Why are endothelial cells in particular sensitive to the damage caused by high plasma glucose levels?
- A. Endothelial cells have a high metabolic activity
- B. Endothelial cells cannot regulate the glucose uptake
- C. Endothelial cells have a low level of antioxidants
- D. All statements provided above are correct
Correct Answer: B
Rationale: Endothelial cells drown in glucose no uptake brakes, high sugar slams them, not just metabolism or low shields. A chronic vessel weak spot nurses watch this sugar soak.
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The nurse Questions which order for a client with thrombocytopenia?
- A. Apply ice to areas of trauma
- B. Administer intramuscular (IM) medication
- C. Test all urine and stool for the presence of occult blood
- D. Avoid enemas
Correct Answer: B
Rationale: Thrombocytopenia's bleed risk IM shots pierce muscle, risking hematomas, a questionable order nurses flag, as low platelets can't clot it. Ice curbs swelling, occult blood tests track bleeds, enemas avoid rectal tears all fit. Nurses challenge IM, pushing IV routes, a safety catch in this platelet-poor state.
A primary nursing responsibility is the prevention of lung cancer by assisting patients in smoking/tobacco cessation. Which tasks would be appropriate to delegate to the LPN/LVN?
- A. Develop a quit plan
- B. Explain the application of a nicotine patch
- C. Discuss strategies to avoid relapse
- D. Suggest ways to deal with urges for a tobacco
Correct Answer: B
Rationale: LPN/LVNs shine in standardized teaching like explaining nicotine patch application, a medication-focused task within their scope, detailing placement and timing to aid cessation. Developing a quit plan requires RN-level planning and assessment of individual needs. Discussing relapse strategies involves behavioral counseling, an RN forte. Suggesting urge-coping methods needs tailored insight, beyond LPN/LVN training. Patch explanation leverages their skills, supporting lung cancer prevention through practical cessation aid, a delegated task enhancing team efforts while keeping complex planning with RNs.
What is the cut-off of blood pressure for the diagnosis of hypertension that is recommended by MOH Clinical Practice Guideline?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/70 mmHg
- D. 140/90 mmHg
Correct Answer: D
Rationale: MOH guidelines hold hypertension at 140/90 mmHg, a conventional cutoff balancing sensitivity and specificity for diagnosis in primary care, aligning with global norms like WHO. Lower thresholds 120/70, 125/75, 130/70, 135/80 catch prehypertension or align with newer AHA standards, but MOH sticks to 140/90 for actionable clarity, triggering treatment to curb stroke or heart risks. This higher bar avoids overdiagnosis in resource-stretched settings, ensuring focus on clear disease, a practical call for managing chronic vascular load.
Self-management is an important principle in optimal management and prevention of exacerbation. In order for the patient to self-manage appropriately, which of the following is not required?
- A. Understanding of the pathophysiology of disease, nature of inflammation and bronchoconstriction and trigger avoidance
- B. Education on medication compliance, use of devices and correct inhalation technique, as well as when to increase dosage
- C. Assessment by multidisciplinary team to address additional health concerns
- D. Development of an action plan in knowledge on when to implement and when to seek assistance
Correct Answer: C
Rationale: Asthma self-rule needs know-how pathology, meds, triggers, action plans not a full team probe. That's extra, not must-have; core's patient-led. Nurses train this, a chronic solo skill.
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.
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