Nokea
Which of the following client statements reflect an outcome expectancy statement?
- A. I am not able to exercise
- B. Exercise helps people lose weight
- C. Exercise is too hard on my arthritis
- D. Dietary restrictions work better than exercise to lose weight
Correct Answer: B
Rationale: Outcome expectancy ties behavior to results exercise shedding pounds nails it, a belief nurses tap for motivation. Can't-do's, pain gripes, or diet bets miss that link, just vent or compare. It's a chronic nudge, faith in action's payoff.
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Which of the following statements on NAFLD is false?
- A. Weight loss is the prime way of management
- B. Long-term management is needed
- C. Patients should be referred to specialists for further evaluation
- D. Metformin should be used as first-line treatment in patients with NAFLD and diabetes mellitus
Correct Answer: D
Rationale: Weight loss (5-10%) is prime for NAFLD, long-term care is essential, and specialist referral aids complex cases all true. Statins manage dyslipidemia safely in NAFLD. Metformin, though first-line for diabetes, isn't for NAFLD itself lacking evidence for steatosis reversal making this false. Physicians must clarify this in chronic care planning.
A 35-year old teacher on allopurinol 200 mg OM for the past year reports three recent gout attacks. BMI 27 kg/m2, BP 144/94 mm Hg. You notice tophi over both hands and elbows. You will now:
- A. Stop the allopurinol during this acute gout attack
- B. Start hydrochlorothiazide 25 mg OM for BP control
- C. Continue allopurinol despite the attack and aim to reduce uric acid <300 umol/L
- D. Advise to rest and avoid exercise for 3 months as he is having acute pain
Correct Answer: C
Rationale: Tophi, flares allopurinol stays, push uric <300; thiazides worsen, rest flops, losartan's late. Nurses hold this chronic crystal line.
A client has a platelet count of 9800/mm^3. What action by the nurse is most appropriate?
- A. Assess the client for calf pain, warmth, and redness.
- B. Instruct the client to call for help to get out of bed.
- C. Obtain cultures as per the facility's standing policy.
- D. Place the client on protective isolation precautions.
Correct Answer: B
Rationale: A platelet count of 9800/mm^3 is severely low (normal is 150,000-450,000/mm^3), indicating thrombocytopenia, a common chemotherapy side effect that heightens bleeding risk. The most appropriate action is instructing the client to call for help before getting out of bed to prevent falls or injuries that could trigger uncontrolled bleeding, such as intracranial hemorrhage. Assessing for calf pain, warmth, and redness checks for thrombosis, which is unrelated to low platelets thrombosis risk rises with high counts. Obtaining cultures relates to infection, tied to low white cells, not platelets. Protective isolation is for neutropenia, not thrombocytopenia. This safety-focused intervention minimizes physical risk, crucial in oncology where low platelets demand proactive prevention to avoid life-threatening bleeds, empowering the client while ensuring nurse oversight.
Choose the CORRECT statement Babies born from mothers with gestational diabetes:
- A. Are at a high risk of being born with diabetes
- B. Are usually hypoglycaemic due to maternal insulin drug therapy
- C. Are usually of higher birth weight
- D. Are always given a glucose challenge test
Correct Answer: C
Rationale: Gestational diabetes fattens babies high maternal sugar pumps fetal growth, a hefty birth norm. They don't inherit diabetes at birth, hypo's rare unless mom's on insulin, tests aren't routine. Nurses track this, a chronic womb echo.
The nurse is caring for a client with type 2 diabetes who has been hospitalized with severe hyperglycemia. Which of the following topics will be most important to include in discharge teaching?
- A. Effect of endogenous insulin on transportation of glucose into cells
- B. Function of the liver in formation of glycogen and gluconeogenesis
- C. Impact of the client's family history on likelihood of developing diabetes
- D. Symptoms indicating that the client should contact the health care provider
Correct Answer: D
Rationale: Discharge teaching for type 2 diabetes post-hyperglycemia hinges on crisis prevention knowing when symptoms like thirst or confusion scream for help beats insulin mechanics, liver roles, or family odds. Clients need actionable cues to self-manage, not just theory; recognizing trouble and calling in keeps them out of the ER. Physiology's useful, genetics informative, but spotting escalation's life-saving, a chronic care must nurses drill into patients for real-world control.