Nokea
Which of the following is NOT an early warning symptom of hypoglycaemia?
- A. Giddiness, drowsiness
- B. Anxiety
- C. Tremors
- D. Diaphoresis
Correct Answer: A
Rationale: Early hypoglycemia symptoms from low blood glucose (<70 mg/dL) include anxiety, tremors, diaphoresis, and palpitations adrenergic responses signaling the body's counter-regulatory effort. Giddiness and drowsiness, while possible, are neuroglycopenic symptoms appearing later as brain glucose drops further, not early warnings. Recognizing early signs allows timely intervention (e.g., glucose intake), critical in diabetes management to prevent severe outcomes like confusion or seizures. Physicians must teach patients these distinctions for effective self-care in chronic conditions.
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The disease progress of cancers, such as cervical or Hodgkin's, can be classified according to a clinical staging system. Place the description of stages 0-IV in the correct order.
- A. Metastasis
- B. Limited local spread
- C. Cancer in situ
- D. Tumor limited to tissue of origin
Correct Answer: C
Rationale: Clinical staging tracks cancer progression: starting with cancer in situ, where abnormal cells stay confined, non-invasive stage 0. Next, tumor limited to tissue of origin marks stage I, with localized growth but no spread. Limited local spread, stage II, shows slight extension beyond the origin. Extensive local and regional spread, stage III, involves nearby tissues or nodes. Metastasis, stage IV, indicates distant spread, the most advanced. The sequence cancer in situ, tumor limited to origin, limited spread, extensive spread, metastasis reflects increasing severity, guiding treatment from surveillance to aggressive therapy. Nurses use this to educate patients, aligning interventions with disease extent, critical for prognosis in cancers like cervical or Hodgkin's.
In the year 2012, appropriate statements regarding complications of percutaneous cervical cordotomy in the UK include:
- A. Estimates of complication rates are based on pooled data in a national registry.
- B. Complications are similar to those after open surgical cordotomy.
- C. Rates of major complications such as death and paralysis are between 1 in 10000 and 1 in 1000.
- D. Persistent postural hypotension is uncommon.
Correct Answer: D
Rationale: In 2012, UK percutaneous cervical cordotomy (PCC) complication data were limited, not pooled nationally case series or institutional reports dominated. PCC's minimally invasive nature yields fewer complications (e.g., no wound infections) than open cordotomy's extensive approach. Major complications like death or paralysis are rare (<1%), below 1-in-1000 estimates, due to precise imaging and technique. Persistent postural hypotension is uncommon, linked to rare sympathetic disruption (e.g., Horner's syndrome), resolving typically. Headaches occur but aren't persistent. The low incidence of sustained hypotension reflects PCC's targeted spinothalamic focus, sparing autonomic pathways, making it a safer palliative option versus historical benchmarks.
A nurse reviews the arterial blood gas (ABG) values of a client admitted with end-stage kidney disease; pH 7.26; PaCO2 37 mm Hg; PaO2 94 mm Hg and HCO3 15 mEq/L. What do these values indicate?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: End-stage kidney disease hampers acid excretion pH 7.26 (below 7.35) and HCO3 15 mEq/L (below 22) confirm metabolic acidosis, as kidneys fail to buffer, dropping bicarbonate. PaCO2 37 mm Hg (normal) rules out respiratory issues lungs aren't compensating yet. PaO2 94 mm Hg shows oxygenation's fine. Alkalosis options contradict low pH; respiratory acidosis needs high CO2. Nurses recognize this acid-base shift, anticipating bicarbonate or dialysis, a key intervention in renal failure's metabolic chaos.
The family of a neutropenic client reports that the client is confused and 'is not acting right.' What action by the nurse is the priority?
- A. Delegate taking a set of vital signs
- B. Ask the client about pain
- C. Look at today's laboratory results
- D. Assess the client for a urinary tract infection
Correct Answer: A
Rationale: Neutropenia slashes immunity confusion screams infection, like sepsis, needing instant vitals to catch fever or shock, a priority delegated to flag danger fast per ABCs. Pain's a clue, but vitals trump. Labs lag; UTI assessment follows. Nurses lean on teamwork, ensuring rapid data in this infection-prone fog, a life-saving first step.
A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.