Nokea
Which of the following are not part of the diabetic retinopathy that cause visual impairment in patients with diabetes?
- A. Pre proliferative retinopathy
- B. Macular oedema
- C. Proliferative retinopathy
- D. Macular degeneration
Correct Answer: D
Rationale: Diabetic retinopathy pre-proliferative, edema, proliferative blur eyes from sugar's vessel rot. Macular degeneration's age, not diabetes. Nurses spot this, a chronic sight split.
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A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.
What does the abbreviation DALY stand for?
- A. Definition of anticipated life years
- B. Diabetes-affected life years
- C. Disability-adjusted life years
- D. Disease-affected life years
Correct Answer: C
Rationale: DALY disability-adjusted life years tallies lost health, not diabetes alone or vague terms. Nurses use this, a chronic burden metric.
The nurse understands that the physician would need to be notified regarding a chemotherapy dose if the client experiences:
- A. Fatigue
- B. Nausea and vomiting
- C. Stomatitis
- D. Bone marrow suppression
Correct Answer: D
Rationale: Chemotherapy's marrow hit bone marrow suppression drops counts like neutrophils or platelets, risking infection or bleeding, a dose-limiting toxicity needing physician review to adjust or pause treatment. Fatigue, nausea, and stomatitis are common, manageable with nursing care rest, antiemetics, mouth rinses unless extreme. Suppression's severity, tied to labs (e.g., ANC <500), halts therapy to protect the client, a critical threshold nurses monitor, distinguishing it from routine side effects, ensuring safety in this marrow-bashing regimen.
A 30yr NZ man goes to PNG, takes 300 mg chloroquine weekly for 2 weeks prior and 4 weeks post his trip. 3/12 later gets febrile/sweats/maleana with malaria parasites on film. The following is true
- A. He took 1/2 the normal dose of chloroquine
- B. If he took primaquine for 2/52 this wouldn't have happened
- C. Assume chloroquine resistance and treat accordingly
- D. This is probably p. falciparum
Correct Answer: C
Rationale: PNG malaria chloroquine's 250 mg norm, resistance rife, not dose, primaquine, or falciparum lock. Nurses switch this chronic resistant fix.
Officially approved blood glucose meters used for self-testing and point-of-care diagnostics are not always suitable to measure the blood glucose values in neonates. Question: What is the main cause for this?
- A. Some meters are calibrated to plasma glucose and other meters to blood glucose
- B. Some measurement methods are sensitive to high levels of ascorbic acid (vitamin C)
- C. The measurement variation of some meters is too large
- D. Some meters are sensitive to abnormal haematocrit values
Correct Answer: D
Rationale: Neonate glucose flubs haematocrit swings throw meters off, not calibration, vitamin C, or variance. Nurses adjust for this, a chronic baby glitch.