Nokea
The spinothalamic and dorsal column sensation are examined as part of a neurological examination. One of the items belonging to dorsal column sensation is the sense of vibration, which is examined by means of a tuning fork. Question: What is the required frequency of this tuning fork?
- A. 512 Hz
- B. 256 Hz
- C. 128 Hz
- D. 64 Hz
Correct Answer: C
Rationale: Vibration check 128 Hz hums right, dorsal column's sweet spot, not higher or lower. Nurses tune this, a chronic nerve test.
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Clients with chronic illness want the health care system to provide them with which of the following?
- A. Less information
- B. Less travel time
- C. Ways to adjust to disease consequences
- D. Limited information on ways to cope with their symptoms
Correct Answer: C
Rationale: Chronic folks crave adaptation tools handling fear, sleep woes, or sex shifts not less info or travel ease. Nurses deliver this, a lifeline for illness' long tail, not just quick fixes.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient's subsequent plan of care?
- A. Limit the time that visitors spend at the patient's bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patient's care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: HDR implants (brachytherapy) emit radiation limiting visitor time (e.g., 30 min) cuts exposure risk. Self-care's nice but not safety-driven. Gender's irrelevant pregnant staff avoid, not males. Shared rooms up exposure, not safety. Nurses in oncology enforce this, shielding others while the source's active, a radiation rule of thumb.
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.
Madam Lim 79 years old is functionally independent and lives in the community. She has osteoarthritis of the knee and hypertension. What would you set her target BP to be?
- A. <120/80 mmHg
- B. <130/80 mmHg
- C. <135/85 mmHg
- D. <150/90 mmHg
Correct Answer: D
Rationale: Fit 79 <150/90 balances hypertension, age; tighter risks falls, joints. Nurses set this chronic elder goal.
Which of the following is FALSE about brain natriuretic peptide (BNP)?
- A. Plasma levels of BNP often correspond to the severity of underlying cardiac dysfunction and can provide relatively reliable prognostic information
- B. It is secreted in response by the atria and ventricles in response to stretching for increased wall tension
- C. Obesity, diuretics, ACE inhibitors, beta blockers, angiotensin receptor antagonists, and aldosterone antagonists can lead to falsely high levels of BNP
- D. Common conditions that may falsely elevate plasma BNP levels include age and significant renal dysfunction
Correct Answer: C
Rationale: BNP reflects cardiac dysfunction severity and wall tension response true. Age and renal dysfunction elevate BNP falsely true. However, obesity, diuretics, ACEi, beta blockers, ARBs, and MRAs lower BNP (obesity reduces secretion, drugs reduce tension), not raise it making this false. High BNP (>1,000 pg/mL) signals poor prognosis. This corrects BNP interpretation in chronic HF.