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.
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Which of the following conditions/abnormalities is always present in people who are diagnosed with metabolic syndrome?
- A. Type 2 diabetes mellitus
- B. Disturbed renal function
- C. Hypertension
- D. Insulin resistance
Correct Answer: D
Rationale: Metabolic syndrome's core insulin resistance ties the knot, not always diabetes, kidney flops, or high BP. A chronic root nurses peg this constant.
Fatty liver disease is more common in people with metabolic syndrome or type 2 diabetes. The pathogenesis of fatty liver disease is not yet completely known. Question: What does current research suggest with respect to the pathogenesis?
- A. Steatosis correlates with inflammation
- B. Inflammation correlates with fibrosis
- C. Steatosis correlates with liver damage
- D. Steatosis correlates with insulin resistance
Correct Answer: D
Rationale: Fatty liver's tale steatosis ties to insulin resistance, a metabolic syndrome root, not just inflammation, fibrosis, or vague damage. Nurses see this, a chronic fat-glucose knot.
Which is the most common organism infecting coral cuts?
- A. non-cholera vibrio
- B. mycobacterium marinum
- C. aeromonas species
- D. strep pyogenes
Correct Answer: D
Rationale: Coral cuts strep pyogenes streaks in, not vibrio, mycobacterium, aeromonas, or E. coli's swim. Nurses hit this chronic skin ripper.
With regards to starting drug therapy for arterial hypertension, at which level of diastolic pressure should treatment be considered?
- A. 60 to 69 mmHg
- B. 70 to 79 mmHg
- C. 80 to 89 mmHg
- D. 90 to 95 mmHg
Correct Answer: D
Rationale: Arterial hypertension management follows guidelines like those from the American College of Cardiology, where drug therapy is typically considered when blood pressure exceeds certain thresholds. Diastolic pressure of 90 mmHg or higher is a widely accepted level for initiating treatment in adults, especially if sustained or accompanied by risk factors like diabetes or organ damage, as it indicates stage 1 hypertension needing intervention to prevent cardiovascular complications. Levels below 90 mmHg (60-69, 70-79, 80-89 mmHg) may warrant lifestyle changes but not immediate drug therapy unless systolic pressure or other risks elevate the profile. The 90-95 mmHg range aligns with clinical practice to start antihypertensives, balancing benefit and risk, particularly in primary care settings where family physicians aim to reduce stroke and heart disease incidence effectively.
Epigenetic changes play a role in the development of type 2 diabetes mellitus. Question: Which of the following statements about epigenetics is correct?
- A. Epigenetic modifications lead to mutations in DNA
- B. Mutations in DNA lead to epigenetic modifications
- C. Epigenetic modifications only take place at a young age
- D. None of the statements provided above is correct
Correct Answer: D
Rationale: Epigenetics tweaks gene dials no mutations, not from mutations, not age-locked. Diet, stress flip switches anytime, a chronic type 2 player nurses note this, no false leads fit.