A 72 years old man is diagnosed to have Type 2 DM, hypertension and hyperlipidemia with stage 3 chronic kidney disease. He is otherwise well and asymptomatic. He is referred to you for follow-up care. His blood pressure is 142/70 mmHg with HbA1c 6.5%. You would continue his following medications EXCEPT
- A. Hydrochlorothiazide 12.5 mg OD
- B. Simvastatin 40 mg ON
- C. Aspirin 100 mg OD
- D. Glibenclamide 10 mg bid
Correct Answer: D
Rationale: Stage 3 CKD eGFR 30-59 means glibenclamide's out; it piles up, risking hypoglycemia in shaky kidneys. Thiazide holds BP, simvastatin guards lipids, aspirin shields heart, irbesartan protects kidneys all stay. Nurses swap sulphonylureas here, dodging chronic sugar crashes in fragile renal states.
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A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to support the patient's self-esteem?
- A. Encourage the patient to purchase a wig or hat to wear when hair loss begins.
- B. Suggest that the patient limit social contacts until regrowth of the hair occurs.
- C. Teach the patient to wash hair gently with mild shampoo to minimize hair loss.
- D. Inform the patient that hair usually grows back once chemotherapy is complete.
Correct Answer: A
Rationale: Alopecia from chemo (e.g., cyclophosphamide) guts self-esteem prepping with wigs or hats hands control back, softening the blow. Limiting contact isolates; gentle washing won't stop it follicles are toast. Regrowth is true but delayed. Nurses in oncology push this proactive step it's practical, empowering, and tackles the psychosocial hit head-on.
What is the most influential source of self-efficacy?
- A. Mastery
- B. Affective states
- C. Verbal persuasion
- D. Vicarious experience
Correct Answer: A
Rationale: Self-efficacy's backbone is mastery past wins breed belief, a nurse's gold for chronic self-care push. Watching others, pep talks, or mood sway less; doing it trumps all, a confidence anchor in illness battles.
Cardiac catheterisation (angiography) is performed to assess blood flow through the coronary arteries through use of a contrast agent and radiographic imaging. The nursing responsibilities in caring for the patient post angiography do not include:
- A. Applying pressure and observing the insertion site for bleeding or haematoma formation
- B. Informing the patient of the findings of the angiogram to allay fear and provide reassurance
- C. Monitor for arrhythmias by both cardiac monitoring and assessing apical or peripheral pulses
- D. Encourage fluids to increase urinary output and flush out the dye
Correct Answer: B
Rationale: Post-angio, nurses press sites, watch rhythms, flush dye hands-on musts. Telling results? Docs' turf nurses soothe, don't spill, a chronic care line.
A nurse is caring for a client diagnosed with atherosclerosis. Which of the following is considered a risk factor for the development of this disorder?
- A. Diet high in vitamin K
- B. Low HDL-C/High LDL-C
- C. High HDL-C/Low LDL-C
- D. Vegan diet
Correct Answer: B
Rationale: Atherosclerosis loves lipids low HDL (good cholesterol) and high LDL (bad cholesterol) pile plaque, a prime risk factor driving vessel narrowing. Vitamin K aids clotting, not plaque. High HDL/low LDL protects. Vegan diets cut fats, lowering risk. Nurses flag lipid imbalance, pushing statins or diet shifts, a cholesterol-fueled root of this vascular scourge.
The Pulmonary rehabilitation program consists of several specific components. Which of the following are not a part of the program?
- A. Education and self-management
- B. Exercise training
- C. Coping measures to relieve anxiety, depression and changes in behaviour
- D. Spirometry
Correct Answer: D
Rationale: Pulmonary rehab builds COPD strength education, exercise, coping tools for mind and mood, all in. Spirometry's a test, not therapy diagnoses, doesn't train. Nurses skip it here, a chronic fix's focus.