Nokea
The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first?
- A. A 35-yr-old patient who has wet desquamation associated with abdominal radiation
- B. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer
- C. A 24-yr-old patient who received neck radiation and has blood oozing from the neck
- D. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation
Correct Answer: C
Rationale: Neck oozing post-radiation flags carotid rupture a bleed-out risk trumping wet skin , sobs , or heart rub (D tamponade's slower). Nurses in oncology bolt here airway and blood loss kill fastest, demanding stat checks.
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Oxygen radicals play a role in the development of which of the following options?
- A. Diabetic dyslipidaemia
- B. Insulin resistance
- C. Mitochondrial dysfunction
- D. B+C
Correct Answer: D
Rationale: Oxygen radicals torch cells insulin resistance via inflammation, mitochondrial dysfunction via damage. Dyslipidaemia rides along, not direct nurses see this duo, a chronic stress pair.
The mechanism of action of Rosiglitazone is a
- A. Insulin releasing agent
- B. PPAR γ agonist
- C. Increases cellular uptake of glucose
- D. Reduces release of insulin
Correct Answer: B
Rationale: Rosiglitazone's PPAR γ agonist flips gene switches, boosts insulin sensitivity, a chronic cell tweak. It's not an insulin releaser, direct uptake driver, or suppressor sulphonylureas release, metformin ups uptake, none cut insulin. Pharmacists bank on this, a sensitivity shift for type 2's root.
Which of the following interventions should be included in the nutrition care plan of the client with atherosclerosis?
- A. Limit sodium intake to 6 g per day
- B. Increase full-fat dairy products
- C. Increase saturated fats
- D. Increase daily intake of vegetables, fruits, and whole grains
Correct Answer: D
Rationale: Atherosclerosis plaque-laden arteries thrives on poor diet. Boosting vegetables, fruits, and whole grains slashes cholesterol and inflammation, slowing plaque via fiber and antioxidants, a cornerstone of cardiac nutrition. Sodium limits help hypertension, but 6 g exceeds heart-healthy goals (2.3 g). Full-fat dairy and saturated fats fuel plaque, worsening disease. Nurses push plant-based eating, aligning with evidence to reverse atherosclerosis's march, a proactive step over mere restriction in this vascular battle.
A 56 year old lady with Type 2 DM and a BMI of 30 kg/m2 is reviewed by her family doctor due to poor glycaemic control. She is treated with oral gliclazide since she is diagnosed as diabetic and currently she is on 160 mg bid. Her serum creatinine is 110 μmol/L. Which ONE of the following medications should be most appropriately to be added next?
- A. Metformin
- B. Acarbose
- C. Pioglitazone
- D. Insulin
Correct Answer: A
Rationale: Gliclazide maxed, HbA1c off metformin's next, safe at creatinine 110 (eGFR likely 50+), tackling insulin resistance in obesity. Acarbose slows carbs, pioglitazone risks fluid, insulin's later, linagliptin's fine but less foundational. Nurses add this chronic sugar anchor, boosting control without kidney strain.
Which of the following laboratory abnormalities is NOT associated with fatty liver?
- A. Elevated uric acid
- B. Elevated LDL-cholesterol
- C. Elevated fasting glucose
- D. Elevated creatinine kinase
Correct Answer: D
Rationale: Fatty liver (NAFLD) links to metabolic syndrome elevated uric acid, LDL-cholesterol, fasting glucose, and triglycerides reflect insulin resistance and dyslipidemia. Elevated creatinine kinase (CK) indicates muscle damage (e.g., myopathy), not a typical NAFLD feature, though liver enzymes (ALT/AST) rise. CK's absence from NAFLD profiles guides physicians in differential diagnosis during chronic liver disease assessment.