Nokea
The signs and symptoms of heart failure do not include:
- A. Dyspnoea
- B. Orthopnoea
- C. Urinary frequency
- D. Fatigue
Correct Answer: C
Rationale: Heart failure floods breathless, flat-lie gasps, swelling, wiped out. Peeing often? Kidneys, not heart others scream pump fail. Nurses clock these, a chronic wet mess minus bladder.
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The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
- A. Monthly self-breast exams
- B. Smoking cessation
- C. Annual colonoscopies
- D. Monthly testicular exams
Correct Answer: B
Rationale: Lung cancer tops the list of cancer deaths in North America for both men and women, as noted in the feedback, with over 570,000 deaths projected in 2011 alone. Smoking is the primary risk factor for lung cancer, making cessation the most direct intervention to tackle this killer. Self-breast and testicular exams target breast and testicular cancers, respectively, which rank lower in mortality (breast is second for women, prostate second for men). Colonoscopies address colorectal cancer, third in frequency, but lung cancer's dominance ties directly to smoking's prevalence. By pushing cessation, nurses hit the root cause head-on, reducing exposure to carcinogens like tar and nicotine that drive malignant transformation in lung tissue. This aligns with primary prevention, cutting incidence before it starts, unlike screening which catches disease later.
Essential education for patients with regards to insulin therapy includes the following except:
- A. Hypoglycaemia management
- B. Sickday management
- C. Prescribing insulin
- D. Safe driving
Correct Answer: C
Rationale: Insulin education patients learn hypo fixes, sick day tweaks, driving rules, needle skills; prescribing's the doc's job, not their load. Nurses drill this chronic self-care kit, skipping the script-writing bit for pros.
The family of a neutropenic client reports that the client is confused and 'is not acting right.' What action by the nurse is the priority?
- A. Delegate taking a set of vital signs
- B. Ask the client about pain
- C. Look at today's laboratory results
- D. Assess the client for a urinary tract infection
Correct Answer: A
Rationale: Neutropenia slashes immunity confusion screams infection, like sepsis, needing instant vitals to catch fever or shock, a priority delegated to flag danger fast per ABCs. Pain's a clue, but vitals trump. Labs lag; UTI assessment follows. Nurses lean on teamwork, ensuring rapid data in this infection-prone fog, a life-saving first step.
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?
- A. The patient requests that her family bring her makeup and wig
- B. The patient begins to discuss the future with her family
- C. The patient reports less disruption from pain and discomfort
- D. The patient cries openly when discussing her disease
Correct Answer: A
Rationale: Alopecia guts self-image, especially at 16 requesting makeup and a wig shows she's fighting back, reclaiming her look and confidence. It's active, not passive, unlike future talks (hopeful but vague), less pain (physical, not emotional), or crying (raw but not progress). Nurses in oncology cheer this, knowing it signals resilience against chemo's brutal psychosocial hit, a win for body image goals.
The Lee Revised Cardiac Risk Index:
- A. Has been validated to predict the risk of mortality after major non-cardiac surgery.
- B. Is a complex algorithm.
- C. Provides a simple additive score incorporating six risk factors.
- D. Discriminates well between patients at moderate and severe risk of adverse cardiac outcome.
Correct Answer: C
Rationale: The Lee Revised Cardiac Risk Index (RCRI) predicts cardiac complications (e.g., myocardial infarction) after non-cardiac surgery. It's validated for morbidity, not mortality specifically, though it correlates with outcomes. It's not a complex algorithm but a straightforward tool: six factors (high-risk surgery, ischemic heart disease, heart failure, stroke/TIA, diabetes on insulin, renal insufficiency) are scored additively (0-6). This simplicity aids clinical use, providing risk percentages (e.g., 0.4% for 0 points, 11% for ≥3). It discriminates moderate-to-high risk well but less so at extremes. Age >70 isn't an automatic point; risk factors are specific. Its strength lies in its evidence-based, user-friendly design for perioperative cardiac risk stratification.