Nokea
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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The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
- A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer
- B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer
- C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer
- D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition
Correct Answer: B
Rationale: With a positive screening test and family history, she's high-risk tamoxifen, a SERM, cuts breast cancer odds by 50% in such cases, per NCI trials. It blocks estrogen fueling tumors, a proven chemoprevention move. Diet helps (antioxidants, less fat), but it's not enough solo. Exercise (30 min/day) trims risk via weight control, but tamoxifen's got stronger data here. Saying little can be done' ignores options genetics load the gun, but lifestyle and drugs can unload it. Nurses in oncology push tamoxifen for its edge, tailoring advice to her risk profile.
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.
The role of the nurse and other health professions in chronic disease is to:
- A. Support the person in managing their condition
- B. Provide direction to the person about their treatment
- C. Ensure the person takes their medications and avoids risk factors
- D. Decide on the best approach to manage the condition and direct the implementation of this care
Correct Answer: A
Rationale: Chronic disease management hinges on patient empowerment, not authoritarian control. Supporting individuals in managing their condition aligns with modern nursing philosophy, fostering self-efficacy through education, emotional support, and resource provision key in texts like Deravin and Anderson (2019). Providing direction implies guidance, but it's less collaborative than support, often overstepping patient autonomy. Ensuring medication adherence and risk avoidance is paternalistic, assuming enforcement over partnership, which conflicts with patient-centered care principles. Deciding and directing care outright disregards patient input, undermining shared decision-making critical for long-term adherence in chronic illness. Support encompasses holistic care physical, psychological, and social enabling patients to navigate their condition, adapt lifestyles, and cope with challenges, reflecting the multidisciplinary team's role in enhancing quality of life rather than dictating it.
Which complications are the three main consequences of leukemia?
- A. Bone deformities, spherocytosis and infection.
- B. Anemia, infection, and bleeding tendencies.
- C. Lymphocytopoiesis, growth delays, and hirsutism.
- D. Polycythemia, decreased clotting time, and infection.
Correct Answer: B
Rationale: Leukemia, a bone marrow cancer, replaces normal marrow elements with immature, dysfunctional white blood cells (lymphoblasts), leading to three primary complications: anemia, infection, and bleeding tendencies. Anemia results from reduced red blood cell production, causing fatigue and pallor. Infection risk rises due to neutropenia immature lymphoblasts lack infection-fighting ability making children prone to severe illnesses. Bleeding tendencies occur from thrombocytopenia, low platelet counts causing bruising or petechiae. Bone deformities and spherocytosis aren't leukemia hallmarks; the former might occur in bone cancers like osteosarcoma, and the latter is a red cell disorder. Lymphocytopoiesis is a process, not a complication, while growth delays and hirsutism aren't primary leukemia effects. Polycythemia (high red cells) and decreased clotting time oppose leukemia's anemia and bleeding risks. Nurses must monitor these complications, as they guide interventions like transfusions or antibiotics, critical for supporting children through leukemia treatment.
Repaglinide belongs to the class
- A. Sulphonylureas
- B. Thiazolidinediones
- C. Benzoic acid derivatives
- D. Biguanides
Correct Answer: C
Rationale: Repaglinide's benzoic acid kin short, sharp insulin jolts, not sulphonylureas' long haul, thiazolidinediones' sensitivity boost, or biguanides' glucose clamp. It's a mealtime spike buster, a chronic tool pharmacists slot apart from sulphonylurea's sustained push, a nuanced diabetes dance.