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The nurse is caring for a client with mitral regurgitation. Which of the following would the nurse anticipate the client to develop if left untreated?
- A. Left-sided heart failure
- B. Right-sided heart failure
- C. Renal failure
- D. Myocardial ischemia
Correct Answer: A
Rationale: Mitral regurgitation backflows blood into the left atrium, hiking pressure and volume untreated, it overburdens the left ventricle, leading to left-sided heart failure. Pulmonary congestion follows, with dyspnea and edema, a direct consequence of this valve flaw. Right-sided failure stems from downstream effects or separate causes, not primary here. Renal failure or ischemia might complicate advanced disease, but left-sided failure's progression is the immediate risk, rooted in mitral dysfunction's mechanics. Nurses anticipate this, monitoring for early signs like crackles, ensuring timely intervention to halt this predictable cardiac cascade.
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Triglycerides in VLDL particles can be passed on to HDL particles. Question: Which enzyme mediates this process?
- A. Cholesteryl ester transfer protein (CETP)
- B. Hepatic lipase (HL)
- C. Hormone sensitive lipase (HSL)
- D. Lipoprotein lipase (LPL)
Correct Answer: A
Rationale: CETP swaps triglycerides VLDL to HDL, not lipase cutters. Nurses know this, a chronic lipid shuffle.
Regarding oxygen consumption by the adult human body:
- A. It is approximately 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at rest in the awake adult patient.
- B. It rises to approximately 11 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at peak exercise in healthy young adults.
- C. Increases by approximately 5-fold after major surgery.
- D. Peak oxygen consumption is likely to be quantified accurately by cardiopulmonary exercise testing.
Correct Answer: A
Rationale: Oxygen consumption (VOâ‚‚) reflects metabolic demand. At rest, VOâ‚‚ is approximately 3-4 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ in awake adults, aligning with basal energy needs (250-300 ml/min total). During peak exercise, healthy young adults can reach 30-40 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹, far exceeding 11 ml, depending on fitness. Post-major surgery, VOâ‚‚ increases 50-100% (1.5-2-fold), not 5-fold, due to stress and healing, though critical illness may spike higher briefly. Cardiopulmonary exercise testing (CPET) accurately measures peak VOâ‚‚, unlike the Duke Activity Status Index, which estimates it via questionnaire. The resting value of 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ is a physiological constant, foundational to understanding perioperative oxygen delivery and demand.
An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?
- A. Adhering to primary tumor cells
- B. Inducing mutation of cells of another organ
- C. Phag projecting healthy cells
- D. Invading healthy host tissues
Correct Answer: D
Rationale: Bone mets mean cancer's invaded malignant cells burrow into nearby tissues, breaking barriers to spread, a hallmark of metastasis. They don't just stick to the primary (adhesion's weak), mutate distant cells (that's not how it rolls), or eat healthy ones (phagocytosis is immune, not cancer). Invasion's the ticket cells chew through matrix, hit lymph or blood, and land in bones. Nurses in oncology spotlight this, tying it to why radiation's aimed at those hotspots, slowing the creep.
The Pulmonary rehabilitation program consists of several specific components. Which of the following are not a part of the program?
- A. Education and self-management
- B. Exercise training
- C. Coping measures to relieve anxiety, depression and changes in behaviour
- D. Spirometry
Correct Answer: D
Rationale: Pulmonary rehab builds COPD strength education, exercise, coping tools for mind and mood, all in. Spirometry's a test, not therapy diagnoses, doesn't train. Nurses skip it here, a chronic fix's focus.
For a patient who is receiving chemotherapy, which laboratory result is of particular importance?
- A. WBC
- B. PT and PTT
- C. Electrolytes
- D. BUN
Correct Answer: A
Rationale: Chemotherapy suppresses bone marrow, slashing white blood cell counts especially neutrophils heightening infection risk, making WBC monitoring paramount. Low counts trigger protective measures or treatment holds, directly tied to therapy's myelosuppressive core. PT and PTT track clotting, relevant for bleeding but less immediate. Electrolytes matter for overall status, but imbalances aren't chemotherapy's primary threat. BUN reflects kidney function, indirectly affected by some drugs, not the frontline concern. WBC's critical drop demands swift action fevers in neutropenia are emergencies underscoring its priority in safeguarding patients through treatment's immune-compromising phases.