Nokea
The nurse is caring for a client with type 2 diabetes who has been hospitalized with severe hyperglycemia. Which of the following topics will be most important to include in discharge teaching?
- A. Effect of endogenous insulin on transportation of glucose into cells
- B. Function of the liver in formation of glycogen and gluconeogenesis
- C. Impact of the client's family history on likelihood of developing diabetes
- D. Symptoms indicating that the client should contact the health care provider
Correct Answer: D
Rationale: Discharge teaching for type 2 diabetes post-hyperglycemia hinges on crisis prevention knowing when symptoms like thirst or confusion scream for help beats insulin mechanics, liver roles, or family odds. Clients need actionable cues to self-manage, not just theory; recognizing trouble and calling in keeps them out of the ER. Physiology's useful, genetics informative, but spotting escalation's life-saving, a chronic care must nurses drill into patients for real-world control.
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A male client is presenting with radiating chest pain. Which of the following would the nurse recognize as indicators that an acute myocardial infarction may be occurring?
- A. Positive troponin markers
- B. ST elevation on EKG on two contiguous leads
- C. Pain relieved with rest
- D. Diaphoresis
Correct Answer: B
Rationale: MI's hallmark ST elevation in contiguous leads flags acute infarction, showing transmural injury, a nurse's red alert for cath lab prep. Troponins rise later, confirming damage. Rest-relieved pain fits angina, not MI. Diaphoresis tags along but isn't diagnostic alone. EKG's immediacy nails this, driving urgent care in this chest pain crisis.
Triglycerides are absorbed in the intestines after a meal. Question: After being absorbed by intestinal cells, triglycerides are transported in the blood circulation by which lipid particle?
- A. Chylomicron particle
- B. HDL particle
- C. IDL particle
- D. VLDL particle
Correct Answer: A
Rationale: Post-meal triglycerides ride chylomicrons gut to blood, not HDL, IDL, or VLDL's liver gig. Nurses track this, a chronic fat ferry.
The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
- A. Poor oral intake
- B. Frequent loose stools
- C. Complaints of nausea and vomiting
- D. Increase in carcinoembryonic antigen (CEA)
Correct Answer: D
Rationale: Colorectal cancer's chemo tracks via CEA rising levels signal progression or resistance, a red flag for therapy tweak, needing provider input. Poor intake, diarrhea, and nausea are side effects, manageable with nursing care diet, fluids, antiemetics unless extreme. CEA's uptick, a tumor marker, trumps symptoms, hinting at disease outpacing treatment. Nurses flag this, pushing for scans or regimen shifts, a critical catch in this cancer's chemo dance.
A government initiative to reduce the effects of fatigue in the workforce has recently been rolled out. As anaesthetic lead, you are asked by the chief executive of your institution to develop strategies to reduce fatigue in your department. Appropriate strategies are likely to include:
- A. Changing the frequency of night shifts on the on-call rota from every 3 days to every 2 weeks.
- B. Including a section in the trainee's handbook on the signs of fatigue, along with prevention and management strategies.
- C. Acquiring a departmental exercise bike.
- D. Reducing the number of night shifts worked by colleagues over 55 years of age.
Correct Answer: A
Rationale: Fatigue mitigation in anaesthesia enhances safety. Reducing night shift frequency from every 3 days to every 2 weeks allows recovery (per sleep science, 48-72 hours post-night shift), significantly cutting cumulative fatigue versus less impactful measures. A handbook educates on fatigue signs (e.g., yawning, errors) and strategies (naps, caffeine), but it's passive. An exercise bike offers minor alertness boosts but not sustained relief. Age-based shift reduction addresses older workers' recovery needs, yet evidence favors roster spacing for all. Refreshments help minimally. Frequent night shifts disrupt circadian rhythms and sleep homeostasis, amplifying error risk (e.g., medication misdosing); a 2-week gap aligns with occupational health guidelines for sustained performance.
Which statement is true regarding CT and LP in AIDS patients?
- A. they should all have a CT prior to LP
- B. if they have no focal neurology they do not need a CT
- C. if they have a GSC of 15 they do not need a CT
- D. all of the above are true
Correct Answer: D
Rationale: AIDS LP CT skips if no focal signs, full GCS, no fever push; all hold. Blanket CT's overkill nurses weigh risks, a chronic brain check dance dodging pressure flops.