Nokea
Which of the following diseases has the highest proportion of chronic illness deaths in Canada?
- A. Cancer
- B. Diabetes
- C. Cardiovascular disease
- D. Chronic respiratory disease
Correct Answer: C
Rationale: Cardiovascular disease tops Canada's chronic death chart 37% globally in 2012 outpacing cancer's 27%, respiratory's 8%, and diabetes' 4%. Heart attacks and strokes dominate, fueled by aging and lifestyle, a stat nurses lean on for prevention focus. Cancer's big, breathing woes and sugar issues trail, but heart's the killer king, a chronic burden demanding vigilance.
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Chronic obstructive pulmonary disease (COPD) is associated with:
- A. Skeletal muscle dysfunction.
- B. Mean pulmonary arterial pressure of ≥ 25 mm Hg.
- C. Significant reversibility in airflow limitation with bronchodilator therapy.
- D. Depression.
Correct Answer: A
Rationale: COPD is a progressive lung disease characterized by airflow limitation that is not fully reversible. Skeletal muscle dysfunction is a well-documented extrapulmonary manifestation due to systemic inflammation, oxidative stress, and reduced physical activity, leading to muscle wasting and weakness. Elevated mean pulmonary arterial pressure (≥ 25 mm Hg) defines pulmonary hypertension, which can occur secondary to COPD but is not a universal feature. Significant reversibility in airflow limitation is more typical of asthma, not COPD, where bronchodilator response is limited. The FEVâ‚/FVC ratio in COPD is typically <0.7, not >0.7, making that option incorrect. Depression is common in COPD patients due to chronic illness and reduced quality of life, but it's not a defining feature. Among these, skeletal muscle dysfunction is most consistently associated with COPD pathophysiology, reflecting its systemic impact beyond the lungs.
Appropriate statements concerning radiology and trauma interventional radiology include:
- A. To rule out injury of the cervical spine in the unconscious patient, application of a protocol involving a computed tomography (CT) scan to the neck is recommended.
- B. A FAST (Focused Assessment with Sonography for Trauma) scan is a specific investigation for assessment of intraperitoneal bleeding.
- C. In a patient who is persistently hypotensive in the emergency department despite adequate fluid resuscitation, radiological interventions to treat bleeding caused by a pelvic fracture are not recommended.
- D. Interventional radiology has a role in the management of injuries to the liver, kidney and spleen.
Correct Answer: A
Rationale: Trauma radiology optimizes diagnosis and intervention. CT is the gold standard for cervical spine assessment in unconscious patients, per NICE guidelines, offering high sensitivity for fractures/ligamentous injury versus plain films. FAST scans detect free fluid (e.g., blood) intraperitoneally but lack specificity positive findings need confirmation (e.g., CT). Persistent hypotension with pelvic fracture warrants interventional radiology (e.g., embolization), not dismissal contrary to the statement. Interventional radiology manages solid organ injuries (liver, kidney, spleen) via embolization, reducing surgical need. Staffing in radiology matches theatre for critical cases. CT's diagnostic precision in cervical spine trauma ensures timely, accurate management, critical in unconscious patients where clinical exam is unreliable.
The nurse is caring for a client with mitral regurgitation. Which of the following would the nurse anticipate the client to develop if left untreated?
- A. Left-sided heart failure
- B. Right-sided heart failure
- C. Renal failure
- D. Myocardial ischemia
Correct Answer: A
Rationale: Mitral regurgitation backflows blood into the left atrium, hiking pressure and volume untreated, it overburdens the left ventricle, leading to left-sided heart failure. Pulmonary congestion follows, with dyspnea and edema, a direct consequence of this valve flaw. Right-sided failure stems from downstream effects or separate causes, not primary here. Renal failure or ischemia might complicate advanced disease, but left-sided failure's progression is the immediate risk, rooted in mitral dysfunction's mechanics. Nurses anticipate this, monitoring for early signs like crackles, ensuring timely intervention to halt this predictable cardiac cascade.
Risk factors for developing COPD do not include:
- A. Smoking - passive or active
- B. Age
- C. High fat diet
- D. Indoor and outdoor air pollution
Correct Answer: C
Rationale: COPD's lung wreckers smoking, age, pollution scar airways, no dodge. High fat diet fattens, not chokes lungs; it's metabolic, not respiratory. Nurses target smoke and smog, not butter, a chronic breath stealer's true culprits.
For a patient who is receiving chemotherapy, which laboratory result is of particular importance?
- A. WBC
- B. PT and PTT
- C. Electrolytes
- D. BUN
Correct Answer: A
Rationale: Chemotherapy suppresses bone marrow, slashing white blood cell counts especially neutrophils heightening infection risk, making WBC monitoring paramount. Low counts trigger protective measures or treatment holds, directly tied to therapy's myelosuppressive core. PT and PTT track clotting, relevant for bleeding but less immediate. Electrolytes matter for overall status, but imbalances aren't chemotherapy's primary threat. BUN reflects kidney function, indirectly affected by some drugs, not the frontline concern. WBC's critical drop demands swift action fevers in neutropenia are emergencies underscoring its priority in safeguarding patients through treatment's immune-compromising phases.