Which of the following procedures are performed for a client with a pericardial effusion?
- A. Thoracotomy
- B. Pericardiocentesis
- C. Coronary artery bypass graft
- D. Thoracentesis
Correct Answer: B
Rationale: Pericardial effusion fluid around the heart threatens tamponade, compressing cardiac output. Pericardiocentesis drains this via needle or catheter, relieving pressure, a targeted fix for this diagnosis. Thoracotomy, an open chest surgery, is overkill unless complications escalate. Coronary bypass addresses arterial blockages, unrelated to effusion. Thoracentesis taps pleural fluid, not pericardial. Nurses prep for pericardiocentesis, anticipating its urgency in restoring function, a procedure matching the condition's anatomy and risk, critical for stabilizing clients in this cardiac emergency.
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Which of the following health determinants is NOT a component of Lalonde's model?
- A. Biological factors
- B. Physical environment
- C. Health care
- D. Attitude to life
Correct Answer: D
Rationale: Lalonde's grid biology, environment, care, not attitude shapes health, not mindsets. Nurses map this, a chronic model cut.
Which of the following condition has low risk of progression to liver cirrhosis:
- A. Hepatic steatosis
- B. Hepatic steatohepatitis
- C. Hepatic steatohepatitis with fibrosis
- D. Chronic hepatitis
Correct Answer: A
Rationale: Steatosis fat sits, low cirrhosis odds; steatohepatitis, fibrosis, chronic, booze burn scar. Nurses mark this chronic liver lite.
There are several different transmembranous glucose transporters (Gluts). Question: Which Gluts occur most frequently in the liver and which in the pancreas?
- A. Glut 1 in the liver and Glut 2 in the pancreas
- B. Glut 2 in the liver and Glut 2 in the pancreas
- C. Glut 2 in the liver and Glut 1 in the pancreas
- D. Glut 4 in the liver and Glut 2 in the pancreas
Correct Answer: B
Rationale: Liver slurps glucose with Glut 2, pancreas senses it the same both lean on this transporter's flow. Glut 1's elsewhere, Glut 4's muscle-fat turf nurses know this, a chronic glucose gate map.
In the treatment of COPD:
- A. Inhaled long-acting β₂ agonists are a first-line treatment for breathlessness.
- B. Most patients require maintenance use of oral corticosteroids.
- C. The dosage of oral theophylline needs to be reduced in patients commenced on erythromycin.
- D. Long-term oxygen therapy is indicated in a stable patient with a Paâ‚“â‚‚ of 8.5 kPa.
Correct Answer: C
Rationale: COPD management focuses on symptom relief and preventing exacerbations. Inhaled long-acting β₂ agonists are indeed used for breathlessness but are not always first-line; short-acting bronchodilators often precede them. Maintenance oral corticosteroids are not standard due to significant side effects; inhaled corticosteroids are preferred. Theophylline, a bronchodilator, has its metabolism inhibited by erythromycin (a CYP3A4 inhibitor), increasing plasma levels and toxicity risk, necessitating dose reduction. Long-term oxygen therapy is indicated for severe hypoxemia (Paₓ₂ < 7.3 kPa or 7.3-8 kPa with complications), not at 8.5 kPa, which is relatively normal. Non-invasive ventilation is reserved for acute exacerbations, not first-line treatment. The interaction between theophylline and erythromycin is a critical pharmacological consideration in COPD management, making it the standout correct statement.
An oncology patient has just returned from the postanesthesia care unit after an open hemicolectomy. This patient's plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome
- B. Assess the patient's fine motor skills once per shift
- C. Assess the patient's wound for dehiscence every 4 hours
- D. Maintain the patient's head of bed at 45 degrees or more at all times
Correct Answer: C
Rationale: Post-hemicolectomy, wound dehiscence splitting open is a killer risk, tied to infection or poor healing, needing checks every 4 hours. Compartment syndrome's a fracture thing, not gut surgery. Fine motor's irrelevant here neuro's not the issue. High head-of-bed helps breathing but isn't universal post-op. Nurses in oncology prioritize this, catching leaks or redness early, critical after cancer gut surgery.