Nokea
Which of the following would predispose a client to mitral stenosis?
- A. Obesity
- B. Rheumatic fever
- C. Intravenous drug use
- D. Diabetes
Correct Answer: B
Rationale: Mitral stenosis narrows the valve rheumatic fever's scarring, from streptococcal aftermath, is the prime culprit, stiffening leaflets over years. Obesity, IV drug use (tied to endocarditis), or diabetes don't directly scar valves. Nurses link rheumatic history to this, watching for dyspnea or murmurs, a legacy of infection shaping this cardiac bottleneck.
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A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patient's nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: Gastric cancer blocking oral and enteral routes needs TPN via a PICC delivering calories and protein centrally, bypassing the gut. Peripheral IV can't handle TPN's osmolarity veins fry. NG's out with tumor placement. NPO with just fluids starves her long-term. Nurses in oncology peg TPN as the lifeline, keeping strength up when cancer chokes other options.
A nurse is caring for a 65-year-old male who recently underwent an aortic valve replacement. Which of the following is a post-operative nursing care priority?
- A. Temperature monitoring
- B. Assess for bleeding
- C. Advance diet as tolerated
- D. Dressing change
Correct Answer: B
Rationale: Valve replacement bleeds assessing for hemorrhage at surgical sites or anticoagulation tops post-op care, a life-or-death watch per ABCs. Fever, diet, dressings matter, but bleeding's immediate. Nurses hunt oozing or shock, ensuring stability, a priority in this fresh-cut cardiac zone.
In order to delay the progression of CKD, the single most important intervention is:
- A. Prescription of an ACE or ARB
- B. Reducing dietary sodium
- C. Increasing physical activity
- D. Achieving good blood pressure control
Correct Answer: D
Rationale: CKD's brake BP control tops ACEs, salt cuts, or workouts, slashing glomeruli strain, a chronic slowdown king. Nurses prioritize this, a pressure-driven win.
The body has several mechanisms to increase the blood glucose level in case of hypoglycaemia. Question: Which of the following options best describes the role of glucagon and adrenaline in hypoglycaemia?
- A. Glucagon and adrenaline stimulate glycogenolysis in the liver
- B. Glucagon and adrenaline inhibit the insulin-stimulated glucose uptake in the muscles
- C. Glucagon stimulates glycogen synthase and adrenaline stimulates glycogenolysis in the liver
- D. Glucagon and adrenaline stimulate glycogen synthase en adrenaline stimulates glycogenolysis in the muscles
Correct Answer: A
Rationale: Hypo hits glucagon and adrenaline rip glycogen apart in liver, sugar surges. No muscle block, no synthase flip straight breakdown's the play nurses watch this, a chronic rescue duo.
During general anaesthesia for orthognathic surgery:
- A. A head-down supine position is popular to minimize the risk of airway soiling.
- B. Lidocaine with adrenaline 1:80000 is used for infiltration.
- C. Non-steroidal anti-inflammatory drugs (NSAIDs) are avoided even after haemostasis is achieved.
- D. Blocks of both mandibular and maxillary nerves are possible and useful.
Correct Answer: D
Rationale: Anaesthesia for orthognathic surgery balances airway and bleeding risks. Head-up positioning, not head-down, reduces venous congestion and airway soiling from blood head-down risks aspiration. Lidocaine with adrenaline (typically 1:80,000-1:200,000) minimizes bleeding via vasoconstriction, a standard infiltration. NSAIDs are used post-haemostasis for analgesia, not universally avoided, unless bleeding risk persists. Mandibular and maxillary nerve blocks (e.g., V2, V3) reduce opioid needs and enhance pain control, leveraging regional anaesthesia's precision in jaw surgery. Propofol TIVA may improve recovery versus volatiles, per studies, but isn't definitive. Nerve blocks' utility optimizes perioperative pain management, critical in extensive osteotomies.