Nokea
When using induced hypotension during orthognathic surgery:
- A. Mean arterial blood pressure may be reduced to 30% of normal in patients of ASA grade I.
- B. The stress response to surgery is attenuated.
- C. Drugs that cause relative bradycardia are useful adjuncts.
- D. The desired effects of clonidine are mediated by αâ‚-adrenoceptors.
Correct Answer: C
Rationale: Induced hypotension in orthognathic surgery reduces bleeding, enhancing visibility. Mean arterial pressure (MAP) drops to 50-65 mmHg (not 30% of normal, ~20-25 mmHg, which risks ischemia), safe in ASA I patients with monitoring. Stress response attenuation occurs with deep anaesthesia, not hypotension alone. Bradycardia-inducing drugs (e.g., β-blockers, remifentanil) stabilize haemodynamics, aiding controlled hypotension by lowering cardiac output safely. Clonidine, an α₂-agonist (not αâ‚), reduces sympathetic outflow, supporting hypotension and sedation. Invasive monitoring mitigates pressure injury risk. Bradycardia's role enhances technique precision, minimizing transfusion needs while maintaining perfusion in healthy patients.
You may also like to solve these questions
Cholesterol contributes to the pathogenesis and progression of NASH via which mechanism?
- A. Reduction of steatosis
- B. Increase of steatosis
- C. Increase of inflammation
- D. Increase of the feeling of satiety
Correct Answer: C
Rationale: Cholesterol stokes NASH inflammation rises, not steatosis alone or satiety shifts. A chronic fire feeder nurses link this to liver woes.
In patients who are awake during craniotomy, appropriate statements include:
- A. For a temporal lesion, neurosurgeons are likely to require the sitting position.
- B. A tracheal tube is likely to be used.
- C. A urinary catheter is likely to be inserted.
- D. Intraoperative seizures are likely to occur during cortical mapping.
Correct Answer: C
Rationale: Awake craniotomy allows functional mapping and patient cooperation. The sitting position is rare due to air embolism risks and is not specific to temporal lesions; supine or lateral positions are standard. A tracheal tube is avoided to maintain airway control via less invasive means (e.g., nasal cannula), as patients must remain responsive. A urinary catheter is routine for longer procedures to manage fluid balance and patient comfort, given immobility and duration. Patient anxiety is common but manageable, not an absolute contraindication. Seizures can occur during cortical mapping due to electrical stimulation, but likely' overstates frequency; they're a risk, not a certainty. The urinary catheter's inclusion reflects practical perioperative care, ensuring monitoring and comfort without interrupting the procedure's focus on brain function preservation.
Regarding HIV/AIDS
- A. Shingles, seborrhoeic dermatitis and recurrent HSV infections are typical of early infection
- B. A CD4 count of 1.0 x 10^9/L is associated with late stage AIDS
- C. Pre and post test counselling for HIV serology is now no longer mandatory
- D. Pneumococcus is a more likely pathogen than TB in AIDS patients with pneumonia
Correct Answer: D
Rationale: HIV early skin woes, CD4's units flop, counseling holds, TB trumps pneumococcus, toxo hits brain. Nurses chase this chronic lung truth.
The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?
- A. Salvage surgery
- B. Palliative surgery
- C. Prophylactic surgery
- D. Reconstructive surgery
Correct Answer: C
Rationale: A bilateral mastectomy here is prophylactic removing nonvital breasts to prevent cancer in a high-risk patient with a positive tumor marker and family history. It's about risk reduction, not treatment of existing disease. Salvage surgery tackles recurrence after a less aggressive initial approach, like resecting a regrown tumor. Palliative surgery eases symptoms (e.g., pain from obstruction) in advanced cases, not prevention. Reconstructive surgery restores form or function post-treatment, like breast reconstruction after curative mastectomy. Prophylactic fits this preemptive strike, driven by genetic or familial risk (e.g., BRCA mutations), a growing trend in oncology to outpace cancer's onset, guided by nurses supporting informed, tough choices.
A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate?
- A. The cancer involves only the cervix.
- B. The cancer cells look like normal cells.
- C. Further testing is needed to determine the spread of the cancer.
- D. It is difficult to determine the original site of the cervical cancer.
Correct Answer: A
Rationale: Tis, N0, M0 means carcinoma in situ cancer's stuck to the cervix's surface, no invasion (T0), no lymph nodes (N0), no metastases (M0). It's early, contained. B's wrong grading, not staging, covers cell look (differentiation). C's off no spread's confirmed already. D's nonsense the cervix is the origin. Nurses break this down in oncology to ease fears only the cervix' signals a shot at cure with local treatment, not systemic chaos yet.