Nokea
Which of the following is NOT involved with weight regulation?
- A. The hypothalamic arcuate nucleus (ARC)
- B. The lateral geniculate nucleus
- C. The lateral hypothalamic area
- D. The paraventricular nucleus
Correct Answer: B
Rationale: Weight's brain game ARC, lateral hypothalamus, paraventricular nucleus, and solitary tract tunes hunger, satiety, and energy via hormones and gut signals. The lateral geniculate nucleus, a vision hub, sits out, irrelevant to food's dance. Clinicians map this circuitry, targeting obesity's roots, a chronic fix sidestepping eyeballs.
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In which of these do you see clue cells?
- A. trichomonas vaginalis
- B. bacterial vaginosis
- C. candida
- D. HSV 2
Correct Answer: B
Rationale: Clue cells BV's fishy flag, not trich's swim, candida's yeast, HSV's sores, or syphilis' chancre. Nurses scope this chronic hint.
Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy?
- A. Using lemon glycerin swabs for oral hygiene.
- B. Keeping the child NPO until all sores are healed.
- C. Having the child swish and swallow viscous lidocaine.
- D. Giving the child pudding for breakfast.
Correct Answer: D
Rationale: Mucositis, a painful chemotherapy side effect, involves inflamed, ulcerated mucous membranes, often in the mouth, complicating eating and hygiene. Offering pudding a soft, bland, cool food is the best intervention, as it minimizes irritation and pain, encouraging nutrition without exacerbating sores. Lemon glycerin swabs are harsh, with citric acid and chemicals worsening discomfort and delaying healing. Keeping the child NPO (nothing by mouth) for weeks until sores heal is impractical and risks malnutrition, as mucositis can persist throughout chemotherapy. Viscous lidocaine might numb pain but is a last resort if the child refuses all intake, not a first-line comfort measure. Pudding supports hydration and calorie intake safely, aligning with nursing's goal to maintain nutrition and comfort in pediatric oncology, reducing mucositis-related distress effectively.
Which of the following models view disability as directly caused by disease or trauma?
- A. Social
- B. Nursing
- C. Medical
- D. Collaborative
Correct Answer: C
Rationale: The medical model pins disability on disease or injury fix the body, fix the problem a view nurses use for acute hits. Social blames society's gaps; nursing, collaborative blend care angles, not cause. It's a chronic lens shift, body-first.
A 58-year-old man with a known history of heart failure from cardiomyopathy, with an ejection fraction of 30 percent returns for a 3-week follow-up visit after being started on frusemide 40 mg od for increasing symptoms of dyspnea. Since starting frusemide, his symptoms have returned to baseline and he has lost 3 kg. He is maintained on guideline-directed medical therapy for heart failure including sacubitril/valsartan 97 mg/103 mg BD, carvedilol 12.5 mg BD, Simvastatin 40 mg ON, and aspirin 81 mg OD. His physical examination reveals: blood pressure of 128/80 mmHg, regular heart rate of 78 bpm, respiratory rate of 18 breaths/min, and room air oxygen saturation of 96 percent with no saturation decrease with hallway ambulation. He has no peripheral edema. A clinic electrocardiogram reveals a left bundle branch block with a QRS duration of >150 msec. What would be the most appropriate next step in management?
- A. Refer him to an electrophysiologist
- B. Discontinue the sacubitril/valsartan 97 mg/103 mg BD
- C. Change his diuretic to spironolactone 25 mg OD
- D. Increase the frusemide to 40 mg BD
Correct Answer: A
Rationale: HFrEF at 30% EF with LBBB >150 msec stabilized on meds hints at dyssynchrony, ripe for cardiac resynchronization therapy, so an electrophysiologist's next. Ditching sacubitril/valsartan or swapping diuretics lacks cause; upping frusemide or re-echoing waits. Clinicians tap this referral, boosting chronic pump sync, a guideline nod.
A client is admitted with superior vena cava syndrome. What action by the nurse is most appropriate?
- A. Administer a dose of allopurinol (Aloprim).
- B. Assess the client's serum potassium level.
- C. Gently inquire about advance directives.
- D. Prepare the client for emergency surgery.
Correct Answer: C
Rationale: Superior vena cava syndrome (SVCS) occurs when cancer (often lung or lymphoma) obstructs the superior vena cava, impairing venous return from the head and upper body. It's often a late-stage manifestation with a poor prognosis, though treatable with radiation or stenting. After stabilizing the client (e.g., with oxygen, positioning), gently inquiring about advance directives is most appropriate, as it opens a compassionate discussion about goals of care amid a potentially terminal condition. Allopurinol and potassium levels relate to tumor lysis syndrome, not SVCS. Surgery is rare for SVCS, with non-invasive options preferred. This action respects the client's autonomy and prepares for realistic outcomes, aligning with oncology nursing's holistic approach to end-of-life care in advanced disease.