A 36 year old woman visits her family doctor requesting blood test to check her cholesterol. She has family history of premature coronary heart disease. Physical examinations are unremarkable. Lipid profile is done and shows it the following results: Total cholesterol 5.8 mmol/L, HDL-cholesterol 1.1 mmol/L, LDL-cholesterol 3.6 mmol/L, Triglyceride 2.4 mmol/L. What is the MOST likely diagnosis?
- A. Familial hyperlipidemia
- B. Mixed hyperlipidemia
- C. Hypercholesterolaemia
- D. Familial combined hyperlipidemia
Correct Answer: B
Rationale: Cholesterol 5.8, LDL 3.6, triglycerides 2.4 both up, HDL lowish screams mixed hyperlipidemia, not lone cholesterol or triglyceride spikes. Family heart history hints genetics, but numbers don't pin familial types yet. Nurses flag this chronic dual lipid mess, tied to early coronary risk.
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Which of the following is FALSE about reduced ejection fraction heart failure (HFrEF)?
- A. The goals of therapy are to reduce morbidity (i.e., reducing symptoms, improving health-related quality of life and functional status, decreasing the rate of hospitalisation) and to reduce mortality
- B. Beta blockers, angiotensin converting enzyme (ACE) inhibitor, angiotensin II receptor blocker (ARB), or angiotensin receptor-neprilysin inhibitor (ARNI) and mineralocorticoid receptor antagonist (MRA) are the preferred antihypertensive agents because these agents improve survival
- C. Recommended lifestyle modifications include smoking cessation, restriction of alcohol consumption, salt restriction, weight reduction in obese patients, as well as daily weight monitoring to detect fluid accumulation before it becomes symptomatic
- D. Patients at high risk for re-hospitalisation should be referred to a long-term care facility
Correct Answer: D
Rationale: HFrEF goals, preferred drugs (beta blockers, ACEi, ARBs, ARNI, MRA), and lifestyle changes are true, per ESC/ACC guidelines. However, high re-hospitalization risk doesn't mandate long-term care referral outpatient management or cardiac rehab is preferred unless dependency justifies it. This false claim refines chronic HFrEF management focus.
A nurse reviews the arterial blood gas (ABG) values of a client admitted with end-stage kidney disease; pH 7.26; PaCO2 37 mm Hg; PaO2 94 mm Hg and HCO3 15 mEq/L. What do these values indicate?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: End-stage kidney disease hampers acid excretion pH 7.26 (below 7.35) and HCO3 15 mEq/L (below 22) confirm metabolic acidosis, as kidneys fail to buffer, dropping bicarbonate. PaCO2 37 mm Hg (normal) rules out respiratory issues lungs aren't compensating yet. PaO2 94 mm Hg shows oxygenation's fine. Alkalosis options contradict low pH; respiratory acidosis needs high CO2. Nurses recognize this acid-base shift, anticipating bicarbonate or dialysis, a key intervention in renal failure's metabolic chaos.
The signs and symptoms of heart failure do not include:
- A. Dyspnoea
- B. Orthopnoea
- C. Urinary frequency
- D. Fatigue
Correct Answer: C
Rationale: Heart failure floods breathless, flat-lie gasps, swelling, wiped out. Peeing often? Kidneys, not heart others scream pump fail. Nurses clock these, a chronic wet mess minus bladder.
Insulin is an anabolic hormone. Question: A catabolic state induced by insulin deficiency has an effect on which metabolism?
- A. Protein metabolism
- B. Glucose metabolism
- C. Fat metabolism
- D. A+B+C
Correct Answer: D
Rationale: Insulin gone, catabolism rages proteins break, glucose spikes, fats burn all unravel. No picking one; it's a full-body crash nurses see this in type 1's ketosis, a chronic fuel flip.
Assessment of a wound does not include which of the following?
- A. Location
- B. Size
- C. Blood Pressure
- D. Colour of wound
Correct Answer: C
Rationale: Wound checks where, how big, what hue guide care. BP's body-wide, not wound-specific. Nurses skip it, a chronic sore's focus.
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