Nokea
Which of the following statements is INCORRECT? The treatment of diabetes in traditional Chinese medicine involves
- A. Formula for Diabetes (Xiaoke Fang) for the Upper Type: Heat in the Lung which consumes Body Fluid
- B. Jade Maid Decoction (Yunu Jiang) for the Middle Type: excessive Heat in the Stomach
- C. Six Ingredients Rehmannia Pill (Liuwei Dihuang Wan) for the Lower Type: excessive of Kidney Yin and excessive of Yin and Yang
- D. Yam (Dioscorea opposita)
Correct Answer: C
Rationale: Traditional Chinese diabetes care Upper, Middle, Lower types nails Lung heat, Stomach fire, but Kidney's Yin deficiency, not excess Yin-Yang, flops. Xiaoke Fang, Yunu Jiang fit; Liuwei Dihuang Wan balances, doesn't overdo; yam's a lone root, not typed. Clinicians spot this, a chronic TCM misstep.
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Your junior trainee has been in theatre for 5 h with a patient undergoing a femorodistal bypass procedure. He is yawning and seems withdrawn. The trainee's fatigue is likely to be improved by:
- A. Imbibing one 60 ml shot of espresso coffee.
- B. Taking a 1-h nap.
- C. Increasing the brightness of the theatre lighting.
- D. Walking around and chatting to other members of staff.
Correct Answer: B
Rationale: Fatigue during long procedures impairs performance. A 60 ml espresso shot (50-100 mg caffeine) boosts alertness temporarily (20-30 minutes onset), but its effect wanes after 5 hours of sustained effort. A 1-hour nap restores cognitive function and vigilance significantly, countering sleep pressure per sleep research (e.g., NASA nap studies), with benefits lasting hours. Bright lighting enhances alertness via circadian stimulation but is less effective mid-fatigue. Walking and chatting provide a break, mildly boosting arousal, but lack restorative depth. Microsleeps signal severe fatigue, worsening performance. A nap's superiority lies in addressing accumulated sleep debt, critical in high-stakes settings like surgery, offering sustained recovery over stimulants or environmental tweaks.
Which of these does not need treatment of the sexual partner?
- A. trichomonas vaginalis
- B. bacterial vaginosis
- C. candida
- D. chlamydia
Correct Answer: B
Rationale: BV vaginal flora shift, not partner-fed; trich, chlamydia, gonorrhea, candida swap. Nurses skip this chronic duo fix.
Which condition assessed by the nurse would be an early warning sign of childhood cancer?
- A. Difficulty swallowing
- B. Frequent cough or hoarseness
- C. Change in bowel and bladder habits
- D. Swellings, lumps or masses anywhere on the body
Correct Answer: D
Rationale: Childhood cancers often present with subtle, non-specific signs, but swellings, lumps, or masses anywhere on the body are a key early warning, indicating possible tumors like leukemia (lymphadenopathy), Wilms tumor, or sarcomas. Nurses must assess these palpable abnormalities, as they prompt urgent diagnostic workup imaging or biopsy to catch cancer early when treatment is most effective. Difficulty swallowing might suggest esophageal or brain tumors but isn't a common early childhood cancer sign. Frequent cough or hoarseness could indicate adult cancers (e.g., lung) or late-stage disease, not typical pediatric onset. Bowel and bladder changes are more adult-specific (e.g., colorectal cancer) or late effects in children. Lumps' prominence in pediatric guidelines underscores their priority, aligning with nursing's role in early detection to improve survival rates in young patients.
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
- A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
- B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
- C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
- D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.
Correct Answer: C
Rationale: Terminal pancreatic cancer pain's relentless around-the-clock opioids with breakthrough doses keep it tamed, per hospice norms. Waiting for 5/10 lags; IV isn't inherently better oral's fine. Nonopioids at max opioid miss the mark escalation's the play. Nurses in oncology teach this steady dosing plus rescues nails chronic cancer pain, a win if families get it.
Ziconotide is:
- A. Licensed for administration by the intrathecal route in Europe and North America.
- B. Associated with intrathecal granuloma formation.
- C. Contraindicated in schizophrenic patients.
- D. Likely to lead to hypogonadotropic hypogonadism during long-term infusion.
Correct Answer: A
Rationale: Ziconotide, a non-opioid analgesic, blocks N-type calcium channels intrathecally. It's licensed in Europe and North America for chronic pain (e.g., cancer, neuropathic), delivered via pumps. Unlike opioids, it doesn't form granulomas at catheter tips those are opioid-specific complications. It's contraindicated in psychosis (e.g., schizophrenia) due to neuropsychiatric side effects (confusion, hallucinations), per prescribing guidelines. Hypogonadism isn't linked; that's an opioid effect via hypothalamic suppression. Tolerance occurs, requiring dose escalation, but it's manageable. Its licensure reflects extensive trials showing efficacy and safety for refractory pain, distinguishing it as a targeted, non-addictive option in intrathecal therapy, critical for patients intolerant to opioids.