Nokea
A study by the Dutch Institute for Public Health and Environment (RIVM) called 'Nederland de maat genomen' [Measuring the Dutch], conducted in 2009-2010, shows that more than half of all Dutch people are overweight (BMI >25). Question: What are the results of this study when looking separately at men and women?
- A. 55% of the men and 55% of the women are overweight
- B. 60% of the men and 45% of the women are overweight
- C. 65% of the men and 50% of the women are overweight
- D. 70% of the men and 55% of the women are overweight
Correct Answer: B
Rationale: Over half the Dutch being overweight suggests a split men typically tip higher than women in Western stats. Sixty percent men, 45% women fits: men's bigger frames and habits stack BMI over 25 more, while women hover lower, averaging out above 50%. Even splits or higher jumps overshoot trends nurses see this gender gap in obesity clinics, a chronic load reflecting lifestyle and biology.
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With regards to adverse effects of first-line antihypertensive medications, angioedema has been associated with which ONE of the following classes of antihypertensives?
- A. Angiotensin receptor blockers
- B. Angiotensin-converting enzyme inhibitors
- C. Calcium channel blockers (dihydropyridine)
- D. Thiazide diuretics
Correct Answer: B
Rationale: Angioedema, a potentially life-threatening swelling of deep skin layers or mucous membranes, is a well-documented adverse effect of angiotensin-converting enzyme (ACE) inhibitors, occurring in about 0.1-0.7% of patients due to bradykinin accumulation from enzyme inhibition. This distinguishes ACE inhibitors from other first-line antihypertensives. Angiotensin receptor blockers (ARBs) rarely cause angioedema, as they don't affect bradykinin levels. Calcium channel blockers (e.g., dihydropyridines like amlodipine) may cause peripheral edema but not angioedema. Thiazide diuretics are linked to electrolyte imbalances or rashes, not angioedema. Family physicians must recognize this ACE inhibitor risk, ensuring prompt discontinuation and airway management if it occurs, critical for safe chronic disease management.
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.
The antidiabetic also effective in lowering the cholesterol level is
- A. Rosiglitazone
- B. Metformin
- C. Chlorpropamide
- D. Repaglinide
Correct Answer: B
Rationale: Metformin's the cholesterol-trimming antidiabetic cuts glucose and lipids, a dual chronic win. Rosiglitazone ups insulin sensitivity, risks heart fat; chlorpropamide pumps insulin, no lipid perk; repaglinide's quick insulin hit misses cholesterol. Nurses flag metformin's bonus, a type 2 staple with vascular edge.
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.
The hospice nurse has just admitted a new patient to the program. What principle guides hospice care?
- A. Care addresses the needs of the patient as well as the needs of the family
- B. Care is focused on the patient centrally and the family peripherally
- C. The focus of all aspects of care is solely on the patient
- D. The care team prioritizes the patient's physical needs and the family is responsible for the patient's emotional needs
Correct Answer: A
Rationale: Hospice wraps the patient and family in care physical, emotional, spiritual for both, not just one. It's not patient-only or peripheral family focus; it's a unit. Splitting physical and emotional duties misses the holistic vibe. Nurses in oncology's endgame lean on this, ensuring comfort and support ripple out, easing the load for all as death nears.