Nokea
About special considerations in the management of hypertension in older patients, which of the following is the correct answer?
- A. Systolic hypertension - DBP should be <70 mmHg
- B. Dementia - Target SBP should not be <150/90 mmHg
- C. Care home residents - SBP <130 mmHg
- D. Frailty - Target BP not <140/90 mmHg
Correct Answer: D
Rationale: Frail elders BP >140/90 guards perfusion; systolic, dementia, care home tweaks misfire. Nurses ease this chronic frail line.
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Which is NOT the main pharmacological activity of Chinese goldenseal (Coptis chinensis) used as a therapy for diabetes?
- A. Alpha-glucosidase inhibition
- B. Anti-inflammation
- C. Anti-atherosclerosis
- D. Protective effects on vascular endothelial function
Correct Answer: B
Rationale: Chinese goldenseal's diabetes gig alpha-glucosidase block slows sugar, anti-atherosclerosis and endothelial protection guard vessels, all core. Anti-inflammation's a sidekick, not the lead less about sugar control, more general. Clinicians lean on the trio, a chronic herbal angle.
A nurse is caring for a client who presented to the emergency department with complaints of fatigue, palpitations, and chest pains. Upon assessment, the provider notes an S3 and S4 gallop, weak peripheral pulses, and tachycardia. The provider orders a chest x-ray and echocardiogram, which reveals left ventricular dilation. Which of the following disorder is consistent with these findings?
- A. Cardiac tamponade
- B. Dilated cardiomyopathy
- C. Pericarditis
- D. Restrictive cardiomyopathy
Correct Answer: B
Rationale: Left ventricular dilation with S3, S4, weak pulses, and tachycardia paints dilated cardiomyopathy heart muscle stretches, weakening pump, causing fatigue and palpitations. Tamponade compresses, not dilates. Pericarditis inflames without dilation. Restrictive stiffens, resisting stretch. Nurses tie this to DCM's systolic flop, anticipating meds like ACE inhibitors, a fit for this stretched-out heart.
Atherosclerosis is a chronic inflammatory response of the vascular walls to endothelial injury. During the progression of these lesions, interaction occurs between various factors. Question: Which cells do NOT play a role in this process?
- A. Epithelial cells
- B. Lipoproteins
- C. Macrophages
- D. T-lymphocytes
Correct Answer: A
Rationale: Atherosclerosis macrophages, T-cells, lipoproteins clog, not epithelial outsiders. Nurses track this, a chronic vessel crew.
In monitoring patients who are at risk for spinal cord compression related to tumor growth, what is the most likely early manifestation?
- A. Sudden-onset back pain
- B. Motor loss
- C. Constipation
- D. Urinary hesitancy
Correct Answer: A
Rationale: Spinal cord compression from tumors often starts with sudden back pain 95% of cases due to vertebral pressure or nerve irritation, an early red flag demanding urgent imaging and intervention to prevent paralysis. Motor loss, like weakness, emerges later as nerves compress further. Constipation and urinary hesitancy signal advanced autonomic involvement, not initial signs. Pain's prevalence and timing make it the nurse's focus catching it early triggers steroids or surgery, halting progression in cancer patients where spinal integrity dictates function and survival, a critical monitoring priority.
Which of the following assessment findings are consistent with aortic stenosis?
- A. Systolic click
- B. Pitting edema
- C. Harsh systolic crescendo decrescendo murmur
- D. Atrial fibrillation
Correct Answer: C
Rationale: Aortic stenosis narrows the valve, obstructing outflow producing a harsh systolic crescendo-decrescendo murmur, loudest at the aortic area, a classic sign from turbulent flow. Systolic clicks tie to mitral prolapse, not stenosis. Pitting edema reflects heart failure, a late complication, not direct. Atrial fibrillation may coexist but isn't specific. Nurses expect this murmur, auscultating for its distinct pattern, key to spotting stenosis early, guiding diagnostics like echocardiography to prevent progression to failure.