Chronic Illness Questions

Chronic Illness Questions Related

Review Chronic Illness Questions related questions and content

A 3-year-old girl with a Wilms tumor is returning to the unit after a simple nephrectomy. Which of the following actions have the highest priority in caring for this child?

  • A. Maintaining NPO.
  • B. Monitoring the BP every 2 hours.
  • C. Turning her every 2 hours.
  • D. Administering pain medication every 4 hours.
Correct Answer: B

Rationale: After a nephrectomy for Wilms tumor, monitoring blood pressure (BP) every 2 hours is the highest priority because kidney removal disrupts renin-angiotensin regulation, risking hypo- or hypertension, especially in a young child with one remaining kidney. Using the ABCs (airway, breathing, circulation), BP falls under circulation, a critical postoperative focus to detect shock or fluid imbalance early. Maintaining NPO is temporary post-anesthesia but shifts to hydration once awake, less urgent than BP. Turning every 2 hours prevents pressure ulcers, but a mobile 3-year-old post-simple nephrectomy likely moves independently unless sedated, lowering its priority. Pain medication is key but ranks lower (e.g., G' in extended ABCs) than circulation. Frequent BP checks ensure stability, aligning with nursing's role in pediatric surgical care to prevent complications in a child adapting to single-kidney function.

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The Barker hypothesis describes the relationship between birth weight and the development of diseases. Question: Which relationship is correct?

  • A. High birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
  • B. High birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
  • C. Low birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
  • D. Low birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
Correct Answer: D

Rationale: Barker's call low birth weight scars metabolism, upping later obesity, diabetes, heart woes. High weight leans risky too, but low's the proven chronic link nurses track this fetal echo.

Which of the following test(s) is/are routinely used in the assessment of heart failure?

  • A. Holter monitoring
  • B. ECG and echocardiography
  • C. Ambulatory blood pressure monitoring
  • D. Echocardiography
Correct Answer: B

Rationale: ECG and echocardiography are routine in heart failure assessment ECG detects ischemia/arrhythmias, echocardiography confirms ejection fraction and structure, per ESC guidelines. Holter monitoring targets arrhythmias, not routine. Ambulatory BP aids hypertension, not HF directly. Trans-oesophageal echo is specialized. This pair ensures comprehensive chronic HF evaluation.

Research into people's eating behaviour has produced several findings. Question: Which finding is NOT correct?

  • A. When eating in a group, you eat more than when eating alone
  • B. Portion size does not influence how much a person eats
  • C. Low prices of high-calorie food contribute to overeating
  • D. If you eat with people who eat a lot, you will eat more yourself as well
Correct Answer: B

Rationale: Eating truths groups, big portions, cheap junk, piggybacking all pile on, but portion size sways intake, not static. Nurses debunk this, a chronic portion myth.

Which ONE of the following is consistent with scarlet fever:

  • A. Punctate rash on neck and trunk
  • B. Circumoral erythema
  • C. Geographic tongue
  • D. Only occurs in association with streptococcal pharyngitis
Correct Answer: B

Rationale: Scarlet fever circumoral pallor, not erythema, rash, tongue, strep, peeling fit. Nurses spot this chronic strep face.

Mr Yee, a 45-year-old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over the left elbow. He says that two years ago he took allopurinol 100 mg for one month, then 200 mg OM for one month but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago, and he says he probably took it 'once or twice a week'. He states he did not experience any rashes or other side effects to it then. He does not drink alcohol except one glass of wine once or twice a year on special occasions. He has past history of renal stones and also underlying ischaemic cardiomyopathy for which he is still being followed up by the cardiologist. Two weeks ago, he was admitted to the hospital for a gout flare. He had a blood test done, with the following results: Uric acid 620 mmol/L, Creatinine 120 umol/L, eGFR 55 mL/min, BP 144/94 mmHg, he has Hypertension on HCTZ long-term. He is asking you to give him Arcoxia 120 mg OM standby as it usually works for his gout flare. Which is correct advice?

  • A. Discuss HLA B5801 testing particularly as febuxostat is being prescribed for him
  • B. Advise that he will need stepwise up-titration of allopurinol to reach the uric acid target. Regular blood tests will allow this to be done safely
  • C. Advise that colchicine prophylaxis is helpful to prevent gout attacks and increase hydrochlorothiazide to optimise his BP control
  • D. Offer to initiate probenecid immediately as allopurinol is ineffective
Correct Answer: B

Rationale: Tophus and frequent flares with uric acid 620 mmol/L indicate chronic gout needing ULT. Prior allopurinol failure' likely stems from non-adherence (once/twice weekly), not ineffectiveness. Stepwise up-titration of allopurinol, starting low (e.g., 100 mg) due to eGFR 55, with regular blood tests (uric acid, creatinine), targets <360 mmol/L safely, per ACR guidelines. HLA-B5801 testing is for high-risk groups (e.g., Han Chinese) before allopurinol, not febuxostat-specific here. Colchicine helps, but increasing HCTZ (urate-retaining) may worsen gout. Probenecid suits renal underexcretors, not proven here. This approach optimizes chronic gout control.

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