Nokea
Which of the following is the surgical treatment of choice for end-stage heart failure?
- A. Cardiac resynchronization therapy (CRT)
- B. Percutaneous angiogram
- C. Genetic counseling
- D. Ventricular assist devices (VADs)
Correct Answer: D
Rationale: End-stage heart failure, when drugs and pacing fail, leans on ventricular assist devices mechanical pumps aiding circulation, a bridge to transplant or destination therapy. CRT syncs ventricles, less invasive, but VADs tackle severe pump collapse. Angiograms diagnose, not treat; genetic counseling's irrelevant. Nurses prep for VADs, managing post-op risks, the go-to surgical fix in this terminal cardiac scenario.
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A government initiative to reduce the effects of fatigue in the workforce has recently been rolled out. As anaesthetic lead, you are asked by the chief executive of your institution to develop strategies to reduce fatigue in your department. Appropriate strategies are likely to include:
- A. Changing the frequency of night shifts on the on-call rota from every 3 days to every 2 weeks.
- B. Including a section in the trainee's handbook on the signs of fatigue, along with prevention and management strategies.
- C. Acquiring a departmental exercise bike.
- D. Reducing the number of night shifts worked by colleagues over 55 years of age.
Correct Answer: A
Rationale: Fatigue mitigation in anaesthesia enhances safety. Reducing night shift frequency from every 3 days to every 2 weeks allows recovery (per sleep science, 48-72 hours post-night shift), significantly cutting cumulative fatigue versus less impactful measures. A handbook educates on fatigue signs (e.g., yawning, errors) and strategies (naps, caffeine), but it's passive. An exercise bike offers minor alertness boosts but not sustained relief. Age-based shift reduction addresses older workers' recovery needs, yet evidence favors roster spacing for all. Refreshments help minimally. Frequent night shifts disrupt circadian rhythms and sleep homeostasis, amplifying error risk (e.g., medication misdosing); a 2-week gap aligns with occupational health guidelines for sustained performance.
In which ethnic group are people over 35 years advised to have their blood glucose levels checked because of the risk of type 2 diabetes?
- A. Creoles
- B. Hindu
- C. Moroccans
- D. Turks
Correct Answer: B
Rationale: Hindus over 35 South Asian risk rockets type 2, outpacing others' odds. Nurses screen this, a chronic ethnic flag.
How do you treat secondary syphilis?
- A. oral penicillin
- B. i.m. penicillin
- C. i.v. penicillin
- D. erythromycin
Correct Answer: B
Rationale: Secondary syphilis IM penicillin blasts treponemes, not oral, IV, or erythro sidesteps. Nurses shoot this chronic cure.
The suture material which poses the highest risk of infection is
- A. Vicryl
- B. Chromic gut
- C. Silk
- D. Prolene
Correct Answer: C
Rationale: Silk braided, bacteria's nest tops infection risk, not Vicryl, gut's absorb, or slick Prolene, nylon. Nurses stitch this chronic trap warily.
Many people with obesity have a lower insulin-stimulated glucose uptake compared with people without increased body weight. It is assumed that several factors play a role in the development of insulin resistance. Question: Which of the following factors is LEAST likely to play a role in the development of insulin resistance?
- A. Reduced insulin levels
- B. Increased adipokine levels
- C. Increased triglyceride levels
- D. Low-grade continuous inflammation
Correct Answer: A
Rationale: Insulin resistance brews from fat's adipokines, triglycerides, inflammation not low insulin, that's type 1's game. Obesity's chronic jam needs excess, not lack nurses flag this misfit.