Nokea
With regards to metabolic and bariatric surgery performed in East Asia, which ONE of the following is most commonly performed?
- A. Roux-en-Y gastric bypass (RYGB)
- B. Adjustable gastric banding (AGB)
- C. Mini-gastric bypass
- D. Sleeve gastrectomy (SG)
Correct Answer: D
Rationale: In East Asia, sleeve gastrectomy (SG) has emerged as the most common bariatric surgery, surpassing Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB), per regional data and trends. SG's popularity stems from its technical simplicity, lower complication rates, and effectiveness in weight loss and metabolic improvement, appealing in populations with lower average BMI but high visceral fat, like Asians. RYGB, while effective, is less favored due to complexity and malabsorption risks. AGB has declined globally due to less sustained outcomes. Mini-gastric bypass is rising but not dominant. SG's prominence reflects practical and cultural fit, informing physicians on regional preferences for obesity management.
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On a population level, differences can be observed between the body composition of people with and people without a disturbed glucose tolerance. Question: Which of the following options describes the body composition of overweight people with a disturbed glucose tolerance compared to that of healthy people without overweight?
- A. More adipose tissue and similar muscle mass
- B. More adipose tissue and less muscle mass
- C. More adipose tissue and more muscle mass
- D. More adipose tissue and less muscle mass, including a change in the ratio of different types of muscle fibres
Correct Answer: B
Rationale: Glucose tolerance tanks overweight pile fat, lose muscle, not same or more, no fibre shift specifics. Nurses see this, a chronic lean loss.
The nurse is caring for a patient diagnosed with stage I colon cancer. When assessing the need for psychologic support, which question by the nurse will provide the most information?
- A. How long ago were you diagnosed with this cancer?'
- B. Do you have any concerns about body image changes?'
- C. Can you tell me what has been helpful to you in the past when coping with stressful events?'
- D. Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?'
Correct Answer: C
Rationale: Stage I colon cancer's early psych support hinges on coping history . Past wins reveal strengths, more than timing , body image (B less hit here), or textbook stages . Nurses in oncology dig this how they've handled stress before predicts now, guiding tailored help.
Madam Tan is newly diagnosed to have Type 2 DM. Her fasting plasma glucose is 12 mmol/L. Her blood pressure and fasting lipid profile are normal. She has been provided with patient education and advice on therapeutic life-style modification. Which is the most appropriate course of management for this lady?
- A. Commence her on combination therapy of three oral hypoglycaemic agents
- B. Motivate her to adhere with life-style modification
- C. Commence her on monotherapy of oral hypoglycaemic agent
- D. Commence her on combination therapy of two oral hypoglycaemic agents
Correct Answer: C
Rationale: New type 2, fasting 12 lifestyle's fresh, so metformin monotherapy starts, easing glucose without overload. Triple or dual oral's too much; insulin's for later; pushing lifestyle alone won't cut it yet. Nurses build this chronic base, balancing effort and meds.
The thickening of the glomerular basal membrane in an early stage of diabetes mellitus is a consequence of which mechanism?
- A. AGE deposition
- B. Proteinuria
- C. Inflammation
- D. All mechanisms mentioned above
Correct Answer: A
Rationale: Early diabetic kidney AGEs glue GBM thick, not protein spill or inflammation yet. Nurses catch this, a chronic sugar scar.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.