Nokea
The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?
- A. Tumor lysis syndrome (TLS)
- B. Syndrome of inappropriate antidiuretic hormone (SIADH)
- C. Disseminated intravascular coagulation (DIC)
- D. Hypercalcemia
Correct Answer: A
Rationale: Non-Hodgkin lymphoma's fast cell turnover, plus recent chemo, primes for TLS dead cells dump potassium, phosphorus, and uric acid, risking kidney failure days post-treatment. SIADH (low sodium) and hypercalcemia (bone mets) are less tied to this timeline. DIC's bleeding chaos isn't lymphoma's usual post-chemo hit. Nurses hunt TLS signs fatigue, nausea, arrhythmias knowing it's a fatal oncology curveball if missed early.
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The signs and symptoms of heart failure include:
- A. Polyphagia and polydipsia.
- B. Orthopnoea and gastrointestinal disruption.
- C. Urinary frequency and acute pulmonary oedema.
- D. Dyspnoea and peripheral oedema.
Correct Answer: D
Rationale: Heart failure (HF) manifests through circulatory and fluid overload effects. Polyphagia and polydipsia align with diabetes, not HF. Orthopnoea (breathlessness lying flat) is HF-specific, but gastrointestinal disruption (e.g., nausea) is secondary, less hallmark. Urinary frequency occurs nocturnally in HF (nocturia), but acute pulmonary edema is an acute crisis, not a chronic sign. Dyspnoea (shortness of breath) from pulmonary congestion and peripheral edema (swelling) from venous backup are classic, per Farrell (2017) reflecting left and right HF respectively. These stem from reduced cardiac output and fluid retention (e.g., elevated jugular venous pressure), driving clinical presentation. Dyspnoea limits activity, edema signals systemic impact, making them definitive over less specific or acute-only symptoms.
Choose the CORRECT statement Babies born from mothers with gestational diabetes:
- A. Are at a high risk of being born with diabetes
- B. Are usually hypoglycaemic due to maternal insulin drug therapy
- C. Are usually of higher birth weight
- D. Are always given a glucose challenge test
Correct Answer: C
Rationale: Gestational diabetes fattens babies high maternal sugar pumps fetal growth, a hefty birth norm. They don't inherit diabetes at birth, hypo's rare unless mom's on insulin, tests aren't routine. Nurses track this, a chronic womb echo.
For a patient with osteogenic sarcoma, you would be particularly vigilant for elevations in which laboratory value?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Hematocrit
Correct Answer: B
Rationale: Osteogenic sarcoma, a bone cancer, often triggers hypercalcemia bone destruction releases calcium into blood, risking arrhythmias or kidney damage, a life-threatening shift demanding close watch. Sodium and potassium imbalances aren't bone-specific, more tied to general metabolism or treatment side effects. Hematocrit reflects anemia, common in cancer but not osteogenic sarcoma's hallmark. Calcium's spike, linked to osteolysis, makes it the nurse's focus elevations signal tumor activity or progression, prompting urgent interventions like fluids or bisphosphonates, a vigilance rooted in this cancer's skeletal impact and metabolic havoc.
The immediate nursing care to be provided to a patient presenting with a suspected ischaemic stroke include:
- A. Position on left lateral side, insert nasogastric tube, conduct an ECG and insert an IV line
- B. Primary/Secondary survey, give analgesia, 4th hourly neuro obs and vital signs, maintain oral intake
- C. Primary/Secondary survey, 4th hourly neuro obs and vital signs, monitor BGL and maintain nil by mouth
- D. 4th hourly neuro obs and vital signs, monitor BGL, insert an IV line and reduce intracranial pressure by positioning and reduced stimulation
Correct Answer: C
Rationale: Stroke hits fast surveys spot deficits, neuro obs track brain, vitals catch crashes, BGL rules out mimics, and nil by mouth preps for scans or clots, a tight first step. Lateral's for airways, not here; analgesia's late; IVs and ICP control follow. Nurses nail this, racing for tPA windows, a chronic precursor's acute kickoff.
There are several mechanisms through which AGEs can lead to increased oxidative stress. Question: Which AGE-induced mechanism supposedly plays an important role in the development of oxidative stress in endothelial cells?
- A. Crosslinking of matrix proteins
- B. Induction of apoptosis
- C. Intracellular glycation by methylglyoxal
- D. All three statements provided above are correct
Correct Answer: C
Rationale: AGEs spark stress methylglyoxal's indoor glycation fries cells, outpacing crosslinking or death calls. Key in endothelium, a chronic oxidative kick nurses target this mess.