Nokea
The single most effective intervention to reduce the risk of developing COPD and stop its progression is
- A. Increased physical activity
- B. Prompt intervention for chest infection
- C. Smoking Cessation
- D. Avoidance of indoor and outdoor pollutants
Correct Answer: C
Rationale: COPD's king fix quit smoking slashes risk and stalls damage, trumping exercise, infection zaps, or pollution dodges. It's the top toxin, 80% of cases, a chronic killer nurses chase down hard.
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Which of these organisms causing gastroenteritis produce the toxin in the food prior to ingestion?
- A. vibrio cholera
- B. salmonella
- C. staph aureus
- D. clostridium perfringens
Correct Answer: C
Rationale: Staph aureus pre-toxins food, not cholera, salmonella, E. coli, Clostrid's gut brew. Nurses tag this chronic picnic poison.
Renal failure is the second cause of death in patients with diabetes mellitus. Question: What is the end (histological) stage in the development of diabetic nephropathy?
- A. Arteriolar hyalinosis
- B. GBM thickening
- C. Kimmerstiel Wilson lesions
- D. Mesangial matrix expansion
Correct Answer: C
Rationale: Diabetic nephropathy's end Kimmerstiel Wilson nodules scar kidneys, past thickening or expansion. Nurses dread this, a chronic renal doom mark.
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
Which is not an AIDS defining illness?
- A. oesophageal candidiasis
- B. Herpes Zoster
- C. CD4 count <200 cells/microL
- D. Pulmonary TB
Correct Answer: B
Rationale: Herpes zoster's no AIDS marker just shingles, common even sans HIV collapse. Oesophageal thrush, PCP, TB scream opportunists; CD4's a lab line, not illness. Nurses flag true definers chronic crash signs not this skin flare anyone catches.
The nurse is discharging home a client at risk for venous thromboembolism on enoxaparin sodium. What instruction is a priority for the nurse to provide to this client?
- A. Notify your health care provider if your stools appear dark or tarry
- B. You must have your prothrombin time (PT)/international normalized ratio (INR) checked every 2 weeks
- C. Massage the injection site after the heparin is injected
- D. You must have your activated partial thromboplastin time (aPTT) checked every 72 hours
Correct Answer: A
Rationale: Enoxaparin, a low-molecular-weight heparin, thins blood dark, tarry stools signal GI bleed, a dire side effect needing instant reporting to halt hemorrhage. PT/INR tracks warfarin, not enoxaparin; aPTT's for unfractionated heparin. Massaging injection sites risks bruising. Nurses prioritize bleed watch, ensuring safety on this clot-busting med, a discharge must-know.