Nokea
What is an important independent risk factor for the development of type 2 diabetes mellitus?
- A. Alcohol use
- B. Ethnicity
- C. Socioeconomic status
- D. All three options above
Correct Answer: B
Rationale: Ethnicity stands tall South Asians, Hispanics outpace Caucasians in type 2 risk, genes and fat patterns at play. Alcohol's murky, socioeconomic status shapes access, not biology nurses see heritage trump these, a chronic marker needing tailored screens.
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In Europe and the USA, drugs licensed for use in intrathecal drug delivery systems include:
- A. Diamorphine.
- B. Methadone.
- C. Morphine.
- D. Ziconotide.
Correct Answer: C
Rationale: Intrathecal drug delivery systems (IDDS) use specific licensed drugs in Europe and the USA. Morphine is widely approved for its efficacy in cancer and chronic pain, binding spinal opioid receptors with a strong evidence base. Ziconotide, a non-opioid, is also licensed, targeting calcium channels for refractory cases. Diamorphine (heroin) isn't licensed intrathecally; it's used epidurally or systemically in some regions (e.g., UK palliative care) but lacks IDDS approval. Methadone's long half-life and oral efficacy preclude intrathecal use; it's not licensed. Ketamine has experimental use but no formal approval. Morphine's prominence stems from its pharmacokinetic suitability high potency and spinal receptor affinity making it a cornerstone of IDDS therapy alongside ziconotide.
The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient?
- A. Fatigue related to altered metabolic processes
- B. Altered nutrition: less than body requirements related to anorexia
- C. Risk for infection related to altered immunologic response
- D. Body image disturbance related to weight loss and anorexia
Correct Answer: C
Rationale: HSCT obliterates marrow, tanking immunity risk for infection soars as neutrophils vanish, making it the top nursing diagnosis pre-transplant. Sepsis can kill fast in this window, unlike fatigue or nutrition issues, which matter but aren't immediate threats. Body image might nag later with hair loss or weight shifts, but infection's the killer to watch. Nurses lock in on this, driving strict isolation and monitoring, knowing a stray germ could derail everything in oncology's high-stakes transplant game.
A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first?
- A. Give the patient the prescribed PRN opioid.
- B. Assess for sensation and strength in the legs.
- C. Notify the health care provider about the symptoms.
- D. Teach the patient how to use relaxation to reduce pain.
Correct Answer: B
Rationale: Stage IV lung cancer plus back pain flags spinal cord compression leg checks for numbness or weakness come first; paralysis kills fast. Opioids , calls , or relaxation follow. Nurses in oncology prioritize this neuro's the lifeline, catching mets' chaos early.
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching?
- A. The patient ambulates several times a day in the room
- B. The patient's visitors bring in some fresh peaches from home
- C. The patient cleans with a warm washcloth after having a stool
- D. The patient uses soap and shampoo to shower every other day
Correct Answer: B
Rationale: Neutropenia post-chemo low neutrophils craves germ-free zones; fresh peaches from home carry bacteria, a teaching gap as raw produce risks infection in this immune-wrecked state. Ambulation's safe, hygiene's spot-on washcloths and showers cut germs. Nurses reteach, banning unwashed fruit, a vital shield in leukemia's neutropenic peril, ensuring clients grasp this microbial minefield.
The best way to prevent chronic complications of Diabetes is to:
- A. Take medications as prescribed and remove sugar from the diet completely
- B. Check feet daily for cuts, long toe nails and infections between the toes
- C. Maintain a BGL that is as close to normal as possible
- D. Undertake daily exercise to burn up the excess glucose in the system
Correct Answer: C
Rationale: Diabetes' chronic woes tight BGL control trumps meds-no-sugar, foot checks, or exercise alone, cutting nerve, eye, kidney hits. Nurses push this, a sugar-steered win.