with liver damage
- D. Steatosis correlates with insulin resistance
Correct Answer: D
Rationale: Fatty liver's tale steatosis ties to insulin resistance, a metabolic syndrome root, not just inflammation, fibrosis, or vague damage. Nurses see this, a chronic fat-glucose knot.