Nokea
A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
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Which patient is at greatest risk for pancreatic cancer?
- A. An elderly black male with a history of smoking and alcohol use
- B. A young, white obese female with no known health issues
- C. A young black male with juvenile onset diabetes
- D. An elderly white female with a history of pancreatitis
Correct Answer: A
Rationale: Pancreatic cancer risk escalates with specific factors: age, race, smoking, and alcohol. An elderly Black male with smoking and alcohol history tops the list incidence peaks in older adults, Black populations face higher rates, and both habits are strong carcinogens, damaging pancreatic tissue over time. A young, obese white female has obesity as a risk, but youth and fewer exposures lower her odds. A young Black male with diabetes links to a risk factor, yet juvenile onset and age reduce immediate concern. An elderly white female with pancreatitis has a notable risk chronic inflammation predisposes but lacks the compounded impact of smoking and alcohol. The elderly Black male's profile aligns with epidemiological data, making him the nurse's focus for vigilant monitoring and early detection efforts.
The nurse educates the client that besides an echocardiogram, which of the following tests is the best tool for diagnosing heart failure?
- A. Pulmonary artery catheter
- B. Mitigated angiographic (MUGA) scan
- C. B-type natriuretic peptide (BNP)
- D. Radionuclide studies
Correct Answer: C
Rationale: BNP, a blood test, spikes with heart stretch heart failure's calling card, outshining invasive tools for diagnosis. Pulmonary catheters measure pressures, not routine. MUGA scans ejection fraction, less direct. Radionuclide's vague here. Nurses teach BNP's ease and accuracy, a biomarker gold standard, syncing with echo to nail heart failure's fluid tale.
Repaglinide belongs to the class
- A. Sulphonylureas
- B. Thiazolidinediones
- C. Benzoic acid derivatives
- D. Biguanides
Correct Answer: C
Rationale: Repaglinide's benzoic acid kin short, sharp insulin jolts, not sulphonylureas' long haul, thiazolidinediones' sensitivity boost, or biguanides' glucose clamp. It's a mealtime spike buster, a chronic tool pharmacists slot apart from sulphonylurea's sustained push, a nuanced diabetes dance.
A 63 years old woman who is known to have hypertension for 15 years presented to her family doctor with shortness of breath and ankle swelling. An echocardiogram confirmed compromised left ventricular function. Her blood pressure is 150/90 mmHg. She is currently on frusemide and Aspirin. What is the MOST appropriate medication to add?
- A. Aldosterone antagonists
- B. Calcium channel blockers
- C. Beta blockers
- D. Angiotensin converting enzyme - inhibitors
Correct Answer: D
Rationale: Heart failure with LV dysfunction ACE inhibitors cut mortality, ease load, atop frusemide's fluid flush and aspirin's clot block. Aldosterone blockers add later; calcium blockers don't help heart; beta blockers need stability first; ARBs sub if ACE flops. Nurses push this chronic heart saver, proven to stretch life.
Patients on insulin therapy should receive essential education on the following EXCEPT:
- A. Insulin injection technique
- B. Recognition and self-management of hypoglycaemia
- C. Sick day management
- D. Stopping all oral hypoglycaemic agents
Correct Answer: D
Rationale: Insulin education builds control technique, hypo spotting, sick days, and driving safety are musts, ensuring delivery, crisis handling, and road smarts. Stopping all oral agents isn't universal; many stay on metformin or SGLT-2s for synergy, not a blanket rule. Tailored plans keep or ditch orals, dodging this absolute. Clinicians teach what fits, not a one-size purge, a nuanced chronic care tweak over rigid cuts.