Nokea
The pathophysiology of Asthma differs from COPD as:
- A. It is characterised by airflow limitation.
- B. There is abnormal inflammatory response to exposure to noxious particles or gases.
- C. The airflow limitation is reversible.
- D. It is considered an obstructive lung disease.
Correct Answer: C
Rationale: Asthma and COPD both feature airflow obstruction, but their pathophysiology diverges critically. Both have limitation, but asthma's is intermittent and reversible with bronchodilators due to bronchial hyperresponsiveness and inflammation (e.g., eosinophilic), per Farrell (2017). COPD's abnormal inflammatory response to noxious stimuli (e.g., smoking) causes progressive, irreversible damage (e.g., neutrophilic, emphysema), not asthma's profile. Reversibility defines asthma spirometry normalizes post-treatment unlike COPD's fixed obstruction (FEVâ‚/FVC <0.7 persists). Both are obstructive diseases, but this isn't the distinguishing feature. Asthma's reversible limitation stems from smooth muscle spasm and mucosal edema, responsive to therapy, contrasting COPD's structural loss (alveolar destruction), making this the key differential in clinical management and prognosis.
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Chemotherapeutic treatment of acute leukemia is done in four phases. Place these phases in the correct order.
- A. Maintenance
- B. Induction
- C. Intensification
- D. Consolidation
Correct Answer: B
Rationale: Acute leukemia's chemotherapy unfolds systematically: induction kicks off, aggressively killing leukemia cells to induce remission, a high-dose blitz. Intensification follows, targeting residual cells over months, relentless in early remission. Consolidation reinforces, eliminating lingering blasts post-remission, solidifying gains. Maintenance, with lower doses, sustains remission long-term, preventing relapse. This order induction, intensification, consolidation, maintenance mirrors the disease's need for initial eradication then sustained control, a structured approach nurses reinforce through patient education and monitoring, ensuring each phase's purpose aligns with leukemia's aggressive biology and treatment goals.
A primary nursing responsibility is the prevention of lung cancer by assisting patients in smoking/tobacco cessation. Which tasks would be appropriate to delegate to the LPN/LVN?
- A. Develop a quit plan
- B. Explain the application of a nicotine patch
- C. Discuss strategies to avoid relapse
- D. Suggest ways to deal with urges for a tobacco
Correct Answer: B
Rationale: LPN/LVNs shine in standardized teaching like explaining nicotine patch application, a medication-focused task within their scope, detailing placement and timing to aid cessation. Developing a quit plan requires RN-level planning and assessment of individual needs. Discussing relapse strategies involves behavioral counseling, an RN forte. Suggesting urge-coping methods needs tailored insight, beyond LPN/LVN training. Patch explanation leverages their skills, supporting lung cancer prevention through practical cessation aid, a delegated task enhancing team efforts while keeping complex planning with RNs.
Which of the following statements is INCORRECT? The treatment of diabetes in traditional Chinese medicine involves
- A. Formula for Diabetes (Xiaoke Fang) for the Upper Type: Heat in the Lung which consumes Body Fluid
- B. Jade Maid Decoction (Yunu Jiang) for the Middle Type: excessive Heat in the Stomach
- C. Six Ingredients Rehmannia Pill (Liuwei Dihuang Wan) for the Lower Type: excessive of Kidney Yin and excessive of Yin and Yang
- D. Yam (Dioscorea opposita)
Correct Answer: C
Rationale: Traditional Chinese diabetes care Upper, Middle, Lower types nails Lung heat, Stomach fire, but Kidney's Yin deficiency, not excess Yin-Yang, flops. Xiaoke Fang, Yunu Jiang fit; Liuwei Dihuang Wan balances, doesn't overdo; yam's a lone root, not typed. Clinicians spot this, a chronic TCM misstep.
During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next?
- A. Obtain more information about the family history.
- B. Schedule a sigmoidoscopy to provide baseline data.
- C. Teach the patient about the need for a colonoscopy at age 50.
- D. Teach the patient how to do home testing for fecal occult blood.
Correct Answer: A
Rationale: Family history of colon cancer flags risk first step's digging deeper: who, when, how many cases? That shapes if it's sporadic or hereditary (e.g., Lynch syndrome), guiding screening timing. Jumping to sigmoidoscopy or fecal tests skips assessment too soon without details. Colonoscopy at 50's standard, but family history might bump it earlier (e.g., 40 or 10 years before kin's diagnosis). Nurses in oncology start here, gathering intel to tailor prevention, not rushing tools that might miss the mark without context.
Mr Yee, 45 years old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over his left elbow. He says that two years ago he took allopurinol 100 mg for one month followed by 200 mg OM for one month, but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago. He says he took it likely 'once or twice a week'. He states that he did not experience any rashes or other side effects to it then. He did not go back to see his previous GP as he has moved house and your clinic is nearer to his home. He does not drink alcohol except one glass of wine once or twice a year on special occasions. Two weeks ago, he was admitted to the hospital for a gout flare. He had blood tests done, which returned the results below. He is asking you to give him Arcoxia standby as it usually works for his gout flare. Uric acid 620 mmol/L, Creatinine 96 umol/L, eGFR >90 mL/min, BP 144/94 mmHg. He has HTN on HCTZ long-term. Which is incorrect advice?
- A. Offer to restart allopurinol and explain that it does not work immediately. You may wish to discuss HLA B5801 testing particularly as it is unclear how frequent and for how long he was taking allopurinol previously
- B. Advise that he will need stepwise up-titration of a urate lowering agent to reach uric acid target. Regular blood tests will allow this to be done safely
- C. Advice that colchicine prophylaxis is helpful to prevent gout attacks, as it takes time for a urate lowering agent to reach uric acid target
- D. Advise him that allopurinol is ineffective. Offer to initiate febuxostat or probenecid immediately
Correct Answer: D
Rationale: Tophus and 620 uric acid yell chronic gout allopurinol's not bunk; past spotty use tanked it, not the drug. Restarting with titration, colchicine cover, and allergy watch fits; HLA testing flags risk. Swapping to febuxostat or probenecid skips allopurinol's shot wrong call when adherence, not efficacy, flopped. Clinicians correct this, steering chronic control right.