Nokea
The nurse assesses a client and documents the following findings: edema 2+ bilateral ankles, brown pigmentation of lower extremity skin, aching pain of lower extremities when standing that resolves with elevation, and 2+ pedal pulses. What condition does the client likely have?
- A. Deep vein thrombosis
- B. Raynaud's disease
- C. Venous insufficiency
- D. Peripheral arterial disease
Correct Answer: C
Rationale: Venous insufficiency pools blood 2+ edema, brown pigmentation from hemosiderin, aching relieved by elevation, and decent pulses fit, as veins fail while arteries hold. DVT clots acutely, often unilateral. Raynaud's spasms, not pigments. PAD dims pulses, pains with walking. Nurses peg this chronic venous flop, suggesting hose or elevation, a textbook stasis tale.
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Pulmonary rehabilitation is one of the most effective interventions in the management of COPD. The primary goals of this program are to:
- A. Ensure the patient eats appropriately, takes their medication as prescribed and exercises every day
- B. Involve the patient in the multidisciplinary team and knows how to manage their condition
- C. Reduce symptoms, improved QOL, increase physical and emotional participation in everyday life
- D. Prevent deterioration, avoid hospitalisation and support the carers
Correct Answer: C
Rationale: Pulmonary rehab reclaims COPD life less wheeze, better QOL, more daily grit, physical and emotional. Diet-meds-exercise is narrow; team play's a means; prevention's a perk, not core. Nurses drive this, a chronic lift.
Which of the following is the surgical treatment of choice for end-stage heart failure?
- A. Cardiac resynchronization therapy (CRT)
- B. Percutaneous angiogram
- C. Genetic counseling
- D. Ventricular assist devices (VADs)
Correct Answer: D
Rationale: End-stage heart failure, when drugs and pacing fail, leans on ventricular assist devices mechanical pumps aiding circulation, a bridge to transplant or destination therapy. CRT syncs ventricles, less invasive, but VADs tackle severe pump collapse. Angiograms diagnose, not treat; genetic counseling's irrelevant. Nurses prep for VADs, managing post-op risks, the go-to surgical fix in this terminal cardiac scenario.
Many people with obesity have a lower insulin-stimulated glucose uptake compared with people without increased body weight. It is assumed that several factors play a role in the development of insulin resistance. Question: Which of the following factors is LEAST likely to play a role in the development of insulin resistance?
- A. Reduced insulin levels
- B. Increased adipokine levels
- C. Increased triglyceride levels
- D. Low-grade continuous inflammation
Correct Answer: A
Rationale: Insulin resistance brews from fat's adipokines, triglycerides, inflammation not low insulin, that's type 1's game. Obesity's chronic jam needs excess, not lack nurses flag this misfit.
Which does not require post exposure prophylaxis for rabies?
- A. scratch
- B. bite on face
- C. bite on extremity
- D. skin contact with blood, urine or faeces
Correct Answer: D
Rationale: Rabies PEP bites, scratches, bat splashes trigger; blood, pee, poop on skin don't. Nurses skip this chronic non-risk.
A 66 year old man has recently been diagnosed with hypertension. He has no history of heart disease and diabetes mellitus. His average blood pressure is recorded as 154/82 mmHg. What is the MOST appropriate first line pharmacological therapy?
- A. Angiotensin converting enzyme-inhibitors
- B. Angiotensin receptor blockers
- C. Thiazide diuretics
- D. Calcium channel blockers
Correct Answer: C
Rationale: New hypertension at 66, 154/82 no heart or sugar issues thiazide diuretics kick off gentle, effective control, especially in older adults. ACE inhibitors or ARBs fit if kidneys or diabetes pop up; calcium blockers work but aren't first; beta blockers lag unless heart history. Nurses lean on thiazides cheap, proven for this chronic pressure nudge, keeping it simple and safe.