Nokea
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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For care of a patient who has oral cancer, which task would be appropriate to delegate to the LPN/LVN?
- A. Assist the patient to brush and floss
- B. Explain when brushing and flossing are contraindicated
- C. Give antacids and sucralfate suspension as ordered
- D. Recommend saliva substitutes
Correct Answer: C
Rationale: LPN/LVNs excel in medication administration within their scope, making giving antacids and sucralfate ordered for oral cancer's mucosal protection ideal. Brushing and flossing assistance fits nursing assistants, a basic task. Explaining contraindications requires RN-level judgment to assess risks like bleeding or infection. Recommending saliva substitutes needs physician or pharmacist input, beyond LPN/LVN authority. Medication delivery leverages their training, easing symptoms like pain or ulcers, ensuring safe, supervised care in oral cancer's complex management, a practical delegation choice.
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.
What do you tell patients is the most important risk factor for lung cancer when you are teaching about lung cancer prevention?
- A. Cigarette smoking
- B. Exposure to environmental/occupational carcinogens
- C. Exposure to environmental tobacco smoke (ETS)
- D. Pipe or cigar smoking
Correct Answer: A
Rationale: Cigarette smoking towers as lung cancer's top risk 80-90% of cases tie to its carcinogens like tar and nicotine, a dose-dependent killer dwarfing other factors. Environmental/occupational exposures like asbestos amplify risk, especially with smoking, but lack its prevalence. ETS hikes risk by 35%, significant yet secondary. Pipe or cigar smoking carries risk, less than cigarettes due to inhalation patterns. Teaching smoking as paramount drives home its preventable dominance, urging cessation as the gold-standard defense, a nurse's key message to slash lung cancer odds, backed by epidemiology and public health campaigns.
An HIV-positive patient presents to the ED complaining of shortness of breath and non-productive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85% on room air. All of the following statements regarding this patient's probable diagnosis are TRUE, EXCEPT
- A. Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients
- B. Pentamidine isothionate is an effective alternate therapy to TMP-SMX
- C. A normal chest x-ray rules out acute PCP infection
- D. 65% of patients relapse within 18 months
Correct Answer: H
Rationale: PCP top AIDS bug, pentamidine swaps TMP-SMX, relapse hits, steroids for hypoxia; normal CXR misses 20%. Nurses nix this chronic x-ray lie.
According to the McGinnis model of 2002, what percentage of health differences between people is related to their behaviour?
- A. 10%
- B. 20%
- C. 30%
- D. 40%
Correct Answer: D
Rationale: McGinnis pegs behaviour smoking, eating at 40% of health gaps, big over genes or care. Nurses lean on this, a chronic choice chunk.