Nokea
Which of the following is FALSE regarding patient education for insulin therapy?
- A. It improves the patients experience and adherence to insulin therapy
- B. It requires time and preparation
- C. Different topics and focus can be covered at different stages of insulin therapy
- D. It can only be done by diabetes nurse educators
Correct Answer: D
Rationale: Patient education for insulin therapy enhances experience and adherence, requires time, and varies by stage e.g., injection skills at initiation, hypoglycemia management later all true per diabetes guidelines. However, stating it can only be done by diabetes nurse educators is false. While specialized educators excel, other healthcare professionals (physicians, pharmacists) can deliver effective education, especially in resource-limited settings. Multidisciplinary involvement ensures broader access and periodic understanding checks, vital for chronic disease management. This flexibility empowers diverse teams to support patients, debunking the exclusivity myth.
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At what pressure goal can we optimally slow CKD progression in diabetic nephropathy?
- A. Less than 125/70 mmHg
- B. Less than 125/80 mmHg
- C. Less than 130/80 mmHg
- D. Less than 135/80 mmHg
Correct Answer: C
Rationale: Diabetic CKD <130/80 slows scarring best; tighter risks flow, looser misses. Nurses lock this chronic renal pace.
Regarding PID
- A. Trichomonas and Gardnerella are commonest organisms
- B. Associated with irregular menstruation
- C. Absence of fever and cervical excitation excludes diagnosis
Correct Answer: B
Rationale: PID chlamydia, gonorrhea lead, irregular menses tie, fever and motion can hide. Nurses link this chronic pelvic thread.
The nurse is assessing a 14-year-old girl with a tumor. Which of the following findings would indicate Ewing sarcoma?
- A. Child complains of dull bone pain just above the knee.
- B. Palpation reveals non-tender swelling on the right ribs.
- C. Parents report a mass on the abdomen that crosses the midline.
- D. Palpation reveals asymptomatic mass on the upper back.
Correct Answer: B
Rationale: Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents, typically arising in flat bones like the pelvis, chest wall (e.g., ribs), or vertebrae, and the diaphysis of long bones. A hallmark is a palpable, non-tender mass, making non-tender swelling on the ribs a strong indicator, as it aligns with the tumor's common chest wall location and lack of initial pain sensitivity. Dull bone pain above the knee suggests a long bone issue, possibly osteosarcoma, which favors the metaphysis, not Ewing's typical diaphysis site. An abdominal mass crossing the midline is more characteristic of Wilms tumor or neuroblastoma, not Ewing sarcoma. An asymptomatic upper back mass could suggest various tumors, but lacks specificity for Ewing's flat bone preference. Nurses must recognize this presentation to facilitate prompt imaging and biopsy, critical for early diagnosis and treatment planning in pediatric oncology.
Cortical stimulation:
- A. Occurs before resection of a tumour.
- B. Localizes areas involved with hearing.
- C. Occurs by indirect application of electrodes.
- D. Allows identification of Wernicke's area, which is involved in the comprehension of language.
Correct Answer: D
Rationale: Cortical stimulation in awake craniotomy maps eloquent brain areas before tumor resection to avoid functional loss. It's performed pre-resection to define safe boundaries, localizing motor, sensory, and language areas, including hearing-related regions in the temporal lobe. Electrodes are applied directly to the cortex, not indirectly, for precision. Wernicke's area, in the dominant temporal lobe, is critical for language comprehension, and stimulation identifies it by eliciting speech errors (e.g., paraphasia). Seizures can occur, managed with cold saline irrigation, not warm. The ability to pinpoint Wernicke's area is pivotal, as its preservation ensures postoperative language function, balancing oncologic goals with quality of life in eloquent cortex surgeries.
A 65-year-old female presented to the emergency room with complaint of progressively worsening fatigue, shortness of breath, and palpitations. Upon assessment, heart rate is 130 beats per minute and irregular, and there is positive jugular vein distention. Heart tones reveal a high-pitched holosystolic murmur. Which of the following disorders are consistent with these findings?
- A. Mitral regurgitation
- B. Mitral stenosis
- C. Mitral valve prolapse
- D. Aortic regurgitation
Correct Answer: A
Rationale: Mitral regurgitation leaks blood back holosystolic murmur, irregular tachycardia, JVD, and dyspnea fit, as left heart flops, backing up into veins. Stenosis murmurs diastolic; prolapse clicks midsystolic; aortic regurgitation's early diastolic. Nurses tie this to MR's volume overload, anticipating echo, a match for this failing valve tale.