Nokea
What is the essence of motivational interviewing?
- A. That change strategies must exactly match the patient's motivation
- B. That behavioural change is impossible if the patient does not want it
- C. That the counsellor motivates the patient to change and increases patient involvement
- D. That the patient's motives to show unhealthy behaviour are systematically analysed
Correct Answer: C
Rationale: Motivational interviewing counsellor sparks, pulls patients in, not rigid matches, impossibles, or motive digs. Nurses roll this, a chronic engagement art.
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The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?
- A. Adjust the dose to the patient's present symptoms
- B. Wash hands with an alcohol-based cleanser following administration
- C. Use gloves and a lab coat when preparing the medication
- D. Dispose of the antineoplastic wastes in the hazardous waste receptacle
Correct Answer: D
Rationale: Antineoplastics are hazardous proper disposal in designated receptacles is critical to protect staff, patients, and the environment from toxic exposure. Gloves and gowns are standard for prep, but the question stresses one action, and disposal trumps as a universal safety net. Dosing's fixed by protocol, not symptoms tweaking's dangerous. Alcohol-based cleansers don't cut it post-exposure; soap and water are needed pre- and post-handling to remove residue. Emphasizing disposal aligns with OSHA and oncology nursing standards, ensuring chemo waste (e.g., IV bags, syringes) doesn't leak into regular trash, a key lesson for newbies in this high-stakes field.
A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, 'I am so tired I can hardly get out of bed in the morning.' Which intervention should the nurse add to the plan of care?
- A. Minimize activity until the treatment is completed.
- B. Establish time to take a short walk almost every day.
- C. Consult with a psychiatrist for treatment of depression.
- D. Arrange for delivery of a hospital bed to the patient's home.
Correct Answer: B
Rationale: Radiation fatigue's brutal Hodgkin's therapy saps energy, but short walks fight deconditioning without overtaxing. Resting fully risks weakness; depression isn't assumed fatigue's treatment-driven. A bed doesn't fix it. Nurses in oncology balance this activity preserves function, key for lymphoma patients slogging through radiation's grind.
Which of the following is NOT an example of intermittent fasting?
- A. Alternate day fasting
- B. Mediterranean dieting
- C. Modified fasting regimes such as the 5:2 diet'
- D. Time restricted feeding
Correct Answer: B
Rationale: Fasting flips alternate, 5:2, timed, holy skips; Mediterranean's steady, not starved. Nurses clock this chronic fast gap.
After a road traffic accident at 50 miles per hour, a healthy 30-year-old patient is admitted to a major trauma centre with a closed femoral shaft fracture and pulmonary contusion. Routine management in the intensive care unit is likely to include:
- A. A tertiary survey.
- B. A course of broad-spectrum antibiotics.
- C. Non-specific medical treatment of a rising creatinine kinase concentration (CK).
- D. Delay in physiotherapy to minimize bleeding.
Correct Answer: A
Rationale: ICU care post-trauma ensures comprehensive management. A tertiary survey (head-to-toe reassessment) identifies missed injuries (e.g., fractures), routine within 24-48 hours per trauma protocols, critical with polytrauma risks like this case. Antibiotics aren't routine without infection (e.g., open fracture); pulmonary contusion alone doesn't justify them. Rising CK from muscle damage (femoral fracture) may need monitoring (rhabdomyolysis risk), but treatment (e.g., fluids) is specific, not non-specific. Early physiotherapy aids recovery, not delayed bleeding risk is minimal with closed fractures post-stabilization. Surviving Sepsis guidelines apply only with sepsis. The tertiary survey's systematic approach prevents oversight, ensuring holistic care in a high-energy trauma patient.
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.