Nokea
What do you tell patients is the most important risk factor for lung cancer when you are teaching about lung cancer prevention?
- A. Cigarette smoking
- B. Exposure to environmental/occupational carcinogens
- C. Exposure to environmental tobacco smoke (ETS)
- D. Pipe or cigar smoking
Correct Answer: A
Rationale: Cigarette smoking towers as lung cancer's top risk 80-90% of cases tie to its carcinogens like tar and nicotine, a dose-dependent killer dwarfing other factors. Environmental/occupational exposures like asbestos amplify risk, especially with smoking, but lack its prevalence. ETS hikes risk by 35%, significant yet secondary. Pipe or cigar smoking carries risk, less than cigarettes due to inhalation patterns. Teaching smoking as paramount drives home its preventable dominance, urging cessation as the gold-standard defense, a nurse's key message to slash lung cancer odds, backed by epidemiology and public health campaigns.
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A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
Which drug should not be given with midazolam?
- A. zidovudine
- B. lamivudine
- C. nevirapine
- D. indinavir
Correct Answer: D
Rationale: Indinavir boosts midazolam P450 clash sedates too deep, unlike zidovudine, lamivudine, nevirapine, or ritonavir's fit. Nurses dodge this chronic sleep trap.
Which of the following health determinants is NOT a component of Lalonde's model?
- A. Biological factors
- B. Physical environment
- C. Health care
- D. Attitude to life
Correct Answer: D
Rationale: Lalonde's grid biology, environment, care, not attitude shapes health, not mindsets. Nurses map this, a chronic model cut.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Recognition and self-management of hypoglycaemia
- C. Sick day management
- D. Stopping all oral hypoglycaemic agents
Correct Answer: D
Rationale: Insulin education builds control technique, hypo spotting, sick days, and driving safety are musts, ensuring delivery, crisis handling, and road smarts. Stopping all oral agents isn't universal; many stay on metformin or SGLT-2s for synergy, not a blanket rule. Tailored plans keep or ditch orals, dodging this absolute. Clinicians teach what fits, not a one-size purge, a nuanced chronic care tweak over rigid cuts.