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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A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?
- A. Encourage several small meals daily
- B. Provide skin care to maintain skin integrity
- C. Assist the patient with hygiene, as needed
- D. Assess the integrity of the patient's oral mucosa regularly
Correct Answer: B
Rationale: Myelosuppression from chemo or cancer slashes white cells, making infection a top killer sepsis often starts at breached barriers like skin. Maintaining skin integrity via cleansing and protection stops bugs (e.g., Staph) from sneaking in, directly tackling this risk. Small meals fight malnutrition, a secondary factor, not the leading death driver. Hygiene helps, but it's broad, not specific to the prime entry point. Oral mucosa checks catch stomatitis, another risk, but skin's the bigger battlefield in oncology stats. Nurses prioritize this, knowing intact skin's the first defense against fatal infections in these fragile patients.
A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client's oral chemotherapy medications. What action by the nurse is most appropriate?
- A. Crush the medications if the client cannot swallow them.
- B. Give one medication at a time with a full glass of water.
- C. No special precautions are needed for these medications.
- D. Wear personal protective equipment when handling the medications.
Correct Answer: D
Rationale: Oral chemotherapy drugs, like their IV counterparts, are hazardous due to their cytotoxic properties, posing risks to healthcare workers through skin contact or inhalation during handling. The most appropriate action is for the nurse to wear personal protective equipment (PPE), such as gloves, to minimize exposure, aligning with oncology safety standards. Crushing these medications is contraindicated, as it increases the risk of aerosolizing toxic particles, endangering both nurse and client many are labeled do not crush.' Giving one at a time with water isn't necessary unless specified and doesn't address safety. Assuming no precautions are needed ignores the drugs' hazardous nature, risking occupational exposure. Using PPE ensures safe administration, protects the nurse's health, and maintains the medication's integrity, reflecting best practices in cancer care where handling precautions are non-negotiable.
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.
A client with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate?
- A. Have the patient eat large meals when nausea is not present
- B. Offer dry crackers and carbonated fluids during chemotherapy
- C. Administer prescribed antiemetics 1 hour before the treatments
- D. Give the patient two ounces of a citrus fruit beverage during treatments
Correct Answer: C
Rationale: Chemo's gut punch severe vomiting bows to preemptive antiemetics, given 1 hour before, blunting nausea's peak, the most effective move per oncology standards. Big meals overload; crackers help post-, not during; citrus risks acid reflux. Nurses time antiemetics, syncing with chemo's onslaught, a proactive strike to ease this metastatic misery, trumping reactive nibbles or sips.
Which of these pulmonary conditions is most likely to be seen with a CD4 count between 200 and 500 ?
- A. pulmonary TB
- B. CMV
- C. PCP
- D. Kaposi sarcoma
Correct Answer: A
Rationale: CD4 200-500 TB sneaks in, lungs ripe before deeper drops. CMV, PCP crave <200; Kaposi's skin-first; cryptococcus hits brains more. Nurses clock TB's early strike, a chronic lung foe at this immune ledge.