Which of the following statements regarding weight regulation is TRUE?
- A. Weight regain after weight loss is physiological and not necessarily due to a failure of conscious efforts (to lose weight)
- B. The reward system of weight regulation is homeostatic in nature
- C. Liking' and wanting' of food are mainly conscious processes
- D. In human studies, functional MRI (fMRI) studies have shown deficiency in reward-encoding brain regions and/or over activation in cortical inhibitory networks in obese people
Correct Answer: A
Rationale: Weight bounces back biology, not just willpower; rewards aren't homeostatic, liking's subconscious, fMRI flips, hypothalamus rules. Nurses get this chronic rebound truth.
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A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct?
- A. Benign tumors do not cause damage to other tissues.
- B. Benign tumors are likely to recur in the same location.
- C. Malignant tumors may spread to other tissues or organs.
- D. Malignant cells reproduce more rapidly than normal cells.
Correct Answer: C
Rationale: Malignant tumors metastasize spreading to distant sites via lymph or blood unlike benign ones, which stay put. That's the key split. Benign tumors can still mess up nearby tissues by pressing on them (e.g., a benign meningioma squeezing brain), so A's off. B's wrong benign tumors rarely recur if fully removed; malignancy's more prone to that. D's a myth malignant cells don't always divide faster; some, like chronic leukemia, creep along. Nurses in oncology nail this down for patients facing biopsies, like this breast case, where fear of spread drives the question. Explaining metastasis clarifies why malignant's scarier it's not just growth, it's invasion, a game-changer for prognosis and treatment.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.
A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?
- A. A client with a swollen and painful left great toe
- B. Client who reports dyspnea
- C. Client with a blood pressure of 180/98 mm Hg
- D. Client who reports calf tenderness and swelling
Correct Answer: B
Rationale: Polycythemia vera thickens blood, risking clots dyspnea signals possible pulmonary embolism, a life-threatening emergency needing instant assessment per ABCs. Toe pain suggests gout, common but less acute. Hypertension, a chronic issue here, waits behind respiratory distress. Calf tenderness hints at DVT, urgent but not immediately fatal like embolism. Nurses triage dyspnea first, ensuring airway and oxygenation, a critical call in this hyperviscous condition prone to thrombotic crises.
A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.
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.
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