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Which statement with respect to the disadvantages of insufficient physical activity is most correct?
- A. People are not so much concerned with the disadvantages, because these will only affect them in the long run
- B. The disadvantages can be compensated by moderate eating
- C. When explained, the disadvantages are enough to motivate people to change their behaviour
- D. The disadvantages result from inadequate behavioural control (self-efficacy)
Correct Answer: A
Rationale: Inactivity's downsides long-term creep, folks shrug, not diet-fixed, rarely spur change, or just control flops. Nurses see this apathy, a chronic slow burn.
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A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient?
- A. A fluid bolus as ordered
- B. Fluid restrictions as ordered
- C. Urinalysis as ordered
- D. Sodium-restricted diet as ordered
Correct Answer: B
Rationale: SIADH, common in lung cancer, overproduces ADH, retaining water and diluting sodium hyponatremia causes weight gain, weakness, nausea. Fluid restriction, the initial fix, curbs water intake, raising sodium levels naturally, tackling the root imbalance. A fluid bolus worsens dilution, risking seizures. Urinalysis checks concentration, not a treatment. Sodium restriction deepens hyponatremia, counterproductive. Anticipating fluid limits aligns with SIADH's pathophysiology nurses expect this order to stabilize the patient, monitoring for symptom relief or escalation, a frontline step in managing this paraneoplastic crisis.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient's subsequent plan of care?
- A. Limit the time that visitors spend at the patient's bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patient's care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: HDR implants (brachytherapy) emit radiation limiting visitor time (e.g., 30 min) cuts exposure risk. Self-care's nice but not safety-driven. Gender's irrelevant pregnant staff avoid, not males. Shared rooms up exposure, not safety. Nurses in oncology enforce this, shielding others while the source's active, a radiation rule of thumb.
What is the relationship between hyperlipidaemia and non-alcoholic steatohepatitis (NASH)?
- A. Hyperlipidaemia contributes to the development of NASH
- B. NASH contributes to the development of hyperlipidaemia
- C. There is no relationship between hyperlipidaemia and NASH
- D. Answers 1 and 2 are correct
Correct Answer: D
Rationale: NASH and hyperlipidaemia dance both ways high lipids pile fat, NASH pumps them back, a chronic loop. No split or null fits nurses track this lipid-liver ping-pong.
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
- A. Leads to hypotension when venous return is reduced significantly.
- B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
- C. May be reduced by using a low respiratory rate.
- D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct Answer: A
Rationale: Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity.
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity.
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds.
- D. The ratio of respiratory effort and respiratory rate.
Correct Answer: A
Rationale: Spirometry is the gold standard for COPD diagnosis and staging, measuring airflow obstruction. The ratio of forced expiratory volume in 1 second (FEVâ‚) to forced vital capacity (FVC) FEVâ‚/FVC quantifies limitation; a value <0.7 post-bronchodilator confirms COPD, with FEVâ‚ percentage grading severity (e.g., GOLD stages). Residual volume (RV) to FVC isn't standard in basic spirometry RV requires advanced testing (e.g., plethysmography) and reflects air trapping, not routine staging. FVC versus a 6-second exhale (FEV₆) approximates in some settings but isn't the clinical norm for COPD. Respiratory effort and rate aren't spirometric; they're observational. FEVâ‚/FVC's precision, per Deravin and Anderson (2019), tracks obstruction progression and guides therapy, making it foundational for assessing COPD's irreversible nature.