Download NSB 231 Revision Exam Questions With Answers 100% Pass. and more Exams Nursing in PDF only on Docsity!
NSB 231 Revision Exam Questions With
Answers 100% Pass
What do beta cells in the pancreas produce? - ANSWER insulin what is diabetes mellitus? - ANSWER A chronic metabolic disease characterised by elevated levels of blood glucose which can lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves over time what is the normal BGL range? - ANSWER 3.5-7.8 mol/L what is type I DM? - ANSWER Results from b cell destruction due to an autoimmune process leading to absolute insulin deficiency does a person with T1DM have to have genetic susceptibility to acquire the disease?
- ANSWER Yes what happens when B cells are destroyed? - ANSWER insulin is not produced will absolute insulin deficiency cause a patient to require lifelong insulin replacement? - ANSWER Yes when does T1DM become symptomatic? - ANSWER When 90% of beta cells are destroyed where are beta cells stored? - ANSWER In the pancreas List 7 common symptoms of T1DM - ANSWER 1. Polyuria
- Polyphagia
- Polydipsia
- Slow healing wounds
- Weight loss
- Blurred vision
- Fatigue, confusion What is T2DM? - ANSWER Results from progressive secretory insulin defect on the background of insulin resistance. Beta cells become exhausted over time, and insulin production is decreased What happens to the body's cells in T2DM? - ANSWER They become resistant to the action of insulin what happens if T2DM is left untreated? Which condition ensues? - ANSWER Chronic hyperglycaemia Will T2DM lead to DKA? Why/ why not? - ANSWER No, it will not lead to DKA, as there is some insulin for uptake and storage. When DKA occurs in T1DM, it is because there is no insulin for uptake T2DM has similar symptoms to T1DM. What are three additional symptoms of T2DM? - ANSWER - frequent infections
- dry, itching skin
- leg cramps and/ or pain List the non-modifiable risk factors for T2DM (5) - ANSWER - age
- genetics/ family history
- male gender
- limit adverse effects of treatment
- maintain quality of life and psychological wellbeing what does metformin do? - ANSWER It aims to reduce resistance to insulin, to help it work more effectively how does metformin work? - ANSWER It decreases appetite by slowing the release of glucose from the liver, slowing absorption of food What does insulin do? - ANSWER promotes the use of glucose as energy and promotes storage of glucose in the tissues, to lower BGL What is the golden rule for insulin administration? - ANSWER To administer insulin safely and at optimal time, we must know
- Onset of action
- Timing of peak
- Duration should insulin ever be used as a threat, or does it represent failure? - ANSWER No Why must all people with T1DM be treated with insulin? - ANSWER They have absolute insulin deficiency and cannot produce it independently do people with diabetes require a sugar free diet? - ANSWER No Why is healthy eating important for diabetes patients? - ANSWER It reduces their risk of acquiring diabetes related complications What is Medical Nutrition Therapy (MNT)? - ANSWER The therapeutic use of dietary
advice to treat medical conditions what benefit does physical activity have for diabetes patients? - ANSWER It improves insulin sensitivity, lowers risk of heart disease and stroke list the 3 methods of monitoring BGL - ANSWER 1. HbA1c
- Self monitoring blood glucose
- Flash glucose monitoring What does HbA1c measure? - ANSWER Average BGL in the last 2-3 months (%) What is the target HbA1c? - ANSWER <7% What is self-monitoring of blood glucose? - ANSWER Using insulin pump and adjusting dosages accordingly to how the body reacts to food/ drink, physical activity, meds, illness, stress etc. What is flash glucose monitoring? - ANSWER Measures interstitial glucose What is the target range for BGL before and 2 hrs after meals for a type I diabetic? - ANSWER - Before meal= 4-8 mmol/L
- after meal= 4-10 mmol/L What is the target range for BGL before and 2 hrs after meals for a type II diabetic? - ANSWER - before meal= 6-8 mmol/L
- after meal= 6-10mmol/L what is the optimal BGL for fasting GDM? - ANSWER < 5 mmol/L
List the 3 main types of diabetes related complications - ANSWER 1. Microvascular disease
- Macrovascular disease
- Diabetic foot ulcers What are 3 examples of microvascular disease? - ANSWER neuropathy, retinopathy, nephropathy What are 3 examples of macrovascular disease? - ANSWER Coronary heart disease, cerebrovascular disease, peripheral vascular disease What increases risk of lower limb ulcers for diabetics? - ANSWER Neuropathy, peripheral vascular disease and foot deformity List 7 complications of diabetes? - ANSWER 1. Microvascular disease
- Macrovascular disease
- Diabetic foot ulcers
- Erectile dysfunction
- Periodontal disease
- Non-alcholic fatty liver disease
- Diabetes related deafness what is respiration? - ANSWER the mechanism of breathing What happens in inspiration? - ANSWER Alveoli fill with air, oxygen is exchanged for CO2. Diaphragm contracts and lowers
What happens in expiration? - ANSWER CO2 is expelled from the lungs. Diaphragm relaxes and rises List 4 risk factors for chronic respiratory diseases - ANSWER 1. Tobacco smoke
- Indoor and outdoor pollutants
- Allergens
- Occupational agents What elements do you consider in the focussed respiratory assessment? (6) - ANSWER - cough
- sputum and nasal secretions
- dyspnoea
- pain
- sleep and rest
- environment What does Arterial Blood Gas (ABG) measure? - ANSWER How much oxygen is dissolved in arterial blood-- ideally around 100 What is a common example of a pulmonary function test? - ANSWER Spirometry What is pulsus paradoxus? - ANSWER When the drop in BP in inspiration is significant and >10mmHg. Normally it only drops slightly, and rises in expiration List two things that identify the presence of asthma? - ANSWER 1. Excessive variation in lung function-- limited expiratory airflow
- Respiratory symptoms
- smoking cessation and other lifestyle factors What does reliever medication do? - ANSWER Acts on beta-2 receptors in the smooth muscle to relax and open airway muscle. They decrease tightness and reduce wheeze what is the name of the long-acting reliever medication? - ANSWER Atrovent (ipratropium bromide) What is the duration for atrovent? - ANSWER 6 hours what does atrovent administration carry a risk of? - ANSWER Glaucoma when is atrovent indicated? - ANSWER In acute exacerbations of asthma with salbutamol administration What do preventers do? - ANSWER Reduce inflammation and mucous production what kind of medications can preventers be? - ANSWER Non-steroids, corticosteroids and combination therapy What is combination medication? - ANSWER Long-acting reliever and preventer in one device List 3 priority problems for asthmatic patient - ANSWER 1. Partial airway obstruction
- Impaired gas exchange
- Lack of education What are the evaluation criteria for asthma? - ANSWER - SpO
- accessory muscle use
- wheezing
- RR
- patient states can breathe easier what is COPD? - ANSWER An umbrella term used to describe three conditions
- Chronic bronchitis
- Emphysema
- Asthma How does the body adapt to changes occurring in the lungs? - ANSWER - pursed lip breathing
- increased accessory muscle use
- postural changes Outline the COPD-X guidelines* - ANSWER C- Confirm diagnosis and assess the severity O- Optimise function P- Prevent deterioration D- Develop support network and self-management X- Manage exacerbations What is pulmonary rehabilitation? - ANSWER A proven self-management program to improve quality of life for patients with respiratory conditions What is cor pulmonale?* - ANSWER heart failure that occurs when pulmonary vascular resistance increases over time
myocardium List the 3 main categories of angina - ANSWER 1. Chronic stable angina
- Prinzmetal's angina
- Unstable angina What is chronic stable angina? - ANSWER chest pain that is predictable and is precipitated by exercise/ activity. It only lasts 5-15 mins and is relieved by rest and/ or medication What is prinzmetal's angina? - ANSWER Angina caused by spasming of the coronary arteries. It often comes in clusters and is not precipitated by increased demand. Will prinzmetal's angina have marked ST elevation on the ECG? - ANSWER no What is unstable angina? - ANSWER chest pain that is unpredictable, new in onset and more severe or prolonged than usual. It indicates an active intracoronary process (blockage) and is a precursor to MI What is ischaemic cardiac chest pain like? - ANSWER Heavy, dull and retrosternal in nature. May be accompanied by nausea, diaphoresis and dyspnoea what do ST segment changes indicate? - ANSWER Ischaemia or infarction what is troponin? - ANSWER A biochemical marker released in cardiac cell death. Level indicates whether or not infarction has occurred List the 3 subtypes in ACS - ANSWER 1. Unstable angina
- NSTEMI
3. STEMI
What is anginine? - ANSWER GTN What happens in AMI? - ANSWER Coronary blood flow is interrupted for an extended period of time, causing myocyte necrosis. Necrosis results in infarction How long does it take for full thickness necrosis to occur in AMI? - ANSWER 4- hours Diagnosis of AMI - ANSWER Troponin levels, ECG, history What are two examples of conditions in which there may be elevated troponin without myocardial necrosis? - ANSWER sepsis and renal failure what is a PPCI? - ANSWER A primary percutaneous coronary intervention. It is the preferred reperfusion strategy for STEMIs What is heart failure? - ANSWER Failure of the heart to pump sufficiently to meet the body's metabolic needs, or impaired ability of the heart to fill at normal pressure or eject blood sufficiently to fulfil the needs of the metabolising organs How is HF categorised? - ANSWER By the associated degree of reduction in the left ventricular ejection fraction (LVEF) What is normal ejection fraction? - ANSWER 55-70% At what ejection fraction does heart failure occur? - ANSWER <50%
Briefly explain the pathophys of HTN - ANSWER increase in CO or SVR. Contraction of smooth muscle increases calcium, which can cause changes to the artery walls if prolonged which two meds are used for HTN? - ANSWER ACEI & CCBs What is the non-pharmacological management for HTN? - ANSWER - manage associated conditions
- lifestyle modification
- monitor BP What happens in a stroke? - ANSWER There is ischaemia or haemorrhage in the brain that causes a sudden decrease in oxygen supply to brain tissue and results in the death of brain cells What is a Transient Ischaemic Attack (TIA)? - ANSWER Mini-stroke, occurs when blood supply to the brain is interrupted for a short period of time only. Symptoms typically last less than one hour and mimic those of a stroke what fraction of TIAs progress to a stroke? - ANSWER 1/ What kind of drugs are given to people who have had a TIA related to atherosclerosis, to prevent stroke? - ANSWER Antiplatelets (aspirin) List the two types of stroke - ANSWER 1. Ischaemic
- Haemorrhagic What is the signature symptom for haemorrhagic stroke? - ANSWER thunderclap headache
What is aphasia? - ANSWER inability to understand and generate speech Dysphasia - ANSWER Difficulty to generate speech Dysarthria - ANSWER Difficulty to articulate speech, due to disturbed muscle control goal of treatment for hyperacute stroke - ANSWER brain preservation What is the most important thing to manage in hemorrhagic stroke and why? - ANSWER BP. If BP increases, the bleed will also increase What is the FeSS protocol, and when is it attended? - ANSWER Fe-Fever (monitor for fever) S- Sugar (BGL should be <10mmol/L) S- Swallow (dysphagia test within 4 hours) It is attended in the hyper acute stroke period (72 hours) what drugs are contraindicated in haemorrhagic stroke treatment? - ANSWER anticoagulants and antiplatelets What does the peripheral vascular disease process involve? - ANSWER It involves narrowing and degeneration of the arteries in the upper and lower extremities List the 4 risk factors for PVD - ANSWER 1. Cigarette smoking
- Hyperlipidaemia
- Hypertension
- DM
do kids have a higher or lower BMR than adults? - ANSWER Higher list 7 signs of increasing respiratory distress present in kids - ANSWER 1. Head bobbing
- Nasal flaring
- Recessions
- See-saw chest movement
- Tripod positioning
- Tachypnoea and tachycardia
- Cyanosis and cool peripheries what does head bobbing indicate? - ANSWER Use of the SCM muscle to assist in breathing what is asthma? - ANSWER Airflow obstruction and airway narrowing occurring as a result of the contraction of the airway smooth muscle and swelling of the airway wall Can the inflammatory process in asthma cause permanent changes in the airway? - ANSWER Yes-- it can cause airway remodelling List as many asthma triggers as you can - ANSWER - viral infections
- sinusitis, rhinitis
- allergens
- animal fur
- exercise
- GORD
- cold weather
- work-related triggers
- air irritants
- certain medicines Is wheeze diagnostic of asthma? - ANSWER No. It is suggestive of asthma, but a history of recurrent wheeze without any other apparent cause is diagnostic What is involved in education to improve asthma control? - ANSWER - allergen avoidance/ control
- written asthma action plan
- smoking cessation
- diet and exercise what happens if kids are on corticosteroids for longer than 3 years? - ANSWER Their linear growth and projected adult height may be reduced What is cystic fibrosis? - ANSWER A genetic, autosomal recessive chronic suppurative lung disease How may CF present in children? - ANSWER May be asymptomatic or present as dehydration with viscous sputum What is bronchiectasis? - ANSWER Permanently enlarged air sacs what is haemoptysis? - ANSWER Coughing up of blood List 4 types of management of CF - ANSWER 1. Chest physiotherapy and exercise
- Antibiotics (IV or oral)
