Nokea
Which of the following laboratory abnormalities is NOT associated with fatty liver?
- A. Elevated uric acid
- B. Elevated LDL-cholesterol
- C. Elevated fasting glucose
- D. Elevated creatinine kinase
Correct Answer: D
Rationale: Fatty liver (NAFLD) links to metabolic syndrome elevated uric acid, LDL-cholesterol, fasting glucose, and triglycerides reflect insulin resistance and dyslipidemia. Elevated creatinine kinase (CK) indicates muscle damage (e.g., myopathy), not a typical NAFLD feature, though liver enzymes (ALT/AST) rise. CK's absence from NAFLD profiles guides physicians in differential diagnosis during chronic liver disease assessment.
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What is the relationship between hyperlipidaemia and non-alcoholic steatohepatitis (NASH)?
- A. Hyperlipidaemia contributes to the development of NASH
- B. NASH contributes to the development of hyperlipidaemia
- C. There is no relationship between hyperlipidaemia and NASH
- D. Answers 1 and 2 are correct
Correct Answer: D
Rationale: NASH and hyperlipidaemia dance both ways high lipids pile fat, NASH pumps them back, a chronic loop. No split or null fits nurses track this lipid-liver ping-pong.
Which of the following is the priority nursing intervention for a client experiencing a transfusion reaction?
- A. Stop transfusion immediately
- B. Check vital signs
- C. Notify the provider
- D. Flush the intravenous line
Correct Answer: A
Rationale: Transfusion reactions hemolytic or allergic kill fast; stopping the infusion halts antigen flood, the priority per ABCs to save life. Vitals, notifying, or flushing follow stopping's first. Nurses act swift, cutting the culprit, a non-negotiable step in this blood-borne crisis, trumping all else.
People with metabolic syndrome have an increased risk of which of the following disorders, besides type 2 diabetes mellitus?
- A. Hypertension, infections
- B. Myocardial infarction, hypertension
- C. Myocardial infarction, infections
- D. Myocardial infarction, liver cirrhosis
Correct Answer: B
Rationale: Metabolic syndrome hikes heart attacks, hypertension vascular hits, not infections or cirrhosis extras. Nurses track this, a chronic CV duo.
Appropriate statements regarding markers of outcome after major surgery in England in 2014 include:
- A. Data about each hospital's complication rates after surgery are readily available.
- B. Data about each hospital's 30-day mortality after surgery are readily available.
- C. For most procedures, 90-day mortality rate are similar to 30-day mortality rates.
- D. National Hospital Episode Statistics (HES) data are useful for monitoring the performance of units.
Correct Answer: B
Rationale: In 2014 England, surgical outcome transparency increased. Complication rates weren't universally published per hospital, varying by procedure and trust. However, 30-day mortality data were widely available, notably via NHS initiatives and specialty audits (e.g., National Joint Registry), reflecting short-term success. Ninety-day mortality often exceeds 30-day rates (e.g., in vascular surgery), capturing delayed deaths, so they're not typically similar. HES data, capturing inpatient episodes, help monitor trends and performance, though coding accuracy limits granularity. Weekend admission mortality was higher, per studies like 2015 BMJ, due to staffing and care differences. The availability of 30-day mortality data was a key quality metric, driving accountability and improvement in surgical care.
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.